Oral Ebru, Neils Andrew, Muratoglu Orhun K
Harris Orthopaedic Laboratory, Massachusetts General Hospital, Boston, Massachusetts; Department of Orthopaedic Surgery, Harvard Medical School, Boston, Massachusetts.
J Biomed Mater Res B Appl Biomater. 2015 May;103(4):790-7. doi: 10.1002/jbm.b.33256. Epub 2014 Aug 13.
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.
已引入抗氧化剂来稳定辐射交联的超高分子量聚乙烯(UHMWPE),以提高全关节植入物承载表面的氧化稳定性。目前,将抗氧化剂(最常见的是维生素E)与UHMWPE树脂粉末混合,然后进行固结和均匀辐射交联,可用于全髋关节和全膝关节。先前的研究表明,通过在整个植入物中空间操纵维生素E的浓度,并将交联限制在植入物表面(耐磨所需的部位),可以进一步提高维生素E混合并辐照的UHMWPE的抗疲劳性。这是通过在植入物表面设计低浓度的维生素E,并在植入物体内部设计较高浓度的维生素E来实现的,因为随着维生素E浓度的增加,UHMWPE中的交联会受到阻碍。在本研究中,我们假设通过限制辐射穿透到具有均匀维生素E浓度的UHMWPE中,可以获得具有低磨损率和高疲劳强度的表面交联UHMWPE。我们的假设得到了证实;我们能够通过控制辐照能量来控制表面交联区域,从而实现极低的磨损和高冲击强度。此外,我们还讨论了通过使用额外的维生素E储存库来提高这种材料抗氧化性的替代方法。这些结果意义重大,因为这种材料可能会使抗氧化剂稳定的交联UHMWPE在高应力应用和更活跃的患者中得到更多应用。