title: High vitamin E content, impact resistant UHMWPE blend without loss of wear resistance.
abstract: Antioxidant stabilization of radiation cross-linked ultrahigh molecular weight polyethylene (UHMWPE) has been introduced to improve the oxidative stability of total joint implant bearing surfaces. Blending of antioxidants (most commonly vitamin E) with UHMWPE resin powder followed by consolidation and uniform radiation cross-linking is currently available for use in both total hips and total knees. It was previously shown that the fatigue resistance of vitamin E-blended and irradiated UHMWPEs could be further improved by spatially manipulating the vitamin E concentration throughout the implant and limiting cross-linking to the surface of the implant where it is necessary for wear resistance. This was possible by designing a low concentration of vitamin E on the surface and higher concentration in the bulk of the implant because cross-linking is hindered in UHMWPE as a function of increasing vitamin E concentration. In this study, we hypothesized that such a surface cross-linked UHMWPE with low wear rate and high fatigue strength could be obtained by limiting the penetration of radiation into UHMWPE with uniform vitamin E concentration. Our hypothesis tested positive; we were able to obtain control of the surface cross-linked region by manipulating the energy of the irradiation, resulting in extremely low wear, and high impact strength. In addition, we discussed alternatives of improving the oxidation resistance of such a material by using additional vitamin E reservoirs. These results are significant because this material may allow increased use of antioxidant-stabilized, cross-linked UHMWPEs in high stress applications and in more active patients.
authors.affiliation: Harris Orthopaedic Laboratory, Massachusetts General Hospital, Boston, Massachusetts; Department of Orthopaedic Surgery, Harvard Medical School, Boston, Massachusetts.
authors.forename: Ebru
authors.initials: E
authors.lastname: Oral
authors.forename: Andrew
authors.initials: A
authors.lastname: Neils
authors.forename: Orhun K
authors.initials: OK
authors.lastname: Muratoglu
mesh_terms: D020007:Implants, Experimental; D008422:Materials Testing; D010084:Oxidation-Reduction; D011095:Polyethylenes / Q000737:chemistry*; D014810:Vitamin E / Q000737:chemistry*
chemical_list: D011095:Polyethylenes; C111601:ultra-high molecular weight polyethylene; D014810:Vitamin E
keywords: antioxidant; hip; knee; synergy; total joint replacement