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7.3 Ultrahigh Molecular Weight Polyethylene Total Joint Implants
Book chapter

7.3 Ultrahigh Molecular Weight Polyethylene Total Joint Implants

E. Oral, S.M. Kurtz and O.K. Muratoglu
Comprehensive Biomaterials II
2017
DOI: https://doi.org/10.1016/B978-0-12-803581-8.10219-X

Abstract

Antioxidant stabilization Biomaterial Fatigue resistance Joint replacement Radiation cross-linking Vitamin E Wear
Ultrahigh molecular weight polyethylene (UHMWPE) is the bearing surface of choice for total joint implants. We discuss the processing methods to prepare implants, the effect of methods such as sterilization on the properties of the material, and structure–property relationships in general. Radiation cross-linking has been a significant development in the last two decades, increasing the wear resistance of the surface, and thereby decreasing the risk of osteolysis, the resorption of periprosthetic bone. The development of first-generation cross-linked UHMWPEs involved thermal treatment (annealing or melting) after irradiation to improve oxidation resistance. While annealing resulted in the retention of some oxidation potential, melted UHMWPEs had reduced fatigue strength because of the crystallinity loss during melting. This brought about the stabilization of radiation cross-linked UHMWPEs by the addition of antioxidants either by diffusion or by blending to obtain oxidation resistance with improved fatigue strength by avoiding postirradiation melting. The development, implant properties, and peri-prosthetic effects of this second-generation highly cross-linked UHMWPE, which has been available clinically since 2007, are discussed. Finally, we have included state-of-the art information on cross-linked UHMWPEs in development, which have improved wear and fatigue properties as a result of further manipulation of the semicrystalline morphology and promise further improvements in the longevity of UHMWPE joint implants.

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