Schwiesau Jens, Fritz Bernhard, Bracco Pierangiola, Bergmann Georg, Puente Reyna Ana Laura, Schilling Christoph, Grupp Thomas M
Research & Development, Aesculap AG, Am Aesculap Platz, 78532 Tuttlingen, Germany.
Department of Orthopaedic and Trauma Surgery, Musculoskeletal University Center Munich (MUM), Campus Grosshadern, LMU Munich, 81377 Munich, Germany.
Bioengineering (Basel). 2025 Jul 24;12(8):793. doi: 10.3390/bioengineering12080793.
Patients undergo total knee arthroplasty (TKA) at younger ages with the expectation that the devices will perform well over two to three decades. During this time, the ultra-high molecular weight polyethylene (UHMWPE) bearing material properties of the implant may change due to aging induced by radiation and oxygen diffusion or other effects. Vitamin E or other antioxidants are promoted since several years to improve the oxidation resistance of UHMWPE. To compare the effectivity of these substances against established materials, a six weeks aging process was used and the chemical, mechanical and bio-tribological properties were analysed. Highly crosslinked and two weeks aged UHMWPE served as a reference for the currently established aging standards and virgin UHMWPE was aged for six weeks to separate the effects of crosslinking and vitamin E blending. Six weeks artificially aging changed the chemical, mechanical and bio-tribological properties of cross-linked UHMWPE significantly compared to only two weeks artificially aging, leading to cracks and delamination during the highly demanding activities wear test. The degradative effect of extended aging was also observed for virgin UHMWPE. These observations are in good accordance to retrieval findings. Minor changes on the chemical properties were observed for the cross-linked UHWMPE blended with vitamin E without impact on the mechanical and bio-tribological properties.
患者在较年轻时接受全膝关节置换术(TKA),期望植入装置能在二三十年里良好运行。在此期间,植入物的超高分子量聚乙烯(UHMWPE)轴承材料特性可能因辐射、氧扩散或其他效应导致的老化而发生变化。数年来,维生素E或其他抗氧化剂被推广用于提高UHMWPE的抗氧化性。为比较这些物质与现有材料相比的有效性,采用了六周的老化过程,并对化学、机械和生物摩擦学特性进行了分析。高度交联且经过两周老化的UHMWPE用作当前既定老化标准的参照,将未使用过的UHMWPE老化六周以区分交联和维生素E混合的影响。与仅经过两周人工老化相比,六周人工老化显著改变了交联UHMWPE的化学、机械和生物摩擦学特性,在高要求的活动磨损测试中导致裂纹和分层。对于未使用过的UHMWPE,也观察到了延长老化的降解效应。这些观察结果与翻修研究结果高度一致。对于与维生素E混合的交联UHWMPE,观察到其化学性质有微小变化,但对机械和生物摩擦学特性没有影响。