Oxidative properties and surface damage mechanisms of remelted highly crosslinked polyethylenes in total knee arthroplasty
MacDonald, D.W., Higgs, G., Parvizi, J. et al.Knee
Purpose
Remelted highly crosslinked polyethylenes (HXLPEs) were introduced in total knee replacement (TKR) starting in 2001 to reduce wear and particle-induced lysis. The purpose of this study was to investigate the damage mechanisms and oxidative stability of remelted HXLPEs used in TKR.
Methods
A total of 186 posteriorly stabilised tibial components were retrieved at consecutive revision operations. Sixty nine components were identified as remelted HXLPE. The conventional inserts were implanted for 3.4 ± 2.7 years, while the remelted components were implanted 1.4 ± 1.2 years. Oxidation was assessed using Fourier transform infrared spectroscopy.
Results
Remelted HXLPE inserts exhibited lower oxidation indices compared to conventional inserts. We were able to detect slight regional differences within the HXLPE cohort, specifically at the bearing surface.
Conclusion
Remelted HXLPE was effective at reducing oxidation in comparison to gamma inert sterilised controls. Additional long-term HXLPE retrievals are necessary to ascertain the long term in vivo stability of these materials in TKR.
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