Maintaining reliability remains a great challenge for ultrahigh molecular weight polyethylene (UHMWPE) bearings due to oxidation in biological environments. This work aimed at inspecting the efficacy of the hybrid antioxidant strategy in stabilizing crosslinked UHMWPE under an in vitro clinically relevant accelerated aging condition. The hybrid antioxidant system was composed of vitamin E (VE) and D-sorbitol (DS) as primary and secondary antioxidants, respectively. The already established in vitro clinically relevant accelerated aging was performed via squalene absorption and subsequent thermal oxidation treatment. Compared to the use of VE alone, the combination of VE and DS significantly protracted the oxidation induction time of UHMWPE with no apparent oxidation after aging, showing a notable synergistic effect on the oxidative stability of UHMWPE. The crosslink density was higher for VE/DS/UHMWPE than VE/UHMWPE at each aging period. It revealed that the hybrid antioxidant strategy settled the longstanding contradiction between oxidation stability and crosslinking of UHMWPE. Attributed to improved oxidation stability, there was a positive reversal in the tensile property between VE/DS/UHMWPE and VE/UHMWPE after aging, where comparable ultimate tensile strength and higher elongation at break were observed. These findings underline the high potential of the hybrid antioxidant strategy for developing artificial joint materials with desired ability to resist oxidation and balanced performance.
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