title: Peroxide cross-linked UHMWPE blended with vitamin E.
abstract: Radiation crosslinked ultrahigh molecular weight polyethylene (UHMWPE) is the bearing surface material most commonly used in total joint arthroplasty because of its excellent wear resistance. Crosslinking agents such as peroxides can also effectively increase wear resistance but peroxide crosslinked UHMWPE has low oxidative stability. We hypothesized that the addition of an antioxidant to peroxide crosslinked UHMWPE could improve its oxidation resistance and result in mechanical, tribological, and oxidative properties equivalent to currently utilized radiation crosslinked UHMWPEs. Various vitamin E (0.1-1.0 wt % and peroxide concentration (0.5-1.5 wt %) combinations were studied to investigate changes in crosslink density, wear rate, mechanical properties, and oxidative stability in comparison to radiation crosslinked UHMWPE. Peroxide crosslinking was more efficient as compared to radiation crosslinking in the presence of vitamin E with the former resulting in lower wear rate with vitamin E concentrations above 0.3 wt %. The tensile mechanical properties were comparable to and the impact strength was higher than those of the clinically relevant radiation crosslinked controls. We also determined that gamma sterilization of peroxide crosslinked vitamin E blends improved wear resistance further. In summary, peroxide crosslinking of vitamin E-blended UHMWPE may provide a feasible and economical alternative to radiation for achieving clinically relevant properties for total joint implants using UHMWPE. © 2016 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 105B: 1379-1389, 2017.
authors.affiliation: Harris Orthopedic Laboratory, Massachusetts General Hospital, Boston, Massachusetts.|Harvard Medical School, Boston, Massachusetts.
authors.forename: Ebru
authors.initials: E
authors.lastname: Oral
authors.affiliation: Harris Orthopedic Laboratory, Massachusetts General Hospital, Boston, Massachusetts.
authors.forename: Brinda N
authors.initials: BN
authors.lastname: Doshi
authors.affiliation: Harris Orthopedic Laboratory, Massachusetts General Hospital, Boston, Massachusetts.|Department of Mechanical Engineering, University of Engineering and Technology, Peshawar, Pakistan.
authors.forename: Rizwan M
authors.initials: RM
authors.lastname: Gul
authors.affiliation: Harris Orthopedic Laboratory, Massachusetts General Hospital, Boston, Massachusetts.
authors.forename: Andrew L
authors.initials: AL
authors.lastname: Neils
authors.affiliation: Harris Orthopedic Laboratory, Massachusetts General Hospital, Boston, Massachusetts.
authors.forename: Sanem
authors.initials: S
authors.lastname: Kayandan
authors.affiliation: Harris Orthopedic Laboratory, Massachusetts General Hospital, Boston, Massachusetts.|Harvard Medical School, Boston, Massachusetts.
authors.forename: Orhun K
authors.initials: OK
authors.lastname: Muratoglu
mesh_terms: D000975:Antioxidants / Q000737:chemistry*; D003432:Cross-Linking Reagents / Q000737:chemistry*; D006622:Hip Prosthesis; D006801:Humans; D010545:Peroxides / Q000737:chemistry*; D011095:Polyethylenes / Q000737:chemistry*; D014810:Vitamin E / Q000737:chemistry*
chemical_list: D000975:Antioxidants; D003432:Cross-Linking Reagents; D010545:Peroxides; D011095:Polyethylenes; C111601:ultra-high molecular weight polyethylene; D014810:Vitamin E
keywords: arthroplasty; oxidation; polyethylene (UHMWPE); total joint replacement