Abstract
Polyethylene (PE) is the key component of total knee replacement (TKR). The wear of polyethylene, a common cause of revision surgeries, depends on multiple factors. The mechanical properties, wear characteristics, and oxidative resistance of PE can be manipulated by the techniques of processing, sterilization, and packaging methods. This article describes the making of conventional and cross-linked poly, packaging, sterilization, processing techniques, and a summary of commercially available plastics and their rationale in TKR including the latest advances.
Highlights
BackgroundPolyethylene (PE) is an integral part of total knee replacement (TKR) and has undergone significant changes in the last three decades
In an effort to absorb residual free radicals and improve oxidation properties, the irradiated HXLPE is remelted above its melting temperature, which is typically done before the plastic is machined into the final product
An ideal PE’s properties include strong resistance to wear, oxidation, and fatigue crack propagation (FCP) and should retain these properties in-vivo for the long-term
Summary
Polyethylene (PE) is an integral part of total knee replacement (TKR) and has undergone significant changes in the last three decades. In an effort to absorb residual free radicals and improve oxidation properties, the irradiated HXLPE is remelted above its melting temperature (greater than 150 degrees Celsius), which is typically done before the plastic is machined into the final product. The annealed plastic has not proven to be as effective as the remelted poly in terms of reducing the quantity of residual free radicals This led to increased oxidative wear and overall deterioration of mechanical properties when subjected to the accelerated aging test. The first method includes blending VitE into resin powder (in concentrations ranging from 1000-8000 ppm) even before consolidation and irradiation Studies demonstrated that this method prevents in-vivo oxidation, accelerated aging, and improves wear characteristics but at the expense of decreased cross-linking efficiency [20].
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