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Research

INVESTIGATION OF LEACHING OF OIL-BASED FLUIDS (VITAMIN E AND LIPIODOL) FROM POLYETHYLENE

The British Orthopaedic Research Society (BORS) Annual Meeting 2020, held online, 7–8 September 2020.



Abstract

Abstract

Objectives

Ultra-High Molecular Weight Polyethylene (UHMWPE) can be made radiopaque through the diffusion of an oil-based contrast agent (Lipiodol Ultra-fluid). A similar process is used for Vitamin E incorporated polyethylene, which has a well-established clinical history. This study aimed to quantify the leaching of Lipiodol and compare to vitamin E polyethylene.

Method

GUR 1050 polyethylene (4 mm thickness) was cut into squares, 10 mm2. Samples (n=5) were immersed in 25 ml Lipiodol (Guerbet, France), or 15 ml Vitamin E (L-atocopherol, Sigma-Aldrich, UK). To facilitate diffusion, samples were held at 105°C for 18 hours. After treatment, all samples were immersed in DMEM (Sigma-Aldrich, UK) with Penicillin Streptomycin (Sigma-Aldrich, Kent, UK) at 4%v/v and held at 37°C in an incubator. Untreated polyethylene samples were included as controls. Leaching was quantified gravimetrically at weeks 2, 4 and 8. The radiopacity of the Lipiodol-diffused samples was investigated from µCT images (162kV, resolution 0.2 mm, X Tec, XT H 225 ST, Nikon Metrology, UK).

Results

The leaching of Lipiodol and Vitamin E followed the same trend and reached a steady state after week 2. At this point there was a 20% decrease in the Hounsfield Unit and droplets of radiopaque oil were visible in the DMEM solution; these were not evident in subsequent scans. Over 8 weeks of 20% Lipiodol leached out of the polyethylene, which was greater than of 10% Vitamin E.

Conclusion

After 8 weeks the radiopaque polyethylene was still identifiable in CT scan images, even though 20% of leaching occurred. The leaching of Lipiodol may be mitigated through cross-linking, which has been shown to reduce leaching of Vitamin E; this will be investigated as future work.

Declaration of Interest

(b) declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research reported:I declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research project.