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Hasegawa M, Tone S, Naito Y, Sudo A. Ultra-High-Molecular-Weight Polyethylene in Hip and Knee Arthroplasties. MATERIALS (BASEL, SWITZERLAND) 2023; 16:2140. [PMID: 36984020 PMCID: PMC10054334 DOI: 10.3390/ma16062140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/12/2023] [Revised: 03/05/2023] [Accepted: 03/06/2023] [Indexed: 06/18/2023]
Abstract
Ultra-high-molecular-weight polyethylene (UHMWPE) wear and particle-induced osteolysis contribute to the failure of total hip arthroplasty (THA) and total knee arthroplasty (TKA). Highly crosslinked polyethylene (HXLPE) was developed in the late 1990s to reduce wear and has shown lower wear rates and loosening than conventional UHMWPE in THA. The irradiation dose for crosslinking is up to 100 kGy. However, during crosslinking, free radical formation induces oxidation. Using HXLPE in THA, the cumulative revision rate was determined to be significantly lower (6.2%) than that with conventional UHMWPE (11.7%) at a mean follow-up of 16 years, according to the Australian Orthopaedic Association National Joint Replacement Registry. However, HXLPE does not confer to TKA the same advantages it confers to THA. Several alternatives have been developed to prevent the release of free radicals and improve polymer mechanical properties, such as thermal treatment, phospholipid polymer 2-methacryloyloxyethyl phosphorylcholine grafting, remelting, and vitamin E addition. Among these options, vitamin E addition has reported good clinical results and wear resistance similar to that of HXLPE without vitamin E, as shown by short-term clinical studies of THA and TKA. This review aims to provide a comprehensive overview of the development and performance of UHMWPE in THA and TKA.
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Kobayashi K, Kidera K, Shiraishi K, Okazaki N, Chiba K, Yonekura A, Osaki M. High risk of elevated metal concentrations with 9/10-mm stem trunnions and highly cross-linked polyethylene grafted with poly(2-methacryloyloxyethyl phosphorylcholine) in total hip arthroplasty. J Orthop Surg Res 2023; 18:24. [PMID: 36627685 PMCID: PMC9830807 DOI: 10.1186/s13018-023-03510-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2022] [Accepted: 01/05/2023] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND The risks of metal release due to fretting and corrosion at the head-neck junction and consequent adverse local tissue reaction (ALTR) have concerns in metal-on-polyethylene (MoP) total hip arthroplasty (THA). Although trunnions have become thinner in diameter to increase the range of motion, it has remained unclear whether this change affects metal release and ALTR in vivo. This study aimed to investigate serum metal concentrations and the prevalence of ALTR in MoP THA with a 9/10-mm stem trunnion. PATIENTS AND METHODS A consecutive series of 37 hips that underwent THA using MoP grafted with poly(2-methacryloyloxyethyl phosphorylcholine) (PMPC) with a 9/10-mm trunnion stem were retrospectively reviewed. Serum metal levels were assessed and compared with those in MoP THA with a 10/12-mm trunnion stem. ALTR was diagnosed with serum metal levels and cross-sectional images. The factors associated with serum metal levels were also assessed. RESULTS The median serum cobalt and chromium levels were 1.5 μg/L and 1.0 μg/L in the 9/10-mm group and 0.2 μg/L and 0.4 μg/L in the 10/12-mm group, respectively. ALTR was found in 5 hips of 3 patients. Revision surgery was performed in 4 hips, and all stem trunnions and femoral heads showed severe corrosion. Postoperative walking ability was associated with serum metal levels. CONCLUSION It was found that a 9/10-mm stem trunnion with MoP grafted with PMPC had high risks of metal release in primary THA. Careful follow-up and cross-sectional imaging are needed to detect ALTR for early revision.
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Affiliation(s)
- Kyosuke Kobayashi
- grid.411873.80000 0004 0616 1585Nagasaki University Hospital, 1-7-1 Sakamoto, Nagasaki City, Nagasaki 852-8501 Japan
| | - Kenichi Kidera
- grid.411873.80000 0004 0616 1585Nagasaki University Hospital, 1-7-1 Sakamoto, Nagasaki City, Nagasaki 852-8501 Japan
| | - Kazuteru Shiraishi
- grid.411873.80000 0004 0616 1585Nagasaki University Hospital, 1-7-1 Sakamoto, Nagasaki City, Nagasaki 852-8501 Japan
| | - Narihiro Okazaki
- grid.411873.80000 0004 0616 1585Nagasaki University Hospital, 1-7-1 Sakamoto, Nagasaki City, Nagasaki 852-8501 Japan
| | - Ko Chiba
- grid.411873.80000 0004 0616 1585Nagasaki University Hospital, 1-7-1 Sakamoto, Nagasaki City, Nagasaki 852-8501 Japan
| | - Akihiko Yonekura
- grid.411873.80000 0004 0616 1585Nagasaki University Hospital, 1-7-1 Sakamoto, Nagasaki City, Nagasaki 852-8501 Japan
| | - Makoto Osaki
- grid.411873.80000 0004 0616 1585Nagasaki University Hospital, 1-7-1 Sakamoto, Nagasaki City, Nagasaki 852-8501 Japan
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Li Q, Wen C, Yang J, Zhou X, Zhu Y, Zheng J, Cheng G, Bai J, Xu T, Ji J, Jiang S, Zhang L, Zhang P. Zwitterionic Biomaterials. Chem Rev 2022; 122:17073-17154. [PMID: 36201481 DOI: 10.1021/acs.chemrev.2c00344] [Citation(s) in RCA: 130] [Impact Index Per Article: 65.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
The term "zwitterionic polymers" refers to polymers that bear a pair of oppositely charged groups in their repeating units. When these oppositely charged groups are equally distributed at the molecular level, the molecules exhibit an overall neutral charge with a strong hydration effect via ionic solvation. The strong hydration effect constitutes the foundation of a series of exceptional properties of zwitterionic materials, including resistance to protein adsorption, lubrication at interfaces, promotion of protein stabilities, antifreezing in solutions, etc. As a result, zwitterionic materials have drawn great attention in biomedical and engineering applications in recent years. In this review, we give a comprehensive and panoramic overview of zwitterionic materials, covering the fundamentals of hydration and nonfouling behaviors, different types of zwitterionic surfaces and polymers, and their biomedical applications.
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Affiliation(s)
- Qingsi Li
- Department of Biochemical Engineering, Frontier Science Center for Synthetic Biology and Key Laboratory of Systems Bioengineering (MOE), School of Chemical Engineering and Technology, Tianjin University, Tianjin, 300350, China
| | - Chiyu Wen
- Department of Biochemical Engineering, Frontier Science Center for Synthetic Biology and Key Laboratory of Systems Bioengineering (MOE), School of Chemical Engineering and Technology, Tianjin University, Tianjin, 300350, China
| | - Jing Yang
- Department of Biochemical Engineering, Frontier Science Center for Synthetic Biology and Key Laboratory of Systems Bioengineering (MOE), School of Chemical Engineering and Technology, Tianjin University, Tianjin, 300350, China
| | - Xianchi Zhou
- MOE Key Laboratory of Macromolecule Synthesis and Functionalization, Department of Polymer Science and Engineering, Zhejiang University, Hangzhou, 310027, China
| | - Yingnan Zhu
- Institute of Drug Discovery and Development, School of Pharmaceutical Sciences, Center for Drug Safety Evaluation and Research, Zhengzhou University, Zhengzhou 450001, China
| | - Jie Zheng
- Department of Chemical, Biomolecular, and Corrosion Engineering, The University of Akron, Akron, Ohio 44325, United States
| | - Gang Cheng
- Department of Chemical Engineering, The University of Illinois at Chicago, Chicago, Illinois 60607, United States
| | - Jie Bai
- College of Chemical Engineering, Inner Mongolia University of Technology, Hohhot, Inner Mongolia 010051, China
| | - Tong Xu
- College of Chemical Engineering, Inner Mongolia University of Technology, Hohhot, Inner Mongolia 010051, China
| | - Jian Ji
- MOE Key Laboratory of Macromolecule Synthesis and Functionalization, Department of Polymer Science and Engineering, Zhejiang University, Hangzhou, 310027, China
| | - Shaoyi Jiang
- Meinig School of Biomedical Engineering, Cornell University, Ithaca, New York 14853, United States
| | - Lei Zhang
- Department of Biochemical Engineering, Frontier Science Center for Synthetic Biology and Key Laboratory of Systems Bioengineering (MOE), School of Chemical Engineering and Technology, Tianjin University, Tianjin, 300350, China
| | - Peng Zhang
- MOE Key Laboratory of Macromolecule Synthesis and Functionalization, Department of Polymer Science and Engineering, Zhejiang University, Hangzhou, 310027, China
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Improved antifouling properties of PVA hydrogel via an organic semiconductor graphitic carbon nitride catalyzed surface-initiated photo atom transfer radical polymerization. Colloids Surf B Biointerfaces 2021; 203:111718. [PMID: 33774491 DOI: 10.1016/j.colsurfb.2021.111718] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Revised: 03/14/2021] [Accepted: 03/18/2021] [Indexed: 01/03/2023]
Abstract
An innovative g-C3N4 catalyzed surface-initiated photo atom transfer radical polymerization (SI-photoATRP) has been developed to construct MEDSAH zwitterionic polymer brushes on PVA hydrogel surface. g-C3N4 catalyzed SI-photoATRP is temporal and spatial control. As a heterogeneous reaction system, it can solve the catalyst residues problem. After grafting with MEDSAH, surface chemical composition and morphology of PVA-g-pMEDSAH hydrogel confirmed that MEDSAH was successfully grafted onto PVA hydrogel. Thermal property of PVA-g-pMEDSAH hydrogel decreased and hydrophilicity increased. No statistically significant differences between PVA and PVA-g-pMEDSAH were observed on mechanical properties. Cytotoxicity in vitro of PVA-g-pMEDSAH hydrogel could be considered as no cytotoxicity for L929 and NDHF cells. The antifouling properties of PVA-g-pMEDSAH hydrogel were significantly improved due to the enhancement of the surface hydration and steric repulsion effects caused by pMEDSAH polymer brushes. In addition, g-C3N4 is easier to modify to enhance the photocatalyst property. Thus, the heterogeneous reaction system of g-C3N4 catalyzed SI-photoATRP has huge potential applied in biomaterials surface modification.
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