Material properties of ultra-high molecular weight polyethylene: Comparison of tension, compression, nanomechanics and microstructure across clinical formulations.

This is the first study to simultaneously measure material properties in tension, compression, nanoindentation as well as microstructure (crystallinity and lamellar level properties) across a wide variety of clinically relevant ultra-high molecular weight polyethylene (UHMWPE) formulations. Methodologies for the measurement of UHMWPE mechanical properties-namely elastic modulus, yield stress, yield strain, ultimate strength, energetic toughness, Poisson's ratio, hardness and constitutive variables-are evaluated. Engineering stress-strain behavior is compared to true stress-strain behavior for UHMWPE across a range of cross-linking and antioxidant chemistry. The tensile mechanical properties and constitutive behavior of UHMWPE are affected by resin type, antioxidant source and degree of cross-linking. Poisson's ratio is shown to be affected by resin type, antioxidant addition, and cross-linking dosage. Relationships between bulk mechanical properties from different measurement methodologies as well as microstructure are analyzed across all material formulations using Spearman rank correlation coefficients. Modulus and yield strength correlate in both tension and compression. Similarly, tensile and compressive properties including modulus and yield strength correlate strongly with crystallinity (Xc) and lamellar thickness (D). This work has broad application and provides a basis for interpreting the mechanical behavior of UHMWPE used in orthopedic implants.

Analysis of severely fractured glenoid components: clinical consequences of biomechanics, design, and materials selection on implant performance.

BACKGROUND: The longevity of total shoulder replacement is primarily limited by the performance of the ultrahigh-molecular-weight polyethylene (UHMWPE) glenoid component in vivo. Variations in glenoid design (conformity, thickness), biomechanics (joint kinematics), and UHMWPE material selection (sterilization, cross-linking) distinguish total shoulder replacements from hip and knee arthroplasty devices. These variables can lead to severe mechanical failures, including gross fracture. METHODS: Sixteen retrieved glenoids with severe fracture were analyzed. The explant cohort included 3 material groups (gamma-sterilized Hylamer; gamma-sterilized UHMWPE; and gas plasma-sterilized, remelted, highly cross-linked UHMWPE [HXL]) and a range of conformities (0- to 10-mm radial mismatch). Analysis included fractography (optical and scanning electron microscopy) and Fourier transform infrared spectroscopy for oxidative analysis. RESULTS: Fracture primarily occurred along the exterior rim for all 16 explants. Fourier transform infrared analysis and fractography revealed significant oxidative embrittlement for all gamma-sterilized glenoids. Fatigue striations and internal flaws were evident on the fracture surface of the HXL glenoid, with little oxidation detected. CONCLUSIONS: Fracture initiated at the external rim of all devices. Elevated oxidation levels and visible material distortion for representative gamma-sterilized conventional and Hylamer devices suggest oxidative embrittlement as a driving force for crack inception and subsequent fracture. Brittle fracture of theHXL glenoid resulted from a combination of elevated contact stress due to a nonconforming surface, an internal flaw, and reduced resistance to fatigue crack growth. This demonstrates that glenoid fracture associated with oxidation has not been eliminated with the advent of modern materials (HXL) in the shoulder domain. LEVEL OF EVIDENCE: Basic Science Study; Implant Retrieval Study.