Reduction of total knee replacement wear with vitamin E blended highly cross-linked ultra-high molecular weight polyethylene

Ultra-high molecular weight polyethylene (UHMWPE) is a common bearing component in total knee replacement (TKR) implants, and its susceptibility to wear continues to be the long-term limiting factor in the life of these implants. This study hypothesized that in TKR systems, a highly cross-linked (HXL) UHMWPE blended with vitamin E will result in reduced wear as compared to a direct compression-moulded (DCM) UHMWPE. A wear simulation study was conducted using an asymmetric lateral pivoting '3D Knee' design to compare the two inserts. The highly cross-linked UHMWPE was aged prior to the testing and force-controlled wear testing was carried out for 5 million cycles using a load-controlled ISO-14243 standard at a frequency of 1 Hz on both groups. Gravimetric measurements of DCM UHMWPE (4.4 +/- 3.0 mg/million cycles) and HXL UHMWPE with vitamin E (1.9 +/- 1.9 mg/million cycles) showed significant statistical differences (p < 0.01) between the wear rates. Wear modes and surface roughness for both groups revealed no significant dissimilarities.