Quantitative Measurements of Backside Wear in Acetabular Hip Joint Replacement: Conventional Polyethylene Versus Cross-Linked Polyethylene.

Steffen Braun,Robert Sonntag,Stefan Schroeder,Sebastian Jaeger,J Philippe Kretzer

doi:10.3390/ma13081854

Steffen Braun, Robert Sonntag + Show 3 more

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https://doi.org/10.3390/ma13081854

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Journal: Materials	Publication Date: Apr 15, 2020
Citations: 4	License type: CC BY 4.0

Affiliation: Heidelberg University, University Hospital Heidelberg

Abstract

As shown in previous studies, the modification of conventional polyethylene (CPE) to cross-linked polyethylene (XLPE) and the contribution of antioxidants result in a reduction in total wear. The aim of this study was to evaluate XLPE inserts with vitamin E and CPE regarding their resistance to the backside wear mechanism. A cementless hip cup system (Plasmafit® Plus 7, Aesculap) was dynamically loaded using CPE and XLPE inserts. The backside wear was isolated, generated and collected using the two-chamber principle. The chambers were filled with ultrapure water. After 2 × 106 cycles, the fluids were examined for wear particles according to a particle analysis. Using XLPE inserts, the backside wear was significantly reduced by 35%. While XLPE backside wear particles are significantly larger than CPE particles, they do not differ in their morphology. This study confirms the greater resistance to backside wear of XLPE compared to CPE. It can be assumed that the improved fatigue resistance of the vitamin E-stabilized XLPE inserts demonstrates XLPE’s effectiveness against micro-motion and the resulting changing tensions in interface areas like surface breakdown, pitting and the release of very small particles.

Highlights

The modification of conventional polyethylene (CPE) to cross-linked polyethylene (XLPE) and the introduction of antioxidants results in a reduction in joint articular wear [1,2,3].While CPE has been the gold standard in hip joint replacement for many years, it is being increasingly replaced by XLPE at a rate of over 95% in hip arthroplasty [4,5]
An independent t-test was used to compare all the mean parameters
The results of the CPE backside wear with the parameters ETN, morphology

Summary

Introduction

The modification of conventional polyethylene (CPE) to cross-linked polyethylene (XLPE) and the introduction of antioxidants results in a reduction in joint articular wear [1,2,3].While CPE has been the gold standard in hip joint replacement for many years, it is being increasingly replaced by XLPE at a rate of over 95% in hip arthroplasty [4,5]. Polymer chains that are cross-linked as a result of defined gamma or electron radiation in oxygen-free settings and subsequent thermal treatment show a higher articular wear resistance compared to CPE [6]. Antioxidants such as vitamin E are used to bind free radicals in order to improve the mechanical stability, fatigue strength and oxidation resistance of XLPE [7], which results in a further reduction in articular wear [1,2,3].

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