Chemical and mechanical degradation of UHMWPE: Report of the development of anin vitro test

Finite element analysis of polyethylene wear in total hip replacement: A literature review

Evaluation and prediction of wear play a key role in product design and material selection of total hip replacements, because wear debris is one of the main causes of loosening and failure. Multifactorial clinical or laboratory studies are high cost and require unfeasible timeframes for implant development. Simulation using finite element methods is an efficient and inexpensive alternative to predict wear and pre-screen various parameters. This article presents a comprehensive literature review of the state-of-the-art finite element modelling techniques that have been applied to evaluate wear in polyethylene hip replacement components. A number of knowledge gaps are identified including the need to develop appropriate wear coefficients and the analysis of daily living activities.

The Effect of Different Sterilization Methods on Polypropylene Syringes

This presents the influence of gamma irradiation on Pharmacopeia specifications, mechanical and flow parameters of polypropylene (PP) syringes. There has been significant progress in the terminal sterilization of single-use, disposable medical devices with gamma radiation sterilization due to the growing awareness of toxic residues during the ethylene oxide (EtO) sterilization. PP is a widely used polymer for the production of syringes because of its excellent mechanical and thermal properties and has expanded continuously over the last decade. Although 25 kGy was generally recommended for the gamma radiation sterilization of medical products, this radiation dose is high enough to produce substantial damage. Electron spin resonance (ESR) characteristics of irradiated syringes were also studied at normal (25 °C, 60% relative humidity) and accelerated (40 °C, 75% relative humidity) stability test conditions. It was found that the chemical and radiolytic changes and sterility assurance levels (SAL) after gamma radiation sterilization were different in PP syringes. It was shown that for two commercial syringes, E1 and E3, a SAL of 10−4 could be attained with only 10 kGy, with there being less detrimental radiation effects on E1. The differences in the radiosensitivity of the propylene syringes could be due to the different formulations and manufacturing processes. The results indicated that a commercial syringe, identified as E1 could be safely sterilized with gamma irradiation as the radicals decay over a period of days under normal conditions and quenched much faster under stability conditions. Furthermore, ESR technique could be used successfully in monitoring the radiosterilization of this material. Additionally, the confirmation and validation of the SAL doses which are below 25 kGy, will decrease the time and cost of the sterilization with less damaging effects of ionizing irradiation.

Can accelerated aqueous aging simulatein vivo oxidation of gamma-sterilized UHMWPE?

Oxidation of ultrahigh molecular weight polyethylene (UHMWPE) gamma-sterilized arthroplasty components occurs in vivo. Though accelerated in vitro protocols have been developed to test the relative oxidation resistance of various types of UHMWPE, it is desirable to develop an accelerated aging protocol that more closely approximates the in vivo environment. The goal of this study was to investigate the effects of temperature, solute, and oxygen partial pressure in aqueous media on the oxidation of gamma-sterilized UHMWPE, as the basis for the development of improved accelerated aging protocols. The accelerated oxidation behavior of gamma-sterilized GUR 1150 was studied at 60 and 70 degrees C in an open vessel filled with distilled water or PBS in equilibrium with a controlled partial pressure of oxygen. The extent of oxidation was assessed using standardized mechanical and chemical evaluation techniques (small punch and Fourier transform infrared spectroscopy). Accelerated oxidation of UHMWPE was achieved in aqueous environments; however, both clinically relevant and nonrelevant oxidation species (e.g., aldehydes) were observed for long aging times at 60 degrees C, and for all aging times at 70 degrees C. These findings point the way to the development of an accelerated aging protocol. The current data, considered in conjunction with real-time aging studies, suggest that a temperature between body temperature and 60 degrees C may accelerate oxidative degradation without altering the oxidative patterns encountered in vivo.

Assessment of wear in extensively irradiated UHMWPE cups in simulator studies

Higher levels of UHMWPE crosslinking currently are being advocated for improved wear resistance of acetabular cups. Pioneering Japanese studies, begun in 1971, have achieved good clinical results with UHMWPE irradiated to 1000 kGy for use with a cemented-cup design. The objective of our study was to use contemporary simulator techniques to determine the in vitro wear performance of such high-dose irradiated cups. Extruded UHMWPE cups were processed with 500, 1000, and 1500 kGy of gamma-radiation doses under vacuum, annealed, and machined to shape. The cups were mated with 26-mm alumina heads and run in a multidirectional simulator with bovine serum. Over a 6-million cycle (Mc) study, the weight loss of the nonirradiated control cups averaged 52.8 mg/Mc + 1.4% (wear = 57.2 mm(3)/Mc). In contrast, the irradiated wear cups had a consistent weight gain. Thus cups with irradiation of 500-1500 kGy had no detectable wear in this study. The original machining marks still were partially evident in the wear zones, along with some macrofissures in the 1000- and 1500-kGy cups. Areas adjacent to the fissures showed delaminating plaques of 100-300 microm in size. It also was noted that the wear cups systematically gained more weight than their corresponding soak controls. Each 200-kGy radiation gain increased the fluid sorption ratio by 10%. The increased fluid sorption and evidence of some surface deterioration may indicate that such high-dose irradiated cups are more susceptible to mechanical damage. This indicates that we should take care to ensure that our desire to reduce the wear debris to a zero amount does not result in a modified UHMWPE that lacks the necessary mechanical properties for contemporary metal-backed cup designs.

The effect of polyethylene particle chemistry on human monocyte-macrophage function in vitro

Osteolysis remains the most important problem in orthopedic implant failure. Wear debris from the implant contains polyethylene (PE) particulate which has been shown to activate monocyte-derived macrophages (MDM). Although the response of MDM has been shown to be influenced by the size, shape, and chemical type of PE, the effect of chemically altered PE on MDM has not been studied. In this study, human MDM were seeded onto glass coverslips coated with virgin high density (HD)PE and chemically modified HDPE (impregnated with ppm levels of CoCl(2) and oxidized by heat) mixed with type I collagen and cultured for 96 h. Light microscopic evaluation demonstrated consistent phagocytosis of the HDPE particulate that was confirmed by scanning electron and transmission electron microscopy with little evidence of cytotoxicity. Evaluation of pro-inflammatory mediator secretion by MDMs in response to the virgin and chemically modified HDPE revealed significant differences in interleukin (IL)-1, tumor necrosis factor (TNF)-alpha, and IL-6 secretion. A significant elevation of IL-1 secretion was observed after initial exposure to virgin HDPE particles compared with controls (p = 0.001). IL-1 secretion was also elevated in the low oxidized particle groups (p = 0.001), whereas the highly oxidized particles were not different than controls. Secretion of both IL-6 (p = 0.03) and TNF-alpha (p = 0.007) were significantly elevated by the low oxidized HDPE particles whereas the virgin and highly oxidized groups showed no difference. The different effects on MDM activation when HDPE surface chemistry was altered, highlight the importance of defining the particle properties when studying the role of MDM activation in in vitro systems and extrapolating these observations to the in vivo situation.

Predictive model for tensile true stress-strain behavior of chemically and mechanically degraded ultrahigh molecular weight polyethylene

The gamma radiation sterilization of ultrahigh molecular weight polyethylene (UHMWPE) components in air generates long-lived free radicals that oxidize slowly over time during shelf storage and after implantation. To investigate the combined effects of chemical and mechanical degradation on the mechanical behavior of UHMWPE, sterilized tensile specimens were immersed in 0.5% hydrogen peroxide solution at 37 degrees C for up to 9 months and concurrently subjected to cyclic stress levels of 0 (control), 0 to 5, and 0 to 10 MPa. After chemical and mechanical preconditioning, specimen density was measured using the density gradient column technique. The true stress-strain behavior was measured up to 0.12 true strain and characterized using a multilinear material model, the parameters of which were found to vary linearly with density and cyclic stress history. The mechanical behavior of as-irradiated and degraded UHMWPE was accurately predicted by an analytical composite beam model of the tensile specimens. The results of this study support the hypothesis that chemical and mechanical degradation affect the true stress-strain behavior of UHMWPE. In the future, the material model data presented in this study will enable more accurate prediction of the stresses and strains in UHMWPE components following gamma sterilization in air and subsequent in vivo degradation.

Morphology of chemically crosslinked ultrahigh molecular weight polyethylene

Morphological characterization of chemically crosslinked ultrahigh molecular weight polyethylene was performed by differential scanning calorimetry and scanning electron microscopy. The lamellar thickness of nascent UHMWPE inferred from DSC endotherms showed a very broad distribution, which was reduced significantly after melting and recrystallizing in DSC. Peroxide crosslinking further reduced the lamellar thickness distribution compared to uncrosslinked samples. After gamma-irradiation, a slowly cooled peroxide-free sample showed a greater increase in lamellar thickness distribution. Examination of the morphology of freeze-fractured surfaces by SEM showed that a slowly cooled peroxide-free UHMWPE exhibited a rougher fracture while chemically crosslinked samples showed a smoother fracture. After compression molding at 300 degrees C for 2 h, the grain boundaries between particles disappeared for all UHMWPE samples, indicating a complete fusion of the original flakes.

Degradation rate of ultra-high molecular weight polyethylene

Ultra-high molecular weight polyethylene components for total joint replacement chemically degrade before and after implantation, and the degradation is associated with an increase in density. The goal of this study was to determine the average rate of density change in these components following sterilization by gamma radiation in air as a function of shelf age and implantation time. Using the density gradient column method, density profiles were obtained through the thickness from loaded and unloaded regions of 10 retrieved Insall-Burstein/Posterior-Stabilized II tibial components and one operating-room inventory component for which the initial density profile and patient history (if applicable) were known. The average density of the components increased at a constant rate of 0.000186 g/cc/month during the first 50 months after sterilization (r2 = 0.54) but was not significantly affected by loading (p > 0.05). The quantitative degradation rates may be useful to help verify kinetic models to predict bulk degradative changes on the basis of micro-structural and chemical processes. This research also suggests the hypothesis that degradation of ultra-high molecular weight polyethylene can be modeled in terms of changes in bulk or average properties.