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Orthopaedic Proceedings
Vol. 95-B, Issue SUPP_15 | Pages 151 - 151
1 Mar 2013
Conteduca F D'Angelo F Conteduca J Iorio R Ferretti A
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Alpha Lipoic Acid (L.A.) is an effective natural antioxidant discovered in the human body in 1951 from L.J. Reed and I.C. Gunslaus from liver. It is inside broccoli, spinach and red meats, especially liver and spleen. Actually it is largely used as antioxidant in antiaging products according to the low toxicity level of the product.

The present study take into consideration the possibility to reduce oxidation of medical irradiated UHMWPE GUR 1050, mixing together polyethylene powder and Alpha Lipoic Acid powder.

The study is composed of two parts.

Part 1 Thermostability of alpha lipoic acid during polyethylene fusion

Part 2 detection of oxygen level in artificially aged irradiated polyethylene

Solid pieces were made with Gur 1050 powder (Ticona Inc., Bayport, Tex, USA) and mixed with Alpha Lipoic Acid (Talamonti, Italy, Stock 1050919074) 0, 1% and gamma ray irradiated with 30 kGy (Isomedix, Northborough, MA).

An oven (80° Celsius) was used to produce an aging effect for 35 days in the doped and control samples (Conventional not doped polyethylene). This process simulate an aging effect of 10 years into the human body.

THERMAL STABILITY: a Fourier Transfer Infra Red (FTIR) test was made in pieces molded in a cell at 150° and 200°Celsius and pressure of 200 MPa comparing to the UHMWPE powder mixed with alpha lipoic acid. The presence of Alpha Lipoic Acid in the polyethylene was found at any depth in the manufacts.

figure 1: A Pure Lipoic Acid. B Lipoic Acid + UHMWPE melted 150° C. Lipoic Acid + UHMWPE melted 200° C° (A And B spectra subtracted UHMWPE)

OXIDATION: After 5 weeks at 80° Celsius in a oven (ASTM standard F-2003-02)A FOURIER TRANSFER INFRA RED TEST (FTIR) was made in the superficial layer and deeper on the undersurface of doped 0.1% and conventional UHMWPE.

The antioxidation limit is defined as the ratio of the area under 1740 cm/−1 carbonyl and 1370 cm/−1 Methylene absorbance peaks.

In conventional UHMWPE oxidation is detected on the surface and decreases in the deeper layers down to zero under 1500 Micron Fig 2.

figure 2 Pure polyethylene: A Surface, B 1500 Micron, C 3000 Micron

In the doped UHMWPE, FTIR demonstrate a very low oxidation limit on the surface and at any depth, comparing to conventional UHMWPE Fig 3.

figure 3 Doped UHMWPE A surface, B 700 micron deept, C 1700 micron deept

The examples show that Lipoic Acid is effective as antioxidant in irradiated UHMWPE and it is stable with respect to thermal treatment.


Orthopaedic Proceedings
Vol. 93-B, Issue SUPP_II | Pages 175 - 175
1 May 2011
Iorio R Conteduca F Conteduca J Vadalà A Basiglini L Argento G Ferretti A
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Introduction: Mechanical factors are thought to be one of the main reasons in determining tunnel enlargement after ACL reconstruction with hamstrings. The purpose of this prospective study was to evaluate how the different techniques may affect the bone tunnel enlargement.

Material and Method: Forty-five consecutive patients undergoing ACL reconstruction with the use of autologous doubled semitendinosus and gracilis tendons entered this study. They were randomly assigned to enter group A (In-Out technique, with cortical fixation and Interference screw) and group B (Out-In technique, metal cortical fixation on the femour and tibia). At a mean follow-up of 10 months, all the patients underwent clinical evaluation and a CT scan exam to evaluate the post-operative diameters of both femoral and tibial tunnels.

Results: The mean femoral tunnel diameter increased significantly from 9.05±0.3 mm (post op) to 10.01±2.3 mm (follow-up) in group A and from 9.04±0.8 mm to 9.3±1,12 mm in group B. The mean tibial tunnel diameter increased significantly from 9.03±0.04 mm to 10,68±2.5 mm in group A and from 9.04±0.03 mm to 10.±0,78 mm in group B. The mean increase in both femoral and tunnel diameters observed in group A was significantly higher than that observed in group B (p< 0.05). Stability evaluated with kt 1000 don’t significantly differ in the two groups

Conclusion: The results of this study suggest that different angular orientation techniques and different hardware devices may affect tunnel enlargement after hamstrings reconstruction. The reason can be reached from the different stiffness of the devices and their backlashes on the tunnels walls.