Correlation of cross-linking as measured by the trans-vinylene index and in vitro wear of polyethylene from various acetabular liner brands

Aims: Highly cross-linked polyethylene (HXLPE) greatly reduces wear in total hip arthroplasty, compared to conventional polyethylene (CPE). Cross-linking is commonly achieved by irradiation. This study aimed to compare the degree of cross-linking and in vitro wear rates across a cohort of retrieved...

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Main Authors: Peter Wahl, Roman Heuberger, Andrea Pascucci, Thomas Imwinkelried, Markus Fürstner, Niels Icken, Michel Schläppi, Robin Pourzal, Emanuel Gautier
Format: Article
Language:English
Published: The British Editorial Society of Bone & Joint Surgery 2024-11-01
Series:Bone & Joint Research
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Online Access:https://online.boneandjoint.org.uk/doi/epdf/10.1302/2046-3758.1311.BJR-2024-0203.R1
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author Peter Wahl
Roman Heuberger
Andrea Pascucci
Thomas Imwinkelried
Markus Fürstner
Niels Icken
Michel Schläppi
Robin Pourzal
Emanuel Gautier
author_facet Peter Wahl
Roman Heuberger
Andrea Pascucci
Thomas Imwinkelried
Markus Fürstner
Niels Icken
Michel Schläppi
Robin Pourzal
Emanuel Gautier
author_sort Peter Wahl
collection DOAJ
description Aims: Highly cross-linked polyethylene (HXLPE) greatly reduces wear in total hip arthroplasty, compared to conventional polyethylene (CPE). Cross-linking is commonly achieved by irradiation. This study aimed to compare the degree of cross-linking and in vitro wear rates across a cohort of retrieved and unused polyethylene cups/liners from various brands. Methods: Polyethylene acetabular cups/liners were collected at one centre from 1 April 2021 to 30 April 2022. The trans-vinylene index (TVI) and oxidation index (OI) were determined by Fourier-transform infrared spectrometry. Wear was measured using a pin-on-disk test. Results: A total of 47 specimens from ten brands were included. The TVI was independent of time in vivo. A linear correlation (R2 = 0.995) was observed between the old and current TVI standards, except for vitamin E-containing polyethylene. The absorbed irradiation dose calculated from the TVI corresponded to product specifications for all but two products. For one electron beam-irradiated HXLPE, a mean dose of 241% (SD 18%) of specifications was determined. For another, gamma-irradiated HXLPE, a mean 41% (SD 13%) of specifications was determined. Lower wear was observed for higher TVI. Conclusion: The TVI is a reliable measure of the absorbed irradiation dose and does not alter over time in vivo. The products of various brands differ by manufacturing details and consequently cross-linking characteristics. Absorption and penetration of electron radiation and gamma radiation differ, potentially leading to higher degrees of cross-linking for electron radiation. There is a non-linear, inverse correlation between TVI and in vitro wear. The wear resistance of the HXLPE with low TVI was reduced and more comparable to CPE. Cite this article: Bone Joint Res 2024;13(11):682–693.
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spelling doaj-art-6cb3c31f728f4692a8e5b145d92cd7522024-12-12T12:45:23ZengThe British Editorial Society of Bone & Joint SurgeryBone & Joint Research2046-37582024-11-01131168269310.1302/2046-3758.1311.BJR-2024-0203.R1Correlation of cross-linking as measured by the trans-vinylene index and in vitro wear of polyethylene from various acetabular liner brandsPeter Wahl0https://orcid.org/0000-0002-8895-8621Roman Heuberger1https://orcid.org/0000-0003-1474-2040Andrea Pascucci2https://orcid.org/0009-0003-0181-4321Thomas Imwinkelried3https://orcid.org/0000-0002-4805-5401Markus Fürstner4Niels Icken5Michel Schläppi6https://orcid.org/0000-0002-0278-6276Robin Pourzal7https://orcid.org/0000-0001-9610-4864Emanuel Gautier8https://orcid.org/0000-0003-2876-7986 Division of Orthopaedics and Traumatology, Cantonal Hospital Winterthur, Winterthur, Switzerland RMS Foundation, Bettlach, Switzerland RMS Foundation, Bettlach, Switzerland RMS Foundation, Bettlach, Switzerland Division of Medical Radiation Physics and Department of Radiation Oncology, University Hospital Bern, Bern, Switzerland Service for Radioprotection, Cantonal Hospital Winterthur, Winterthur, Switzerland Division of Orthopaedics and Traumatology, Cantonal Hospital Winterthur, Winterthur, Switzerland Department of Orthopedic Surgery, Rush Medical College, Chicago, Illinois, USA Department of Orthopaedic Surgery, HFR Fribourg – Cantonal Hospital, Fribourg, Switzerland Aims: Highly cross-linked polyethylene (HXLPE) greatly reduces wear in total hip arthroplasty, compared to conventional polyethylene (CPE). Cross-linking is commonly achieved by irradiation. This study aimed to compare the degree of cross-linking and in vitro wear rates across a cohort of retrieved and unused polyethylene cups/liners from various brands. Methods: Polyethylene acetabular cups/liners were collected at one centre from 1 April 2021 to 30 April 2022. The trans-vinylene index (TVI) and oxidation index (OI) were determined by Fourier-transform infrared spectrometry. Wear was measured using a pin-on-disk test. Results: A total of 47 specimens from ten brands were included. The TVI was independent of time in vivo. A linear correlation (R2 = 0.995) was observed between the old and current TVI standards, except for vitamin E-containing polyethylene. The absorbed irradiation dose calculated from the TVI corresponded to product specifications for all but two products. For one electron beam-irradiated HXLPE, a mean dose of 241% (SD 18%) of specifications was determined. For another, gamma-irradiated HXLPE, a mean 41% (SD 13%) of specifications was determined. Lower wear was observed for higher TVI. Conclusion: The TVI is a reliable measure of the absorbed irradiation dose and does not alter over time in vivo. The products of various brands differ by manufacturing details and consequently cross-linking characteristics. Absorption and penetration of electron radiation and gamma radiation differ, potentially leading to higher degrees of cross-linking for electron radiation. There is a non-linear, inverse correlation between TVI and in vitro wear. The wear resistance of the HXLPE with low TVI was reduced and more comparable to CPE. Cite this article: Bone Joint Res 2024;13(11):682–693.https://online.boneandjoint.org.uk/doi/epdf/10.1302/2046-3758.1311.BJR-2024-0203.R1polyethylenecross-linkingtrans-vinylene indexpin-on-diskweartvipolyethylenesacetabular linershighly cross-linked polyethylene (hxlpe)cross-linking of the polyethylenetotal hip arthroplasty (tha)spectrometryacetabular cupspolyethylene cupst-testpearson correlation coefficient
spellingShingle Peter Wahl
Roman Heuberger
Andrea Pascucci
Thomas Imwinkelried
Markus Fürstner
Niels Icken
Michel Schläppi
Robin Pourzal
Emanuel Gautier
Correlation of cross-linking as measured by the trans-vinylene index and in vitro wear of polyethylene from various acetabular liner brands
Bone & Joint Research
polyethylene
cross-linking
trans-vinylene index
pin-on-disk
wear
tvi
polyethylenes
acetabular liners
highly cross-linked polyethylene (hxlpe)
cross-linking of the polyethylene
total hip arthroplasty (tha)
spectrometry
acetabular cups
polyethylene cups
t-test
pearson correlation coefficient
title Correlation of cross-linking as measured by the trans-vinylene index and in vitro wear of polyethylene from various acetabular liner brands
title_full Correlation of cross-linking as measured by the trans-vinylene index and in vitro wear of polyethylene from various acetabular liner brands
title_fullStr Correlation of cross-linking as measured by the trans-vinylene index and in vitro wear of polyethylene from various acetabular liner brands
title_full_unstemmed Correlation of cross-linking as measured by the trans-vinylene index and in vitro wear of polyethylene from various acetabular liner brands
title_short Correlation of cross-linking as measured by the trans-vinylene index and in vitro wear of polyethylene from various acetabular liner brands
title_sort correlation of cross linking as measured by the trans vinylene index and in vitro wear of polyethylene from various acetabular liner brands
topic polyethylene
cross-linking
trans-vinylene index
pin-on-disk
wear
tvi
polyethylenes
acetabular liners
highly cross-linked polyethylene (hxlpe)
cross-linking of the polyethylene
total hip arthroplasty (tha)
spectrometry
acetabular cups
polyethylene cups
t-test
pearson correlation coefficient
url https://online.boneandjoint.org.uk/doi/epdf/10.1302/2046-3758.1311.BJR-2024-0203.R1
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