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Savin L, Pinteala T, Mihai DN, Mihailescu D, Miu SS, Sirbu MT, Veliceasa B, Popescu DC, Sirbu PD, Forna N. Updates on Biomaterials Used in Total Hip Arthroplasty (THA). Polymers (Basel) 2023; 15:3278. [PMID: 37571172 PMCID: PMC10422432 DOI: 10.3390/polym15153278] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 07/30/2023] [Accepted: 07/31/2023] [Indexed: 08/13/2023] Open
Abstract
One of the most popular and effective orthopedic surgical interventions for treating a variety of hip diseases is total hip arthroplasty. Despite being a radical procedure that involves replacing bone and cartilaginous surfaces with biomaterials, it produces excellent outcomes that significantly increase the patient's quality of life. Patient factors and surgical technique, as well as biomaterials, play a role in prosthetic survival, with aseptic loosening (one of the most common causes of total hip arthroplasty failure) being linked to the quality of biomaterials utilized. Over the years, various biomaterials have been developed to limit the amount of wear particles generated over time by friction between the prosthetic head (metal alloys or ceramic) and the insert fixed in the acetabular component (polyethylene or ceramic). An ideal biomaterial must be biocompatible, have a low coefficient of friction, be corrosion resistant, and have great mechanical power. Comprehensive knowledge regarding what causes hip arthroplasty failure, as well as improvements in biomaterial quality and surgical technique, will influence the survivability of the prosthetic implant. The purpose of this article was to assess the benefits and drawbacks of various biomaterial and friction couples used in total hip arthroplasties by reviewing the scientific literature published over the last 10 years.
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Affiliation(s)
- Liliana Savin
- Department of Orthopedics and Traumatology, Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania; (L.S.); (D.M.); (M.T.S.); (B.V.); (D.C.P.); (P.D.S.); (N.F.)
- Department of Orthopedics, Clinical Rehabilitation Hospital, 700661 Iasi, Romania;
| | - Tudor Pinteala
- Department of Orthopedics and Traumatology, Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania; (L.S.); (D.M.); (M.T.S.); (B.V.); (D.C.P.); (P.D.S.); (N.F.)
- Department of Orthopedics, Clinical Rehabilitation Hospital, 700661 Iasi, Romania;
| | - Dana Nicoleta Mihai
- Department of Orthopedics, Clinical Rehabilitation Hospital, 700661 Iasi, Romania;
- Department of Protheses Technology, Faculty of Dental Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Dan Mihailescu
- Department of Orthopedics and Traumatology, Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania; (L.S.); (D.M.); (M.T.S.); (B.V.); (D.C.P.); (P.D.S.); (N.F.)
- Department of Orthopedics, Clinical Rehabilitation Hospital, 700661 Iasi, Romania;
| | - Smaranda Stefana Miu
- Department of Rehabilitation, Clinical Rehabilitation Hospital, 700661 Iasi, Romania;
| | - Mihnea Theodor Sirbu
- Department of Orthopedics and Traumatology, Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania; (L.S.); (D.M.); (M.T.S.); (B.V.); (D.C.P.); (P.D.S.); (N.F.)
| | - Bogdan Veliceasa
- Department of Orthopedics and Traumatology, Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania; (L.S.); (D.M.); (M.T.S.); (B.V.); (D.C.P.); (P.D.S.); (N.F.)
| | - Dragos Cristian Popescu
- Department of Orthopedics and Traumatology, Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania; (L.S.); (D.M.); (M.T.S.); (B.V.); (D.C.P.); (P.D.S.); (N.F.)
| | - Paul Dan Sirbu
- Department of Orthopedics and Traumatology, Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania; (L.S.); (D.M.); (M.T.S.); (B.V.); (D.C.P.); (P.D.S.); (N.F.)
- Department of Orthopedics, Clinical Rehabilitation Hospital, 700661 Iasi, Romania;
| | - Norin Forna
- Department of Orthopedics and Traumatology, Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania; (L.S.); (D.M.); (M.T.S.); (B.V.); (D.C.P.); (P.D.S.); (N.F.)
- Department of Orthopedics, Clinical Rehabilitation Hospital, 700661 Iasi, Romania;
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Tateiwa T, Affatato S, Takahashi Y, Shishido T, Pezzotti G, Yamamoto K. To what extent could the acetabular liner thickness be reduced yet remaining tribologically acceptable in metal-on-vitamin E-diffused crosslinked polyethylene hip arthroplasty? J Biomed Mater Res B Appl Biomater 2022; 110:2299-2309. [PMID: 35524679 DOI: 10.1002/jbm.b.35078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 03/07/2022] [Accepted: 04/18/2022] [Indexed: 11/05/2022]
Abstract
The aim of the present study was to evaluate how much reduction in acetabular liner thickness could be tribologically acceptable in metal-on-vitamin-E diffused highly crosslinked ultra-high molecular weight polyethylene (Vit-E XLPE) bearings for total hip arthroplasty. We tested thick- (10.3 mm), moderate- (6.3 mm), and thin- (4.3 mm) Vit-E XLPE liners coupled with 28-mm cobalt-chromium femoral heads on a hip simulator to 5 million cycles, and peak contact stress was predicted based on mathematical modeling. Wear damage was also evaluated in terms of surface topology and morphology. Wear simulation demonstrated that the 2-4 mm thickness reduction (6.3 → 4.3 mm and 10.3 → 6.3 mm) did not significantly affect the wear rate for Vit-E XLPE liner, whereas 6-mm reduction (10.3 → 4.3 mm) significantly increased liner wear (by 309%) and head roughness (by 415%). This effect was attributed to a contact stress increase (by 24-41%). However, the wear rates for all thicknesses tested were much lower than those previously reported for thicker non-crosslinked materials. The original crystalline morphology was maintained in all liners after wear. Our results suggest that the 2-4 mm thickness reduction may be tribologically acceptable in Vit-E XLPE liners. However, more severe and longer term simulations are necessary to determine a minimum acceptable thickness.
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Affiliation(s)
- Toshiyuki Tateiwa
- Department of Orthopedic Surgery, Tokyo Medical University, Tokyo, Japan
| | - Saverio Affatato
- Laboratorio di Tecnologia Medica, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Yasuhito Takahashi
- Department of Orthopedic Surgery, Tokyo Medical University, Tokyo, Japan.,Department of Bone and Joint Biomaterial Research, Tokyo Medical University, Tokyo, Japan
| | - Takaaki Shishido
- Department of Orthopedic Surgery, Tokyo Medical University, Tokyo, Japan
| | - Giuseppe Pezzotti
- Department of Orthopedic Surgery, Tokyo Medical University, Tokyo, Japan.,Ceramic Physics Laboratory, Kyoto Institute of Technology, Kyoto, Japan
| | - Kengo Yamamoto
- Department of Orthopedic Surgery, Tokyo Medical University, Tokyo, Japan
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Synergy between vitamin E and D-sorbitol in enhancing oxidation stability of highly crosslinked ultrahigh molecular weight polyethylene. Acta Biomater 2021; 134:302-312. [PMID: 34311104 DOI: 10.1016/j.actbio.2021.07.041] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2020] [Revised: 07/19/2021] [Accepted: 07/20/2021] [Indexed: 02/05/2023]
Abstract
Oxidative stability of radiation crosslinked ultrahigh molecular weight polyethylene (UHMWPE) artificial joints is significantly improved by vitamin E (VE), but there is a dilemma that VE hinders crosslinking and thus jeopardizes the wear of UHMWPE. In this effort, we proposed an efficient strategy to stabilize UHMWPE under limited antioxidant contents, where VE and D-sorbitol (DS) were used as the primary antioxidant and the secondary antioxidant respectively. For non-irradiated blends with fixed antioxidant contents, oxidative stability accessed by oxidation induction time (OIT) of VE/DS/UHMWPE blends was superior to that of VE/UHMWPE blends, while DS/UHMWPE blends showed no increase in OIT. The cooperation between DS and VE exhibited a synergistic effect on enhancing the oxidative stability of UHMWPE. Interestingly, the irradiated VE/DS/UHMWPE blends showed comparable OIT but a significantly higher crosslink density than the irradiated VE/UHMWPE blends. The crystallinity, melting point, and in vitro biocompatibility of the blends were not affected by VE and DS. The quantitative relationships of mechanical properties, oxidation stability, crystallinity and crosslink density were established to unveil the correlation of these key factors. The overall properties of VE/UHMWPE and VE/DS/UHMWPE blends were compared to elucidate the superiority of the antioxidant compounding strategy. These findings provide a paradigm to break the trade-off between oxidative stability, crosslink density and mechanical properties, which is constructive to develop UHMWPE bearings with upgraded performance for total joint replacements. STATEMENT OF SIGNIFICANCE: VE-stabilized UHMWPE is the most commonly used material in total joint replacements at present. However, oxidation and wear resistance of VE/UHMWPE implants cannot be unified since VE reduces the efficiency of radiation crosslinking. It limits the use of VE. Herein, we proposed a compounding stabilization by the synergy between VE and DS. The antioxidation capability of VE was revived by DS, thus enhancing the oxidation stability of unirradiated UHMWPE. The irradiated VE/DS/UHMWPE exhibited similar oxidation stability but higher crosslink density than irradiated VE/UHMWPE, which is beneficial to combat wear of UHMWPE and to inhibit the occurrence of osteolysis. This synergistic antioxidation strategy endows the UHMWPE joint material with good overall performance, which is of clinical significance.
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Gamna F, Spriano S. Vitamin E: A Review of Its Application and Methods of Detection When Combined with Implant Biomaterials. MATERIALS 2021; 14:ma14133691. [PMID: 34279260 PMCID: PMC8269872 DOI: 10.3390/ma14133691] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 06/23/2021] [Accepted: 06/29/2021] [Indexed: 01/12/2023]
Abstract
Vitamin E is a common compound used for tocopherols and tocotrienols (α, β, γ, δ); it is the component of many natural products of both plant and animal origin. Thanks to its powerful antioxidant capacity, vitamin E has been very successful in hip and knee arthroplasty, used to confer resistance to oxidation to irradiated UHMWPE. The positive results of these studies have made vitamin E an important object of research in the biomedical field, highlighting other important properties, such as anti-bacterial, -inflammatory, and -cancer activities. In fact, there is an extensive literature dealing with vitamin E in different kinds of material processing, drug delivery, and development of surface coatings. Vitamin E is widely discussed in the literature, and it is possible to find many reviews that discuss the biological role of vitamin E and its applications in food packaging and cosmetics. However, to date, there is not a review that discusses the biomedical applications of vitamin E and that points to the methods used to detect it within a solid. This review specifically aims to compile research about new biomedical applications of vitamin E carried out in the last 20 years, with the intention of providing an overview of the methodologies used to combine it with implantable biomaterials, as well as to detect and characterize it within these materials.
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Shah NA, Ren Y, Lan R, Lv J, Gul RM, Tan P, Huang S, Tan L, Xu J, Li Z. Ultrahigh molecular weight polyethylene with improved crosslink density, oxidation stability, and microbial inhibition by chemical crosslinking and tea polyphenols for total joint replacements. J Appl Polym Sci 2021. [DOI: 10.1002/app.51261] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Affiliation(s)
- Nouman Ali Shah
- College of Polymer Science and Engineering, State Key Laboratory of Polymer Materials Engineering Sichuan University Chengdu China
| | - Yue Ren
- College of Polymer Science and Engineering, State Key Laboratory of Polymer Materials Engineering Sichuan University Chengdu China
| | - Ri‐Tong Lan
- College of Polymer Science and Engineering, State Key Laboratory of Polymer Materials Engineering Sichuan University Chengdu China
| | - Jia‐Cheng Lv
- College of Polymer Science and Engineering, State Key Laboratory of Polymer Materials Engineering Sichuan University Chengdu China
| | - Rizwan M. Gul
- Department of Mechanical Engineering University of Engineering and Technology Peshawar Pakistan
| | - Peng‐Fei Tan
- College of Biomass Science and Engineering Sichuan University Chengdu China
| | - Shishu Huang
- Department of Orthopedic Surgery and Orthopedic Research Institute, West China Hospital and West China School of Medicine Sichuan University Chengdu China
| | - Lin Tan
- College of Biomass Science and Engineering Sichuan University Chengdu China
| | - Jia‐Zhuang Xu
- College of Polymer Science and Engineering, State Key Laboratory of Polymer Materials Engineering Sichuan University Chengdu China
| | - Zhong‐Ming Li
- College of Polymer Science and Engineering, State Key Laboratory of Polymer Materials Engineering Sichuan University Chengdu China
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Parekh A, Sood A, Monsef JB, Hamouda M, Hussain A, Gonzalez M. Second-Generation Highly Cross-Linked Polyethylene in Total Hip Arthroplasty. JBJS Rev 2021; 9:e20.00065. [PMID: 33982980 DOI: 10.2106/jbjs.rvw.20.00065] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Amit Parekh
- Department of Orthopaedic Surgery, University of Illinois, Chicago, Illinois
| | - Anshum Sood
- Department of Orthopaedic Surgery, University of Illinois, Chicago, Illinois
| | - Jad Bou Monsef
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota
| | | | - Awais Hussain
- Department of Orthopaedic Surgery, University of Illinois, Chicago, Illinois
| | - Mark Gonzalez
- Department of Orthopaedic Surgery, University of Illinois, Chicago, Illinois
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Ren Y, Wang FY, Lan RT, Fu WQ, Chen ZJ, Lin H, Huang S, Gul RM, Wang J, Xu JZ, Li ZM. Polyphenol-Assisted Chemical Crosslinking: A New Strategy to Achieve Highly Crosslinked, Antioxidative, and Antibacterial Ultrahigh-Molecular-Weight Polyethylene for Total Joint Replacement. ACS Biomater Sci Eng 2020; 7:373-381. [PMID: 33351587 DOI: 10.1021/acsbiomaterials.0c01437] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Highly crosslinked ultrahigh-molecular-weight polyethylene (UHMWPE) bearings are wear-resistant to reduce aseptic loosening but are susceptible to oxidize in vivo/in vitro, as reported in clinical studies. Despite widespread acceptance of antioxidants in preventing oxidation, the crosslinking efficiency of UHMWPE is severely impacted by antioxidants, the use of which was trapped in a trace amount. Herein, we proposed a new strategy of polyphenol-assisted chemical crosslinking to facilitate the formation of a crosslinking network in high-loaded tea polyphenol/UHMWPE blends. Epigallocatechin gallate (EGCG), a representative of tea polyphenol, was mixed with UHMWPE and peroxide. Multiple reactive phenolic hydroxyl groups of tea polyphenol coupled with the nearby free radicals to form extra crosslinking sites. The crosslinking efficiency was remarkably enhanced with increasing tea polyphenol content, even at a concentration of 8 wt %. Given by the hydrogen donation principle, the high-loaded tea polyphenol also enhanced the oxidation stability of the crosslinked UHMWPE. The antioxidative performance was preserved even after tea polyphenol elution. Moreover, superior antibacterial performance was achieved by the in situ tea polyphenol release from the interconnected pathways in the present design. The strategy of polyphenol-assisted chemical crosslinking is applicable for producing highly crosslinked, antioxidative, and antibacterial UHMWPE, which has promising prospects in clinical applications.
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Affiliation(s)
- Yue Ren
- College of Polymer Science and Engineering, State Key Laboratory of Polymer Materials Engineering, Sichuan University, 610065 Chengdu, China
| | - Fei-Yu Wang
- Department of Stomatology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, 200072 Shanghai, China
| | - Ri-Tong Lan
- College of Polymer Science and Engineering, State Key Laboratory of Polymer Materials Engineering, Sichuan University, 610065 Chengdu, China
| | - Wan-Qun Fu
- Department of Stomatology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, 200072 Shanghai, China
| | - Zi-Jian Chen
- Department of Stomatology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, 200072 Shanghai, China
| | - Hao Lin
- College of Polymer Science and Engineering, State Key Laboratory of Polymer Materials Engineering, Sichuan University, 610065 Chengdu, China
| | - Shishu Huang
- Department of Orthopaedic Surgery, West China Hospital, Sichuan University, Chengdu 610065, China
| | - Rizwan M Gul
- Department of Mechanical Engineering, University of Engineering and Technology, 25120 Peshawar, Pakistan
| | - Jing Wang
- Department of Stomatology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, 200072 Shanghai, China
| | - Jia-Zhuang Xu
- College of Polymer Science and Engineering, State Key Laboratory of Polymer Materials Engineering, Sichuan University, 610065 Chengdu, China
| | - Zhong-Ming Li
- College of Polymer Science and Engineering, State Key Laboratory of Polymer Materials Engineering, Sichuan University, 610065 Chengdu, China
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8
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Kamada K, Takahashi Y, Tateiwa T, Shishido T, Masaoka T, Pezzotti G, Yamamoto K. Influence of liner offset and locking mechanism on fatigue durability in highly cross-linked polyethylene total hip prostheses. J Biomed Mater Res B Appl Biomater 2019; 108:1993-2004. [PMID: 31876393 DOI: 10.1002/jbm.b.34540] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Revised: 12/03/2019] [Accepted: 12/08/2019] [Indexed: 12/19/2022]
Abstract
Highly cross-linked, ultrahigh molecular weight polyethylene (HXLPE) acetabular liners are inherently associated to a risk of fatigue failure due to femoral neck impingement. Different thicknesses and designs employed with HXLPE liners greatly affect mechanical loading scenario. The purpose of this study was to clarify the influence of liner offset (lateralization) and locking mechanism (presence/absence of anti-rotation tabs in the external surface) on fatigue durability in annealed and vitamin E-blended HXLPE liners with a current commercial design. Each liner tested had six anti-rotation tabs, which were engaged in the 6 of 12 recesses on the metal shell. The remaining six recesses had no direct contact with the liner, where HXLPE was mechanically unsupported by the metal backing. These mated and/or unmated rim regions in the offset (2, 3, 4-mm lateralized) liners were exposed to severe neck impingement until crack propagation was identified. Phase volume percentages (crystalline, amorphous, and intermediate phase contents) of HXLPE liners were compared before and after impingement in order to interpret differences in impingement micromechanics associated with the rim design variations. Our results showed that the presence of unmated recesses served as a stress concentrator due to the formation of millimeter-scale gaps between the liner and shell. Another potential design problem drawn from our study was liner offset associated with a small volume protruding above the metal rim. Therefore, surgeons should take special care in selecting locking designs and geometries especially when using HXLPE offset liners.
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Affiliation(s)
- Kosuke Kamada
- Department of Orthopedic Surgery, Tokyo Medical University, Tokyo, Japan
| | - Yasuhito Takahashi
- Department of Orthopedic Surgery, Tokyo Medical University, Tokyo, Japan.,Department of Bone and Joint Biomaterial Research, Tokyo Medical University, Tokyo, Japan
| | - Toshiyuki Tateiwa
- Department of Orthopedic Surgery, Tokyo Medical University, Tokyo, Japan
| | - Takaaki Shishido
- Department of Orthopedic Surgery, Tokyo Medical University, Tokyo, Japan
| | - Toshinori Masaoka
- Department of Orthopedic Surgery, Tokyo Medical University, Tokyo, Japan
| | - Giuseppe Pezzotti
- Department of Orthopedic Surgery, Tokyo Medical University, Tokyo, Japan.,Ceramic Physics Laboratory, Kyoto Institute of Technology, Kyoto, Japan
| | - Kengo Yamamoto
- Department of Orthopedic Surgery, Tokyo Medical University, Tokyo, Japan
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Yamamoto K, Tateiwa T, Takahashi Y. Vitamin E-stabilized highly crosslinked polyethylenes: The role and effectiveness in total hip arthroplasty. J Orthop Sci 2017; 22:384-390. [PMID: 28209339 DOI: 10.1016/j.jos.2017.01.012] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2016] [Revised: 12/15/2016] [Accepted: 01/19/2017] [Indexed: 02/09/2023]
Abstract
Morphology and design of ultra-high molecular weight polyethylene (UHMWPE or simply PE) acetabular components used in total hip arthroplasty (THA) have been evolving for more than half a century. Since the late-1990s, there were two major technological innovations in PE emerged from necessity to overcome the wear-induced periprosthetic osteolysis, i.e., the development of highly crosslinked PEs (HXLPEs). There are many literature reporting that radiation crosslinked and remelted/annealed (first-generation) HXLPEs markedly reduced the incidence of osteolysis and aseptic loosening. Regardless of such clinical success in the first-generation technologies, there were some recent shifts in Japan toward the use of new second-generation HXLPEs subjected to sequential irradiation/annealing or antioxidant vitamin E (α-tocopherol) incorporation. Although the selection rate of first-generation liners still account for more than half of all the PE THAs (∼58% in 2015), the use of vitamin E-stabilized liners has been steadily growing each year since their clinical introduction in 2010. In these contexts, it is of great importance to evaluate and understand the real clinical benefits of using the new second-generation liners as compared to the first generation. This article first summarizes structural evolution and characteristic features of first-generation HXLPEs, and then provides a detailed description of second-generation antioxidant HXLPEs in regard to the role of vitamin E incorporation on their chemical and mechanical performances in THA.
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Affiliation(s)
- Kengo Yamamoto
- Department of Orthopedic Surgery, Tokyo Medical University, 6-7-1, Nishishinjuku, Shinjuku-ku, Tokyo 160-0023, Japan.
| | - Toshiyuki Tateiwa
- Department of Orthopedic Surgery, Tokyo Medical University, 6-7-1, Nishishinjuku, Shinjuku-ku, Tokyo 160-0023, Japan
| | - Yasuhito Takahashi
- Department of Orthopedic Surgery, Tokyo Medical University, 6-7-1, Nishishinjuku, Shinjuku-ku, Tokyo 160-0023, Japan; Department of Bone and Joint Biomaterial Research, Tokyo Medical University, 6-7-1,Nishishinjuku, Shinjuku-ku, Tokyo 160-0023, Japan.
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Takahashi Y, Tateiwa T, Pezzotti G, Shishido T, Masaoka T, Yamamoto K. Improved Resistance to Neck-Liner Impingement in Second-Generation Highly Crosslinked Polyethylene-The Role of Vitamin E and Crosslinks. J Arthroplasty 2016; 31:2926-2932. [PMID: 27378642 DOI: 10.1016/j.arth.2016.05.049] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2016] [Revised: 04/26/2016] [Accepted: 05/23/2016] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND Radiation crosslinking of ultrahigh molecular weight polyethylene (UHMWPE) results in the reduced tensile strength and fracture toughness as an expense of dramatic increase in the wear resistance. Clinical rim fracture has been reported due to neck-liner impingement on a first-generation highly crosslinked UHMWPE acetabular component. The objective of this study was to investigate whether a second-generation, vitamin E-blended highly crosslinked UHMWPE possesses the improved impingement resistance. METHODS Cyclic impingement testing was performed in a variety of UHMWPE acetabular components (vitamin E free or blended, noncrosslinked or highly crosslinked, and GUR1050 or GUR1020) with the same design specification. The kinematics used to reproduce the neck-liner impingement was a uniaxial fatigue compression in concert with an axial rotational torque. After the test, the geometry and morphological changes were characterized by coordinate measuring machine, scanning electron microscopy, and confocal Raman microspectroscopy. RESULTS A total of 300-kGy irradiated and annealed GUR1050 liner resulted in a significant geometry change and microcracks on the rim surface after the test. However, regardless of the similar level of crosslinking, much less damage was noted in the 300-kGy irradiated GUR1050 liner blended with vitamin E at a concentration of 3000 ppm. On the other hand, vitamin E-blended noncrosslinked GUR1050 exhibited an extensive microscopic fibrillation and folding on the impinged surface. CONCLUSION These results suggest that vitamin E-blending into UHMWPE has compensated the negative effect of toughness decrease induced by radiation crosslinking. We concluded that the coexistence of vitamin E and crosslinks can restrain impingement damage more effectively than either of them.
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Affiliation(s)
- Yasuhito Takahashi
- Department of Orthopedic Surgery, Tokyo Medical University, Tokyo, Japan; Department of Bone and Joint Biomaterial Research, Tokyo Medical University, Tokyo, Japan
| | - Toshiyuki Tateiwa
- Department of Orthopedic Surgery, Tokyo Medical University, Tokyo, Japan
| | - Giuseppe Pezzotti
- Ceramic Physics Laboratory, Kyoto Institute of Technology, Kyoto, Japan
| | - Takaaki Shishido
- Department of Orthopedic Surgery, Tokyo Medical University, Tokyo, Japan
| | - Toshinori Masaoka
- Department of Orthopedic Surgery, Tokyo Medical University, Tokyo, Japan
| | - Kengo Yamamoto
- Department of Orthopedic Surgery, Tokyo Medical University, Tokyo, Japan
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11
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Wang H, Xu L, Zhang M, Li R, Xing Z, Hu J, Wang M, Wu G. More wear-resistant and ductile UHMWPE composite prepared by the addition of radiation crosslinked UHMWPE powder. J Appl Polym Sci 2016. [DOI: 10.1002/app.44643] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Honglong Wang
- Shanghai Institute of Applied Physics; Chinese Academy of Sciences; Shanghai 201800 People's Republic of China
- University of Chinese Academy of Sciences; Beijing 100049 People's Republic of China
| | - Lu Xu
- Shanghai Institute of Applied Physics; Chinese Academy of Sciences; Shanghai 201800 People's Republic of China
| | - Mingxing Zhang
- Shanghai Institute of Applied Physics; Chinese Academy of Sciences; Shanghai 201800 People's Republic of China
| | - Rong Li
- Shanghai Institute of Applied Physics; Chinese Academy of Sciences; Shanghai 201800 People's Republic of China
| | - Zhe Xing
- Shanghai Institute of Applied Physics; Chinese Academy of Sciences; Shanghai 201800 People's Republic of China
| | - Jiangtao Hu
- Shanghai Institute of Applied Physics; Chinese Academy of Sciences; Shanghai 201800 People's Republic of China
| | - Mouhua Wang
- Shanghai Institute of Applied Physics; Chinese Academy of Sciences; Shanghai 201800 People's Republic of China
| | - Guozhong Wu
- Shanghai Institute of Applied Physics; Chinese Academy of Sciences; Shanghai 201800 People's Republic of China
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12
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Wang H, Xu L, Li R, Hu J, Wang M, Wu G. Improving the creep resistance and tensile property of UHMWPE sheet by radiation cross-linking and annealing. Radiat Phys Chem Oxf Engl 1993 2016. [DOI: 10.1016/j.radphyschem.2016.03.009] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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13
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Takahashi Y, Tateiwa T, Shishido T, Masaoka T, Kubo K, Yamamoto K. Post-deformation shape-recovery behavior of vitamin E-diffused, radiation crosslinked polyethylene acetabular components. J Mech Behav Biomed Mater 2016; 63:399-406. [PMID: 27454526 DOI: 10.1016/j.jmbbm.2016.07.015] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2016] [Revised: 07/06/2016] [Accepted: 07/10/2016] [Indexed: 12/01/2022]
Abstract
The in-vivo progression of creep and wear in ultra-high molecular weight polyethylene (UHMWPE) acetabular liners has been clinically evaluated by measuring radiographic penetration of femoral heads. In such clinical assessments, however, viscoelastic strain relaxation has been rarely considered after a removal of hip joint loading, potentially leading to an underestimation of the penetrated thickness. The objective of this study was to investigate shape-recovery behavior of pre-compressed, radiation crosslinked and antioxidant vitamin E-diffused UHMWPE acetabular liners, and also to characterize the effects of varying their internal diameter (ID) and wall thickness (WT). We applied uniaxial compression to the UHMWPE specimens of various ID (28, 32, 36mm) and WT (4.8, 6.8, 8.9mm) for 4320min under the constant load of 3000N, and subsequently monitored the strain-relaxation behavior as a function of time after unloading. It was observed that there was a considerable shape recovery of the components after removal of the external static load. Reducing ID and WT significantly accelerated the rate of creep strain recovery, and varying WT was more sensitive to the recovery behavior than ID. Creep deformation of the tested liners recovered mostly within the first 300min after unloading. Note that approximately half of the total recovery amount proceeded just within 5min after unloading. These results suggest a remarkably high capability of shape recovery of vitamin E-diffused highly crosslinked UHMWPE. In conclusion, the time-dependent shape recovering and the diameter-thickness effect on its behavior should be carefully considered when the postoperative penetration is quantified in highly crosslinked UHMWPE acetabular liners (especially on the non-weight bearing radiographs).
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Affiliation(s)
- Yasuhito Takahashi
- Department of Orthopedic Surgery, Tokyo Medical University, 6-7-1, Nishishinjuku, Shinjuku-ku, Tokyo 160-0023, Japan; Department of Bone and Joint Biomaterial Research, Tokyo Medical University, 6-7-1,Nishishinjuku, Shinjuku-ku, Tokyo 160-0023, Japan.
| | - Toshiyuki Tateiwa
- Department of Orthopedic Surgery, Tokyo Medical University, 6-7-1, Nishishinjuku, Shinjuku-ku, Tokyo 160-0023, Japan
| | - Takaaki Shishido
- Department of Orthopedic Surgery, Tokyo Medical University, 6-7-1, Nishishinjuku, Shinjuku-ku, Tokyo 160-0023, Japan
| | - Toshinori Masaoka
- Department of Orthopedic Surgery, Tokyo Medical University, 6-7-1, Nishishinjuku, Shinjuku-ku, Tokyo 160-0023, Japan
| | - Kosuke Kubo
- Department of Orthopedic Surgery, Tokyo Medical University, 6-7-1, Nishishinjuku, Shinjuku-ku, Tokyo 160-0023, Japan
| | - Kengo Yamamoto
- Department of Orthopedic Surgery, Tokyo Medical University, 6-7-1, Nishishinjuku, Shinjuku-ku, Tokyo 160-0023, Japan
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14
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Takahashi Y, Tateiwa T, Shishido T, Masaoka T, Kubo K, Yamamoto K. Size and thickness effect on creep behavior in conventional and vitamin E-diffused highly crosslinked polyethylene for total hip arthroplasty. J Mech Behav Biomed Mater 2016; 62:399-406. [PMID: 27261923 DOI: 10.1016/j.jmbbm.2016.05.020] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2016] [Revised: 05/11/2016] [Accepted: 05/15/2016] [Indexed: 11/29/2022]
Abstract
Since the early 2000s, the use of large femoral heads is becoming increasingly popular in total hip arthroplasty (THA), which provides an improved range of motion and joint stability. Large femoral heads commonly necessitate to be coupled with thinner acetabular liners than the conventionally used because of the limited sizes of outer shells (especially for patients with small pelvic size). However, the influence of the liner thinning on the mechanical performance is still not clearly understood. The objective of this study was to experimentally clarify the size and thickness effect on the rates of compressive creep strain in conventional (virgin low-crosslinked) and vitamin E-diffused highly crosslinked, ultra-high molecular weight polyethylene (UHMWPE) acetabular liners. We applied uniaxial compression to these liners of various internal diameters (28, 32 and 36mm) and thicknesses (4.8, 6.8 and 8.9mm) up to 4320min under the constant load of 3000N. Vitamin E-diffused highly crosslinked UHMWPE components showed significantly greater creep resistance than the conventional ones. In the both types of UHMWPE, the rates of creep strain significantly decreased by increasing the internal diameter and thickness. Varying the component thickness contributed more largely to the creep behavior rather than the internal diameter. Our results suggest the positive mechanical advantage of using large femoral heads, but at the same time, a considerable liner thinning is not recommended for minimizing creep strain. Therefore, the further in-vitro as well as in-vivo research are necessary to conclude the optimal balance of head diameter and liner thickness within the limited sizes of outer shells.
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Affiliation(s)
- Yasuhito Takahashi
- Department of Orthopedic Surgery, Tokyo Medical University, 6-7-1, Nishishinjuku, Shinjuku-ku, Tokyo 160-0023, Japan; Department of Bone and Joint Biomaterial Research, Tokyo Medical University, 6-7-1, Nishishinjuku, Shinjuku-ku, Tokyo 160-0023, Japan.
| | - Toshiyuki Tateiwa
- Department of Orthopedic Surgery, Tokyo Medical University, 6-7-1, Nishishinjuku, Shinjuku-ku, Tokyo 160-0023, Japan
| | - Takaaki Shishido
- Department of Orthopedic Surgery, Tokyo Medical University, 6-7-1, Nishishinjuku, Shinjuku-ku, Tokyo 160-0023, Japan
| | - Toshinori Masaoka
- Department of Orthopedic Surgery, Tokyo Medical University, 6-7-1, Nishishinjuku, Shinjuku-ku, Tokyo 160-0023, Japan
| | - Kosuke Kubo
- Department of Orthopedic Surgery, Tokyo Medical University, 6-7-1, Nishishinjuku, Shinjuku-ku, Tokyo 160-0023, Japan
| | - Kengo Yamamoto
- Department of Orthopedic Surgery, Tokyo Medical University, 6-7-1, Nishishinjuku, Shinjuku-ku, Tokyo 160-0023, Japan
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15
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Marchiori G, Lopomo N, Boi M, Berni M, Bianchi M, Gambardella A, Visani A, Russo A, Marcacci M. Optimizing thickness of ceramic coatings on plastic components for orthopedic applications: A finite element analysis. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2016; 58:381-8. [DOI: 10.1016/j.msec.2015.08.067] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/13/2015] [Revised: 07/30/2015] [Accepted: 08/27/2015] [Indexed: 10/23/2022]
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16
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Trommer R, Maru M, Oliveira Filho W, Nykanen V, Gouvea C, Archanjo B, Martins Ferreira E, Silva RF, Achete C. Multi-Scale Evaluation of Wear in UHMWPE-Metal Hip Implants Tested in a hip Joint Simulator. ACTA ACUST UNITED AC 2015. [DOI: 10.1016/j.biotri.2015.08.001] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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