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At least 19 recordsLinked to original sources
PubMed2000

Clinical and hip simulator comparisons of ceramic-on-polyethylene and metal-on-polyethylene wear.

The benefit of reduced polyethylene wear with ceramic in hip replacements does not seem to have been universally appreciated. In this current study, wear predictions from laboratory and clinical studies were compared for ceramic-on-polyethylene and cobalt chrome-on-polyethylene combinations. Many laboratory studies included water-based lubrication and linear-tracking mechanisms. Now it is appreciated that these were inappropriate methods, because of a propensity for very low or virtually no polyethylene wear against ceramics in water. Thus, water-based studies predicting a 20- to 80-fold advantage for ceramic-on-polyethylene compared with metal-on-polyethylene clearly were in error. However, serum-based simulator studies with high protein-concentrations generally have shown greater wear with alumina-on-polyethylene than with metal-on-polyethylene. Controversy still remains over the use of such nonphysiologic protein levels. The simulator studies were just beginning to explore the role of serum protein concentrations and the influence on the various wear models. Polyethylene wear with zirconia systems was particularly affected by serum protein concentrations. In one simulator study, use of proteins in the physiologic range resulted in the alumina-on-polyethylene wear rate decreasing to approximately 50% of that of metal-on-polyethylene. In the literature, many hip design and polyethylene variations were reported which confounded the wear analysis. Overall, the clinical data supported the superior performance of ceramic-on-polyethylene systems by a factor of 1.5- to fourfold. However, the amount of supporting data was not large. This summary of laboratory and clinical data indicated that ceramic-on-polyethylene hip replacement systems offered on average a 50% wear reduction from metal-on-polyethylene systems.

Ceramics↗
PubMed1995

Comparison of polyethylene wear in machined versus molded polyethylene.

Polyethylene wear debris has been identified as a cause of osteolysis, granuloma formation, and loosening in total hip arthroplasty. This study was designed to evaluate differences in polyethylene wear rates between acetabular cups machined from extruded bar stock and those direct compression molded. Two hundred thirty-six hip prostheses underwent radiographic evaluation using the technique of Livermore et al. Seventy-four were all-polyethylene cups machined from extruded bar stock, and 162 were all-polyethylene cups direct compression molded. Both groups were similar in that the acetabular and femoral components were all cemented, the acetabular components were all polyethylene, nonmetal backed, and bearing surfaces of both groups were polished, cobalt chrome. The femoral components were TRIAD in the machined group and TR28 in the molded group. Patient matching was performed, assigning 54 patients in each group, whose average age was 66 years old, average followup 6.7 years, and average weight 161 pounds. Rates of polyethylene wear then were compared. Results showed a linear wear rate of 0.05 mm per year for compression-molded polyethylene and 0.11 mm per year for machined polyethylene. Results of this study raise questions regarding the types of polyethylene fabrication and its ultimate molecular weight, and wear resistance.

Acetabulum↗
PubMed1996

A comparison of the wear of cross-linked polyethylene against itself with the wear of ultra-high molecular weight polyethylene against itself.

Wear tests were carried out on reciprocating pin-on-plate machines which had pins loaded at 10 N and 40 N. The materials tested were irradiated cross-linked polyethylene sliding against itself, irradiated ultra-high molecular weight polyethylene sliding against itself and non-irradiated ultra-high molecular weight polyethylene sliding against itself. After 153.5 km of sliding, the non-irradiated ultra-high molecular weight polyethylene plates and pins showed mean wear factors under 10 N loads, or a nominal contact stress of 0.51 MPa, of 84.0 x 10(-6) mm3/N m for the plates and 81.3 x 10(-6) mm3/N m for the pins. Under 40 N loads, or a nominal contact stress of 2.04 MPa, the non-irradiated ultra-high molecular weight polyethylene pins sheared at 22.3 km. At the last measurement point prior to this failure, 19.1 km, wear factors of 158 x 10(-6) mm3/N m for the plates and 85.0 x 10(-6) mm3/N m for the pins had been measured. After 152.8 km. the irradiated ultra-high molecular weight polyethylene plates and pins showed mean wear factors under 10 N loads of 59.8 x 10(-6) mm3/N m for the plates and 31.1 x 10(-6) mm3/N m for the pins. In contrast, after 150.2 km, a mean wear factor of 0.72 x 10(-6) mm3/N m was found for the irradiated cross-linked polyethylene plates compared with 0.053 x 10(-6) mm3/N m for the irradiated cross-linked polyethylene pins.

Biocompatible Materials↗
PubMed2000

[Radiographic assessment of polyethylene wear in machined versus molded polyethylene in total hip prosthesis].

PURPOSE OF THE STUDY: Wear of polyethylene acetabular components is an important issue in total hip arthroplasty. This study was designed to evaluate differences in polyethylene wear rates between machined and direct compression molded acetabular cups. METHODS: Two hundred thirty-nine prostheses underwent radiographic evaluation using the technique of Chevrot-Kerboull. One hundred thirty-one were all-polyethylene cups machined from extruded bar stock, and one hundred eight were all-polyethylene cups direct compression molded. Both groups, all operated on in 1988, were similar in the acetabular and femoral components, were all cemented, and the acetabular components were all-polyethylene, non metal backed. The femoral components were all Charnley-Kerboull MK III type. Patient weight, average weight, the post-operative PMA score and the duration of the follow-up were similar for the two groups (mean 7.4 years). RESULTS: Results showed a mean linear wear rate of 0.06 mm per year for compression-molded polyethylene and 0.08 mm per year for machined polyethylene. Results were not significantly different. The number of acetabular radiolucencies in zone I (5.5 versus 5.3 p. 100) and the amount of lysis of the proximal part of the femur did not differ between the two groups. The number of excessive wears did not differ either. DISCUSSION AND CONCLUSION: Although polyethylene wear was lower with compression molded acetabular cups than with ram-extruded acetabular cups, results of this study suggest a non significant difference between the two types of components. A more controlled experiment would have to be performed to attribute a difference between two different types of UHMPE processing.

Adult↗
PubMed1992

Tissue response to intraperitoneal implants of polyethylene oxide-modified polyethylene terephthalate.

Polyethylene terephthalate films surface modified with polyethylene oxide of mol wt 18,500 g/mol (18.5 k) by a previously described technique, were implanted in the peritoneal cavity of mice, along with their respective untreated controls, for periods of 1-28 d. The implants were retrieved and examined for tissue reactivity and cellular adherence. The control polyethylene terephthalate surfaces showed an initial inflammatory reaction followed by an extensive fibrotic response with a mean thickness of 60 microns at 28 d. By contrast, polyethylene oxide-modified polyethylene terephthalate showed only a mild inflammatory response and no fibrotic encapsulation throughout the implantation period: at 28 d a cellular monolayer was observed. Apparently either the polyethylene oxide-modified surface was stimulating less inflammation, which was in turn stimulating less fibroblastic overgrowth, or the cellular adhesion to the polyethylene oxide-modified surface was too weak to support cellular multilayers.

Animals↗
PubMed1986

Urinary excretion of polyethylene glycol 3350 and sulfate after gut lavage with a polyethylene glycol electrolyte lavage solution.

Ingestion of an electrolyte lavage solution containing polyethylene glycol 3350 and sulfate is an effective method of cleansing the colon for diagnostic studies. Polyethylene glycol and sulfate are considered poorly absorbed from the gastrointestinal tract. Because of the quantities administered, concern exists about potential toxicity of absorption of even a small percentage, particularly for polyethylene glycol. We measured the urinary excretion of both polyethylene glycol and sulfate in normal subjects and inflammatory bowel patients. Absorption of polyethylene glycol can be assessed by measuring recovery in urine, as 85%-96% of an intravenous load is excreted in urine. Similarly, appreciable sulfate absorption would exceed renal tubular reabsorption and result in increased urinary excretion. Mean percent polyethylene glycol load recovered in urine was minimal and similar for normal (0.06%) and inflammatory bowel (0.09%) subjects. Urinary sulfate excretion after lavage was also similar for both groups and was not different from baseline. These results do not suggest the likelihood of toxicity due to polyethylene glycol 3350 or sulfate absorption during gut lavage with this solution.

Colitis, Ulcerative↗
PubMed1999

Early polyethylene wear and osteolysis in cementless total hip arthroplasty: the influence of femoral head size and polyethylene thickness.

We examined initial polyethylene thickness, early polyethylene liner wear, and osteolysis in 350 primary, cementless total hip arthroplasties (THAs). All of the prostheses were of identical design and used Omnifit components. In the 32-mm head group, the mean liner wear correlated significantly with polyethylene thickness (P<.001) and increased rapidly with initial thinner polyethylene following a logarithmic model, although this increase was not statistically significant (r = -.633). Inadequate polyethylene thickness in the 32-mm head group was implicated as the major cause of higher liner wear. A minimal polyethylene thickness of 7 mm is recommended in cementless metal-backed THAs. The use of a large head combined with poor prosthetic design appeared to be responsible for the unacceptably high incidence of femoral osteolysis.

Acetabulum↗
PubMedDate not supplied

[Differences in polyethylene wear in hip joint prostheses with ceramic- and with metal-polyethylene combination of the articulation surfaces--a study of surgical and of autopsy materials].

Pseudocapsules of artificial hip joints with ceramic- and metal on polyethylene combination of the articulating surfaces from 126 revision arthroplasties and 41 autopsies were studied histologically with semiquantitative evaluation of the polyethylene wear. The results were compared with reports of laboratory tests in the literature. We found in the autopsy specimens as well as in the biopsies from revision arthroplasties of prostheses implanted for 4 to 8 years three times less polyethylene wear particles released from the ceramic on polyethylene prostheses. The newly established synovium surrounding prostheses with ceramic heads appeared 20% reduced in thickness with minor villous transformation. Different types of metal on polyethylene prostheses revealed no differences in wear behaviour with the exception of the bipolar prostheses which showed a markedly increased polyethylene wear.

Adult↗
PubMed1997

[In-vivo wear of the slide combinations ceramics-polyethylene as opposed to metal-polyethylene].

The present study deals with long-term dimensional changes in cemented Müller-type total hip endoprostheses. Creep and wear contribute to different extents to the dimensional changes in polyethylene. The total amount of polyethylene wear is represented by the displacement of the femoral head into the socket. Within the first postoperative years, the head shifts up to a relatively high rate of about 0.5 mm per year. This rate diminishes after 5 years to an average of about 0.1 mm (ceramics) and 0.2 mm (metal) per year. Values exceeding 0.2 mm per year for the shift of the femoral head are considered to be unfavourable with regard to a probable loosening of the prosthesis. In this study we determined the orientation of the centre of the prosthetic head in relation to the wire marker of the polyethylene cup, comprising in all 369 total hip prostheses. After an average of 77 months, 96% of the prostheses with ceramic heads (n = 109) had a wear rate of less than 0.2 mm per year. Using metal heads (Protasul-2 and Protasul-10) this rate could only be measured in 71% (n = 109) of the prostheses (61.5 months). The combination ceramics-polyethylene produces half of the total amount of wear produced by metal-polyethylene. Younger patients should preferably be treated with a ceramic ballhead.

Biocompatible Materials↗
PubMed1994

Severe polyethylene wear in total hip arthroplasty. Observations from retrieved AML PLUS hip implants with an ACS polyethylene liner.

A retrospective review was performed of 94 consecutive Anatomic Medullary Locking Plus (AML+, DePuy, Warsaw, IN) cementless acetabular components implanted between January 1988 and January 1990. All acetabular cups utilized the Acetabular Cup System (ACS) polyethylene liner (Depuy). Of these hips, 72 had been followed for more than 2 years (average, 43 months). There have been 15 (21%) clinical failures, all due to catastrophic wear of the acetabular polyethylene component surfaces. Of the 15 failures, clinical symptoms were absent in 7, an audible squeak was present in 3, and 5 patients reported having pain. All clinical failures had accelerated acetabular wear necessitating revision. Patients in the failure population were younger (56 years vs 62 years) than the remainder of the patients, and had greater cup abduction angles (55 degrees vs 49 degrees). All of the failed ACS polyethylene components had a 32 mm inner diameter articulating surface. The AML + acetabular component outer diameter averaged 56 mm (range, 50-64 mm). Six of 15 failures occurred in cups 58 mm or larger. Acetabular wear in the failure group was 0.77 mm/y (average). The incidence of acetabular (78%) and femoral (71%) osteolysis in the failure population is alarming. The rate of failure (21%) at 46 months of the AML + acetabular component with the ACS polyethylene liner appears to be related to design. The ACS design is flawed by a lack of hemispherical geometry, leading to failure at the superior rim with penetration of the femoral head through the polyethylene and against the metal shell.(ABSTRACT TRUNCATED AT 250 WORDS)

Female↗
PubMed1998

The incidence of modular tibial polyethylene insert exchange in total knee arthroplasty when polyethylene failure occurs.

One of the primary reasons for utilizing modular tibial polyethylene inserts (MTPI) at the time of total knee arthroplasty is to have the ability to simply exchange the polyethylene at the time of revision surgery when polyethylene failure has occurred. During a 2-year period from January 1993 to December 1994, 62 revision total knee arthroplasties were reviewed from five different institutions in North America, which were performed secondary to modular tibial insert failure. In 55 cases (88.7%), significant scoring and/or damage to the femoral and/or tibial components occurred necessitating revision of one or both components. This series does not support the premise that polyethylene exchange is common at the time of revision surgery for MTPI failure. Of the patients 88.7% had MTPI failure resulted in femoral and/or tibial component revision secondary to surface damage to the femoral component and/or tibial component baseplate. In order to avoid femoral and tibial component wear secondary to MTPI failure, early recognition is necessary to allow the much simpler operation consisting of polyethylene liner exchange only.

Aged↗
PubMed2001

A comparison of the wear and physical properties of silane cross-linked polyethylene and ultra-high molecular weight polyethylene.

Cross-linked polyethylenes are being introduced widely in acetabular cups in hip prostheses as a strategy to reduce the incidence of wear debris-induced osteolysis. It will be many years before substantial clinical data can be collected on the wear of these new materials. Silane cross-linked polyethylene (XLPE) was introduced into clinical practice in a limited series of acetabular cups in 1986 articulating against 22.225-mm alumina ceramic femoral heads and showed reduced wear rates compared with conventionally sterilized (gamma irradiation in air) ultra-high molecular weight polyethylene (UHMWPE). We compared the wear of XLPE manufactured in 1986 with the wear of UHMWPE manufactured in 1986 in nonirradiated and irradiated forms. In the nonirradiated forms, the wear of XLPE was 3 times less than UHWMPE when articulating against smooth counterfaces. The nonirradiated materials did not show signs of oxidation. In the irradiated forms, only UHMWPE showed high levels of oxidation, and this caused a substantial increase in wear. Antioxidants added to XLPE during processing gave resistance to oxidative degradation. When sliding against scratched counterfaces, the wear of UHMWPE increased by a factor of 2 to 3 times. Against the same scratched counterfaces, the wear of XLPE increased dramatically by 30 to 200 times. This difference may be attributed to the reduction in toughness of XLPE. Clinically, XLPE has been articulated against damage-resistant ceramic heads, and this probably has been an important factor in contributing to reduced wear. New cross-linked polyethylenes differ considerably from XLPE. This study indicates that it is prudent to examine the wear of new polyethylenes under a range of conditions that may occur in vivo.

Analysis of Variance↗
PubMedDate not supplied

A strategy for characterization of polyethylene glycol-derivatized proteins. A mass spectrometric analysis of the attachment sites in polyethylene glycol-derivatized superoxide dismutase.

Base treatment of polyethylene glycol-derivatized superoxide dismutase in which the polyethylene glycol is linked to the protein via a succinyl bridge, removes the polyethylene glycol leaving a succinyl marker. Exhaustive succinylation with d4-succinic anhydride completes the derivatization in order to minimize fractionation in proteolysis, chromatography, and desorption in the mass spectrometer. Production of peptides from the derivatized protein for high resolution and high-resolution tandem MS allows identification of the site that had been derivatized by polyethylene glycol and the determination of the amount of polyethylene glycol originally at each site. The mass spectrometric strategy outlined herein can be applied to other proteins derivatized for therapeutic administration.

Amino Acid Sequence↗
PubMed1988

[Is high-density polyethylene suitable as an implant material in cement-free anchoring of hip endoprostheses? A histomorphologic study of an explanted polyethylene screw-in acetabula].

Firmly attached screw-in polyethylene acetabula which had been implanted for between 16 and 54 months were explanted after autopsies and subjected to macroscopic, radiologic and histologic examination. Metaplasias were seen around the threads and on the floor of the acetabulum. Their tendency to ossify represents an attempt at secondary stabilization. Due to the low stability of the polyethylene this causes increased wear on the floor of the acetabulum. The small defects in the polyethylene found in the threads, resembling damage done by mice, may be a sign of biodegradation. In view of the tissue reactions pointed out, the material stability of the polyethylene needs to be improved or implantation must be restricted to a very limited range of indications.

Acetabulum↗
PubMed2002

Revision of polyethylene acetabular liners with a cemented polyethylene cup: a laboratory study.

Various technique parameters for the revision of failed polyethylene acetabular liners using a cemented polyethylene cup were evaluated in this laboratory study. The effects of cement mantle thickness and roughening the inner surface of the shell or outer surface of the cup were determined by measuring cup dissociation strength from the metal shell after cyclic loading of the cup. The use of a cement mantle thickness of 2 to 4 mm provided dissociation strengths 3 to 4 times greater than that of the original, press-fit polyethylene liner. If a failed acetabular liner is revised by a cemented cup within the existing, well-fixed, metal shell, the size of the cup selected should create a cement mantle of <4 mm. Roughening the inside of a smooth shell or one with few screw-holes increases fixation strength approximately 20% but also creates particulate debris.

Arthroplasty, Replacement, Hip↗
PubMed1993

Use of polyethylene glycol-bound superoxide dismutase, polyethylene glycol-bound catalase, and nimodipine to prevent hypoxic ischemic injury to the brain of newborn pigs.

OBJECTIVE: To determine if polyethylene glycol-bound superoxide dismutase and catalase and nimodipine, alone or in combination, will ameliorate hypoxic ischemic injury to the brain. SUBJECTS: A total of 78 newborn (0 to 3 days) pigs were used. DESIGN: Prospective, blinded, randomized, controlled trial. INTERVENTIONS: The piglets were subjected to hypoxic ischemic brain injury. Carotid arteries were ligated at time 0 and BP was reduced one third by hemorrhage. At 15 mins, FIO2 was reduced to 0.6. At 30 mins, carotids were released, blood was reinfused, and FIO2 was increased to 1.0. Pigs were randomly assigned at time 35 mins to receive either: 10,000 U/kg of polyethylene glycol-bound superoxide dismutase and catalase (group 1); 0.5 mg/kg of nimodipine (group 2); both 10,000 U/kg of superoxide dismutase and catalase and 0.5 mg/kg of nimodipine (group 3); or no drugs (controls). MEASUREMENTS: The time after reoxygenation for return of electroencephalogram, respiration, blink and pain were recorded in minutes as well as a neurologic examination at 1, 2, and 3 days and pathologic examination of the brain at 3 days, both by blinded observers. MAIN RESULTS: There were no significant differences in the four groups. CONCLUSIONS: Polyethylene glycol-bound superoxide dismutase and catalase, and nimodipine, either alone or in combination, do not ameliorate hypoxic ischemic injury to the brain in the newborn pig when given 5 mins after reoxygenation.

Animals↗
PubMed1999

Porous polyethylene channel implants: a modified porous polyethylene sheet implant designed for repairs of large and complex orbital wall fractures.

PURPOSE: To evaluate the effectiveness of a modified porous polyethylene implant in orbital fracture repair. A porous polyethylene channel implant (PPCI) has internal channels that accept mini- or microplates from conventional plating systems, facilitating fixation to bone in the reconstruction of large, complex orbital fractures. METHODS: The authors used 29 PPCIs to repair 25 orbits. Seventeen cases involved repair of an acute (less than two weeks after injury) fracture of one or more orbital walls. Eight cases represented delayed reconstruction of orbital walls for late enophthalmos or for residual defects after previous operations. RESULTS: A PPCI provides a stable platform for orbital soft tissue. Excellent results were obtained in all patients with acute orbital fractures, whereas good or excellent corrections of enophthalmos and hypoglobus were achieved in all patients who underwent late repair. There were no instances of orbital infection, implant exposure or migration, worsening diplopia, visual loss, or loss of structural support during 31 months of follow-up. CONCLUSIONS: A PPCI allows controlled placement of a porous polyethylene sheet with secure fixation to stable bone. The implant design allows it to be cantilevered from the orbital rim to serve as a stable platform when fractures are too large to support the implant in the posterior orbit. PPCIs are ideally suited for reconstruction of defects resulting from displacement of orbital walls and for repair of posterior floor fractures, medial wall fractures, and combined floor and medial wall defects.

Adult↗
PubMed1991

Biological responses to polyethylene oxide modified polyethylene terephthalate surfaces.

Polyethylene oxide (PEO) of molecular weights 5,000, 10,000, 18,500, and 100,000 g/mol was covalently grafted to surfaces of otherwise cell adhesive polyethylene terephthalate (PET) films. Analysis of these surfaces by measurement of contact angles and ESCA verified the presence of the grafted PEO. Protein adsorption assays of radiolabeled albumin and fibrinogen showed a marked reduction in adsorbed protein for the 18,500 and 100,000 molecular weight PEO coupled surfaces. Cell growth assays using human foreskin fibroblasts in culture showed that the higher-molecular-weight PEO surfaces supported cell growth to a much lower extent than the two lower-molecular-weight PEOs. Flow of whole blood over these surfaces and visualization of platelet adherence using epifluorescence video-microscopy showed very low platelet adherence only on the two higher-molecular-weight PEO coupled surfaces. Scanning electron microscopy corroborated these results. It was concluded that PEO of molecular weights neighboring 18,500 and higher was effective in reducing protein adsorption and cellular interactions on these surfaces.

Adsorption↗