6 - Ultrahigh molecular weight polyethylene (UHMWPE) in joint replacement

Abstract

Publisher Summary This chapter presents that ultrahigh-molecular-weight polyethylene (UHMWPE) has been the material of choice for the polymeric component in total joint replacements primarily because of its excellent combination of wear resistance, structural strength and biocompatibility and remains the gold standard thus far. The wear of UHMWPE prostheses produces billions of sub micron particles annually, which may cause a foreign-body response, leading to extensive bone resorption and gross loosening of the implants. UHMWPE wear is of particular concern for young or active patients who may face one or more revisions with accumulative bone loss in their lifetime. Thus, improving the wear resistance of UHMWPE and thereby reducing the volume of wear particles released to the periarticular tissues should reduce the adverse biological responses and substantially extend the clinical lifespan of total joint replacements. It covers the structure and morphology of UHMWPE, processing, which is fabrication and sterilization, properties, and methods of cross-linking to improve the wear resistance of UHMWPE. Clinical studies on new cross-linked UHMWPE are also discussed in it. Short-term clinical follow-up indicated that the new cross-linked UHMWPEs show a substantial improvement in wear resistance over that of conventional UHMWPE. It is encouraging because with the use of new cross-linked UHMWPEs, the osteolysis induced by UHMWPE wear particles essentially might be eliminated, substantially extending the lifespan of implants.