2006 Otto Aufranc Award paper - Significance of in vivo degradation for polyethylene in total hip arthroplasty
2006 Otto Aufranc Award paper - Significance of in vivo degradation for polyethylene in total hip arthroplasty
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DOI：
10.1097/01.blo.0000246547.18187.0b
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发表时间：
2006-12-01
影响因子：
4.2
通讯作者：
Edidin, Avram A.
中科院分区：
文献类型：
--
作者：
Kurtz, Steven M.;Hozack, William J.;Edidin, Avram A.
我们的研究小组开发了一个植入物回收程序，以研究聚乙烯的体内降解。我们现在有证据支持我们的假设，即辐射灭菌聚乙烯不仅在历史伽马空气灭菌内衬中发生降解，而且在传统伽马惰性灭菌（ArCom）和退火高交联聚乙烯（Crossfire）内衬中也发生降解。我们的研究还发现，体内氧化的最严重表现通常发生在内衬磨损最小的区域，例如部件边缘，体液（含氧化物质）可在此处接触聚乙烯。我们的历史、ArCom和Crossfire检索数据均指向类似的情况，即股骨头限制了关节面处聚乙烯的体内氧化。因此，如果不发生边缘撞击，并且聚乙烯锁定机制与氧化液体保持相对隔离，则体内氧化在植入传统伽马灭菌聚乙烯的前10年内似乎并不具有临床重要性。我们得出的结论是，体内降解应纳入全髋关节置换术用组配式聚乙烯部件的潜在长期失效模式列表中。
Our research group developed an implant retrieval program to study in vivo degradation of polyethylene. We now have evidence to support our hypothesis that degradation of radiation-sterilized polyethylene occurs in the body for not only historical gamma air sterilized liners, but also for conventional gamma inert sterilized (ArCom) and annealed highly crosslinked polyethylene (Crossfire) liners as well. Our research has also led to the discovery that the most severe manifestations of in vivo oxidation typically occur in regions of the liner experiencing minimal wear, such as the rim of the component, where the body fluids (containing oxidizing species) have access to the polyethylene. Our data from historical, ArCom, and Crossfire retrievals all point to a similar scenario in which the femoral head limits the in vivo oxidation of polyethylene at the bearing surface. Consequently, provided rim impingement does not occur, and the polyethylene locking mechanisms remain relatively isolated from oxidizing fluid, in vivo oxidation does not seem to be clinically important in the first 10 years of implantation for conventional gamma sterilized polyethylene. We conclude that in vivo degradation should be included among the list of potential long-term failure modes for modular polyethylene components for total hip arthroplasty.