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Orthopaedic Proceedings
Vol. 98-B, Issue SUPP_9 | Pages 102 - 102
1 May 2016
Oral E Gul R Doshi B Neils A Kayandan S Muratoglu O
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Introduction

Highly cross-linked ultrahigh molecular weight polyethylene (UHMWPE) is the most common bearing surface used in total joint arthroplasty due to its excellent wear resistance. While radiation cross-linking is currently used, cross-linking using a cross-linking agent such as a peroxide can also be effective with improved oxidative stability, which can be achived by an antioxidant such as vitamin E. The peroxide cross-linking behavior of UHMWPE in the presence of vitamin E was unknown. We investigated the cross-linking behavior and the clinically relevant mechanical and wear properties of peroxide cross-linked, vitamin E-blended UHMWPE.

Materials and Methods

Medical grade UHMWPE (GUR1050) was blended with vitamin E and the peroxide (2,5-Dimethyl-2,5-di(t-butylperoxy)hexyne-3 or P130) before compression molding. Various vitamin E (0.1, 0.2, 0.3, 0.5, 0.6, 0.8 and 1.0 wt%) and peroxide concentrations (0.5, 1 and 1.5 wt%) were studied. The cross-link density was calculated as previously described (Oral 2010). The wear rate was determined using a custom-designed pin-on-disc wear tester against CoCr polished discs at 2 Hz and a rectangular path of 5 × 10 mm in undiluted bovine serum (Bragdon 2001). Tensile mechanical properties were determined using Type V dogbones according to ASTM D638. Oxidative stability was determined using oxidation induction testing (Braithwaite 2010). Double-notching and IZOD impact testing was performed according to ASTM D256. Samples prepared with vitamin E concentrations of 0.3 wt% and above and P130 concentrations of 0.5 and 1 wt% were also terminally gamma sterilized. Controls were 150-kGy irradiated vitamin E blends of UHMWPE.


Orthopaedic Proceedings
Vol. 98-B, Issue SUPP_9 | Pages 103 - 103
1 May 2016
Oral E Doshi B Neils A Muratoglu O
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Introduction

Inradiation cross-linked and melted ultrahigh molecular weight polyethylene (UHMWPE) total joint implants, the oxidation potential is afforded to the material by by post-irradiation melting. The resulting cross-linked UHMWPE does not contain detectable free radicals at the time of implantation and was expected to be resistant against oxidation for the lifetime of the implants. Recently, analysis of long-term retrievals revealed detectable oxidation in irradiated and melted UHMWPEs, suggesting the presence of oxidation mechanisms initiated by mechanisms other than those involving the free radicals at the time of implantation. However, the effect of oxidation on these materials was not well studied. We determined the effects of in vitro oxidation on the wear and mechanical properties of irradiated and melted UHMWPEs.

Materials and Methods

Medical grade slab compression molded UHMWPE (GUR1050) was irradiated using 10, 50, 75, 100, 120 or 150 kGy. The irradiated and melted UHMWPEs were accelerated aged at 70°C for 2, 3, 4, 6 and 8 weeks at 5 atm of oxygen.

Oxidation profiles were determined by first microtoming 150 μm cross sections; these were then extracted by boiling hexane for 16 hours and vacuum dried for 24 hours. They were then analyzed on an infrared microscope as a function of depth away from the surface. An oxidation index was calculated per ASTM 2102 as the ratio of the area under the carbonyl peak at 1740 cm-1 to the area under the crystalline polyethylene 1895 cm-1 peak. The cross-link density was calculated as previously described (Oral 2010). The wear rate was determined using a custom-designed pin-on-disc wear tester against CoCr polished discs at 2 Hz and a rectangular path of 5 × 10 mm in undiluted bovine serum (Bragdon 2001). Tensile mechanical properties were determined using Type V dogbones according to ASTM D638.


Orthopaedic Proceedings
Vol. 96-B, Issue SUPP_11 | Pages 200 - 200
1 Jul 2014
Oral E Neils A Doshi B Muratoglu O
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Summary

Low energy irradiation of vitamin E blended UHMWPE is feasible to fabricate total joint implants with high wear resistance and impact strength.

Introduction

Irradiated ultra-high molecular weight polyethylene (UHMWPE), used in the fabrication of joint implants, has increased wear resistance. But, increased crosslinking decreases the mechanical strength of the polymer, thus limiting the crosslinking to the surface is desirable. Here, we used electron beam irradiation with low energy electrons to limit the penetration of the radiation exposure and achieve surface cross-linking.


Orthopaedic Proceedings
Vol. 95-B, Issue SUPP_34 | Pages 469 - 469
1 Dec 2013
Muratoglu O Oral E Neils A Doshi B
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Introduction:

Irradiated ultra-high molecular weight polyethylene (UHMWPE), used in the fabrication of joint implants, has increased wear resistance [1]. But, increased crosslinking decreases the mechanical strength of the polymer [2], thus limiting the crosslinking to the surface is desirable. Here, we usedelectron beam irradiation with low energy electrons to limit the penetration of the radiation exposure and achieve surface cross-linking.

Methods:

Medical grade 0.1 wt% vitamin E blended UHMWPE (GUR1050) was consolidated and irradiated using an electron beam at 0.8 and 3 MeV to 150 kGy. Fourier Transform Infrared Spectroscopy (FTIR) was used from the surface along the depth at an average of 32 scans and a resolution of 4 cm−1. A transvinylene index (TVI) was calculated by normalizing the absorbance at 965 cm−1 (950–980 cm−1) against 1895 cm−1 (1850–1985 cm−1). TVI in irradiated UHMWPE is linearly correlated with the radiation received [3]. Vitamin E indices were calculated as the ratio of the area under 1265 cm−1 (1245–1275 cm−1) normalized by the same. Pin-on-disc (POD) wear testing was conducted on cylindrical pins (9 mm dia., 13 mm length, n = 3) as previously described at 2 Hz [4] for 1.2 million cycles (MC). Wear rate was measured as the linear regression of gravimetric weight change vs. number of cycles from 0.5 to 1.2 MC. Double notched IZOD impact testing was performed (63.5 × 12.7 × 6.35 mm) in accordance with ASTM F648. Cubes (1 cm) from 0.1 wt% blended and 150 kGy irradiated pucks (0.8 MeV) were soaked in vitamin E at 110°C for 1 hour followed by homogenization at 130°C for 48 hours.


Orthopaedic Proceedings
Vol. 94-B, Issue SUPP_XXXVII | Pages 130 - 130
1 Sep 2012
Wannomae K Oral E Neils A Rowell S Muratoglu O
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Introduction

Vitamin E stabilization of radiation crosslinked UHMWPE is done by (1) blending into the resin powder, consolidating and irradiating or (2) diffusing into already consolidated and irradiated UHMWPE and terminally gamma sterilizing. With blending, a higher radiation dose is required for crosslinking to the same level as virgin UHMWPE. With diffusion, the vitamin E amount used is not limited by the crosslink density, but, vitamin E is exposed to terminal sterilization dose of 25–40 kGy, less than the 100–150 kGy used with blending, which may decrease the grafting of the antioxidant onto the polymer. We investigated the efficiency of grafted vitamin E against squlene-initiated accelerated aging.

Methods

Medical grade GUR1050 UHMWPE with vitamin E (0.1 wt%) was irradiated to 150 kGy. Tibial knee insert preforms were irradiated to 100 kGy, diffused with vitamin E using a doping and homogenization procedure. This UHMWPE was used either before or after gamma sterilization. One set of machined blocks (10 × 10 × 6 mm; n = 6) were extracted in boiling hexane for 4 days, then dried. The extracted blocks were doped with squalene at 120°C for 2 hours. One block each was analyzed after doping. The rest were accelerated aged at 70°C and 5 atm. of oxygen for 6 (n = 2) and 14 days (n = 3). Thin sections (150 micron thick) were microtomed and analyzed by Fourier Transform Infrared Spectroscopy to determine a vitamin E index (1245–1275 cm−1 normalized to 1850–1985 cm−1) and an oxidation index (1700 cm−1 normalized to 1370 cm−1) after extraction with boiling hexane for 16 hours and drying.


Orthopaedic Proceedings
Vol. 94-B, Issue SUPP_XL | Pages 132 - 132
1 Sep 2012
Oral E Neils A Ghali B Wannomae K Spiegelberg S Muratoglu O
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Radiation cross-linked ultrahigh molecular weight polyethylene (UHMWPE) is the bearing of choice in joint arthroplasty. The demands on the longevity of this polymer are likely to increase with the recently advancing deterioration of the performance of alternative metal-on-metal implants. Vitamin E-stabilized, cross-linked UHMWPEs are considered the next generation of improved UHMWPE bearing surfaces for improving the oxidation resistance of the polymer. It was recently discovered that in the absence of radiation-induced free radicals, lipids absorbed into UHMWPE from the synovial fluid can initiate oxidation and result in new free radical-mediated oxidation mechanisms. In the presence of radiation-induced free radicals, it is possible for the polymer to oxidize through both existing free radicals at the time of implantation and through newly formed free radicals in vivo. Thus, we showed that reducing the radiation-induced free radicals in vitamin E-stabilized UHMWPE would increase its oxidative stability and presumably lead to improved longevity. We describe mechanical annealing, low pressure annealing, and warm irradiation of irradiated vitamin E blends as novel methods to eliminate 99% of radiation-induced free radicals without sacrificing crystallinity. These are significant improvements in the processing of highly cross-linked UHMWPE for joint implants with improved longevity.