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Highly Crosslinked UHMWPE 
In THR TKR ARTHROPLASTY 
(Polyethylene ) 
DR.SANDEEP AGRAWAL 
Consultant Orthopaedic Surgeon 
Agrasen Fracture Hospital 
Gondia 
Maharashtra
POLYETHYLENE
Timeline of Development of UHMWPE
UHMWPE
Naming of UHMWPE 
(Hoechst/Celanese, 1996) 
 GUR (Granular, UHMWPE, Ruhrchemie) 
 A,B,C,D HP (eg. GUR 1050, GUR 4150 HP) 
 A: 1-Germany, 4-USA, Texas 
 B: 1-Ca stearate, 0-none 
 C: 2- MW=2-4million, 5- MW>4million 
 D: 0 no meaning 
 HP: High Purity, meets the ASTM requirement 
(American Society for Testing and Materials)
Contemporary Highly 
Crosslinked UHMWPE
Manufacturing of UHMWPE Implants
Irradiation in Air 
MW ↓→ strength ↓
Irradiation in Inert Air
DurationTM Stabilization Process 
(1995, Howmedica) 
Precursor of Highly crosslinked 
Stabilization by heating 37-50 ˚C for 144 hrs 
Volumetric wear 32% less than air-irradiated control
Longevity Crosslinked Polyethylene 
Polyethylene is a part 
crystalline, part 
amorphous structure 
Crystalline 
Amorphous Free Radical 
Site 
Heated to Melt the Crystalline Phases 
Heat 
Heat 
Cooled slowly to return to its original structure 
Crosslink
Comparision of 
Highly Crosslinked UHMWPE 
Kyocera, 
Osteonics Zimmer Zimmer Japan 
AeonianTM 
Bar stock 
35KGyGamma 
irradiation 
Machined after XL 
Pack in Nitrogen 
25-40 kGy 
Gamma 
Sterilization 
DePuy- 
Dupont Zimmer 
Smith & 
Nephew
Alternative Bearing Material seek improved 
function, longer survivorship 
Ceramic head- on-metal 
cup 
Michael Piechocki, Fisher J, Orthopedics Today International, July/August, 2006, p17-8
The Basis for a Second-generation Highly 
Crosslinked UHMWPE 
 First generation Highly Cross-linked 
(UHMWPE) 
 Melted highly crosslinked polyethylene may 
be susceptible to fatigue cracking, and 
 Annealed highly crosslinked polyethylene 
may be susceptible to in vivo oxidation. 
Dumbleton JH, D'Antonio JA, Manley MT, Capello WN, Wang A. 
Clin Orthop Relat Res. 2006 Sep 28
The Basis for a Second-generation Highly 
Crosslinked UHMWPE (X3 HXPE) 
 (X3 HXPE) uses a sequential irradiation and 
annealing process. 
 Mechanical strength properties preserved with the highest 
survivorship in functional fatigue testing. 
 Free radical content is low, and performance under 
accelerated aging is the same as virgin UHMWPE 
 Crystallinity, density, and tensile strength was unchanged 
by oxidative challenge. 
 Volumetric wear rate very similar to metal-on-metal 
articulations 
 Wear particles were the same size as those produced from 
conventional UHMWPE. 
Dumbleton JH, D'Antonio JA, Manley MT, Capello WN, Wang A. 
Clin Orthop Relat Res. 2006 Sep 28
Alternative Bearing Material seek improved 
function, longer survivorship 
Ceramic head- on-metal 
cup 
Michael Piechocki, Fisher J, Orthopedics Today International, July/August, 2006, p17-8 
(X3 HXPE)

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Highly Crosslinked UHMWPE In THR TKR ARTHROPLASTY (Polyethylene ),DR.SANDEEP AGRAWAL Agrasen Fracture Hospital Gondia Maharashtra

  • 1. Highly Crosslinked UHMWPE In THR TKR ARTHROPLASTY (Polyethylene ) DR.SANDEEP AGRAWAL Consultant Orthopaedic Surgeon Agrasen Fracture Hospital Gondia Maharashtra
  • 5. Naming of UHMWPE (Hoechst/Celanese, 1996)  GUR (Granular, UHMWPE, Ruhrchemie)  A,B,C,D HP (eg. GUR 1050, GUR 4150 HP)  A: 1-Germany, 4-USA, Texas  B: 1-Ca stearate, 0-none  C: 2- MW=2-4million, 5- MW>4million  D: 0 no meaning  HP: High Purity, meets the ASTM requirement (American Society for Testing and Materials)
  • 8.
  • 9. Irradiation in Air MW ↓→ strength ↓
  • 11. DurationTM Stabilization Process (1995, Howmedica) Precursor of Highly crosslinked Stabilization by heating 37-50 ˚C for 144 hrs Volumetric wear 32% less than air-irradiated control
  • 12. Longevity Crosslinked Polyethylene Polyethylene is a part crystalline, part amorphous structure Crystalline Amorphous Free Radical Site Heated to Melt the Crystalline Phases Heat Heat Cooled slowly to return to its original structure Crosslink
  • 13. Comparision of Highly Crosslinked UHMWPE Kyocera, Osteonics Zimmer Zimmer Japan AeonianTM Bar stock 35KGyGamma irradiation Machined after XL Pack in Nitrogen 25-40 kGy Gamma Sterilization DePuy- Dupont Zimmer Smith & Nephew
  • 14. Alternative Bearing Material seek improved function, longer survivorship Ceramic head- on-metal cup Michael Piechocki, Fisher J, Orthopedics Today International, July/August, 2006, p17-8
  • 15. The Basis for a Second-generation Highly Crosslinked UHMWPE  First generation Highly Cross-linked (UHMWPE)  Melted highly crosslinked polyethylene may be susceptible to fatigue cracking, and  Annealed highly crosslinked polyethylene may be susceptible to in vivo oxidation. Dumbleton JH, D'Antonio JA, Manley MT, Capello WN, Wang A. Clin Orthop Relat Res. 2006 Sep 28
  • 16. The Basis for a Second-generation Highly Crosslinked UHMWPE (X3 HXPE)  (X3 HXPE) uses a sequential irradiation and annealing process.  Mechanical strength properties preserved with the highest survivorship in functional fatigue testing.  Free radical content is low, and performance under accelerated aging is the same as virgin UHMWPE  Crystallinity, density, and tensile strength was unchanged by oxidative challenge.  Volumetric wear rate very similar to metal-on-metal articulations  Wear particles were the same size as those produced from conventional UHMWPE. Dumbleton JH, D'Antonio JA, Manley MT, Capello WN, Wang A. Clin Orthop Relat Res. 2006 Sep 28
  • 17. Alternative Bearing Material seek improved function, longer survivorship Ceramic head- on-metal cup Michael Piechocki, Fisher J, Orthopedics Today International, July/August, 2006, p17-8 (X3 HXPE)