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J Biomed Mater Res B Appl Biomater. 2017 Oct;105(7):1789-1798. doi: 10.1002/jbm.b.33710. Epub 2016 May 18.

Grafted Vitamin-E UHMWPE may increase the durability of posterior stabilized and constrained condylar total knee replacements.

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Zimmer Biomet, Inc., Warsaw, Indiana.
Center for Arthritis Surgery, Hospital Sainte-Marguerite, Aix-Marseille University, Marseille, France.
Hackensack University Medical Center, Hackensack, New Jersey.


The suitability of grafted vitamin-E highly crosslinked polyethylene (VE-HXPE) for use in posterior stabilized (PS) and constrained condylar knee (CCK) applications has not been explored. We hypothesized that VE-HXPE performs better than conventional and crosslinked polyethylene under clinically relevant conditions. PS tibial post fracture resistance under adverse shear loading conditions, CCK tibial post resistance to torsional fatigue, delamination resistance under high stress, and wear resistance were evaluated. Grafted VE-HXPE exhibits (1) 10% and 57% improved PS post fatigue strength compared to conventional PE (CPE) and remelted HXPE; (2) 45% improved CCK post fatigue strength compared to CPE; (3) Greater than 36× the delamination resistance of CPE; and (4) 96% and 73% wear reduction compared to CPE and HXPE. VE-HXPE performed well under clinically relevant in vitro conditions.


UHMWPE; Vitamin E; delamination; fracture; total knee replacements; wear

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