Abstract
Vitamin E (alpha-tocopherol) is a free-radical stabilizing agent used to maintain oxidative stability in radiation crosslinked UHMWPE for total joint replacements. Diffusion of vitamin E into UHMWPE after irradiation is one method of incorporation, while an alternative is blending vitamin E with UHMWPE resin powder and subsequently irradiating the consolidated mixture. With the latter method, it is possible for the antioxidant properties of Vitamin E to be exhausted in blends during irradiation, leading to oxidation.
We report on the relative oxidative resistance of both irradiated (100kGy, 150kGy, 200kGy) vitamin E blends (0.02 wt%, 0.05 wt% and 0.1wt%) and post-irradiation vitamin E-diffused UHMWPE after three years of real-time aging in an aqueous environment at 40°C. Blocks of each type, including irradiated virgin UHMWPE, were also accelerated aged per ASTM F2003. Oxidation was measured with FTIR per ASTM F2102. Oxidation potential was determined through nitric oxide staining of hexane extracted thin sections, FTIR analysis and calculated using the height of the nitrate peak (1630 cm^-1).
Our results showed that unstabilized samples exhibited substantial oxidation and oxidation potential throughout the surface and bulk with both types of aging. Post-irradiation diffused UHMWPE showed no detectable oxidation and decreasing oxidation potential with both aging methods. The vitamin E concentration at the surface of the diffused blocks decreased and the initial non-uniform profile with high surface concentration (3.4 wt%) shifted towards a uniform profile, equilibrating at an index of 0.1 or 0.7 wt% vitamin E. Samples showed a reduction in their initial vitamin E content by 47%– 61% over 36 months, but oxidative stability was not compromised. The non-uniform profile presumably created a driving force for elution into the aqueous environment, while the difference in solubility of vitamin E at 40°C, compared to the initial diffusion temperature at 120°C, may have also contributed. After six months of real-time aging, all irradiated blends showed surface oxidation, while 0.02 wt% blends additionally showed subsurface oxidation potential. However, oxidation was not induced by accelerated aging Methods: in any blended, irradiated samples.
In conclusion, real-time aging resulted in greater differentiation in the relative oxidative stability of vitamin E-stabilized, radiation crosslinked UHMWPEs than accelerated aging. Irradiated blends with vitamin E concentrations as high as 0.1 wt% showed surface oxidation after 3 years; higher vitamin E concentrations cannot address this shelf oxidation as that will also reduce the crosslinking efficiency and increase wear. Post-irradiation diffused UHMWPE, which was not limited by the amount of incorporated vitamin E, showed oxidative resistance up to 3 years with a reduction in oxidative potential.
Correspondence should be addressed to: EFORT Central Office, Technoparkstrasse 1, CH – 8005 Zürich, Switzerland. Tel: +41 44 448 44 00; Email: office@efort.org
Author: Keith Wannomae, United States
E-mail: kwannomae@partners.org