北京生物医学工程

维生素E稳定型高交联聚乙烯人工关节磨损及磨屑的研究进展

Wear and debris of vitamin E stabilized highly cross-linked polyethylene artificial joint: review

作者：冯景李春亚黄秀玲华子恺

单位：上海大学机电工程与自动化学院(上海 200444)<br />通信作者：李春亚。E-mail: lichunya@shu.edu.cn

分类号：R318.08

出版年·卷·期（页码）：2022·41·6（645-651）

摘要：

近年来，添加了抗氧化剂维生素E的维生素E稳定型高交联聚乙烯（vitamin E stabilized highly cross-linked polyethylene,VE/HXLPE）成为了一种继普通超高分子量聚乙烯（ultra high molecular weight polyethylene, UHMWPE）和高交联聚乙烯（highly cross-linked polyethylene, HXLPE）的新一代聚合物类生物材料，已被应用于人工关节置换术中。目前，针对VE/HXLPE型人工关节磨损及磨屑的研究缺少系统总结，因此本文调研了近10年的相关文献，综述VE/HXLPE型人工关节在体外与临床的磨损及磨屑的研究进展，为其应用提供一定的参考和指导。

Conventional ultra high molecular weight polyethylene (UHMWPE) and highly cross-linked polyethylene (HXLPE) are the most widely utilized bearing surfaces in total joint arthroplasty. Vitamin E stabilized highly cross-linked polyethylene (VE/HXLPE) has recently been in clinical use. At present, there is no systematic summary of the wear and debris of VE/HXLPE artificial joint. Based on relevant literature in the past decade, this review focuses on wear performance and debris characterization of VE/HXLPE artificial joint in vitro and clinically, providing some references for the development of artificial joint industry.

参考文献：

[1] Devane PA, Horne JG, Ashmore A, et al. Highly cross-linked polyethylene reduces wear and revision rates in total hip arthroplasty: a 10-year double-blinded randomized controlled trial[J]. The Journal of Bone and Joint Surgery, 2017, 99(20): 1703-1714.
[2] 陈煜, 刘洋, 李鹏, 等. 北京市医用高分子材料在医疗器械产业发展中的现状调研[J].北京生物医学工程, 2017, 36(5): 495-501, 512.
Chen Y, Liu Y, Li P, et al. Investigation on the current development situation of the medical polymers in Beijing medical devices industry[J]. Beijing Biomedical Engineering, 2017,36(5): 495-501, 512.
[3] Hopper Jr RH, Ho H, Sritulanondha S, et al. Otto Aufranc Award: crosslinking reduces THA wear, osteolysis, and revision rates at 15-year followup compared with noncrosslinked polyethylene[J]. Clinical Orthopaedics and Related Research, 2018, 476(2): 279-290.
[4] 咸杰, 何本祥. 维生素E稳定型交联超高分子量聚乙烯在骨关节置换中的研究进展[J]. 中国组织工程研究, 2016, 20(31): 4707-4712.
Xian J, He BX. Vitamin E-stabilized ultrahigh molecular weight polyethylene in joint replacement[J]. Chinese Journal of Tissue Engineering Research, 2016, 20(31): 4707-4712.
[5] Oral E, Christensen S, Malhi A, et al. Wear resistance and mechanical properties of highly cross-linked, ultrahigh-molecular weight polyethylene doped with vitamin E[J]. The Journal of Arthroplasty, 2006, 21(4): 580-591.
[6] Halma JJ, Se?aris J, Delfosse D, et al. Edge loading does not increase wear rates of ceramic-on-ceramic and metal-on-polyethylene articulations[J]. Journal of Biomedical Materials Research. Part B, Applied Biomaterials, 2014, 102(8): 1627-1638.
[7] Affatato S, Freccero N, Taddei P. The biomaterials challenge: a comparison of polyethylene wear using a hip joint simulator[J]. Journal of the Mechanical Behavior of Biomedical Materials, 2016, 53: 40-48.
[8] Affatato S, Bracco P, Luigi C, et al. In vitro wear performance of standard, crosslinked, and vitamin-E-blended UHMWPE[J]. Journal of Biomedical Materials Research. Part A, 2012,100(3): 554-560.
[9] Oral E, Beckos CG, Malhi AS, et al. The effects of high dose irradiation on the cross-linking of vitamin E-blended ultrahigh molecular weight polyethylene[J]. Biomaterials, 2008, 29(26): 3557-3560.
[10] Popoola O, Orozco Villasenor D, Fryman J, et al. High cycle in vitro hip wear of and in vivo biological response to vitamin E blended highly crosslinked polyethylene[J]. Biotribology, 2018,16:10-16.
[11] Grupp TM, Holderied M, Mulliez MA, et al. Biotribology of a vitamin E-stabilized polyethylene for hip arthroplasty – Influence of artificial ageing and third-body particles on wear[J]. Acta Biomaterialia, 2014, 10(7): 3068-3078.
[12] Haider H, Weisenburger J, Kurtz S, et al. Does vitamin E-stabilized ultrahigh-molecular-weight polyethylene address concerns of cross-linked polyethylene in total knee arthroplasty?[J]. The Journal of Arthroplasty, 2011, 27(3): 461-469.
[13] Micheli B, Wannomae K, Lozynsky A, et al. Knee simulator wear of vitamin E stabilized irradiated ultrahigh molecular weight polyethylene[J]. The Journal of Arthroplasty, 2011, 27(1): 95-104.
[14] Wannomae K, Christensen SD, Micheli BR, et al. Delamination and adhesive wear behavior of α-tocopherol-stabilized irradiated ultrahigh-molecular-weight polyethylene[J]. The Journal of Arthroplasty, 2010,25(4): 635-643.
[15] Grupp TM, Fritz B, Kutzne I, et al. Vitamin E stabilised polyethylene for total knee arthroplasty evaluated under highly demanding activities wear simulation[J]. Acta Biomaterialia, 2017, 48: 415-422.
[16] Vaidya C, Alvarez E, Vinciguerra J, et al. Reduction of total knee replacement wear with vitamin E blended highly cross-linked ultra-high molecular weight polyethylene[J]. Proceedings of the Institution of Mechanical Engineers. Part H, Journal of Engineering in Medicine, 2011, 225(1): 1-7.
[17] Wernle JD, Mimnaugh KD, Rufner AS, et al. Grafted vitamin-E UHMWPE may increase the durability of posterior stabilized and constrained condylar total knee replacements[J]. Journal of Biomedical Materials Research. Part B, Applied Biomaterials, 2017, 105(7): 1789-1798.
[18] Rowell S, Muratoglu O. Investigation of surgically retrieved, vitamin E-stabilized, crosslinked UHMWPE implants after short-term in vivo service: short-term oxidative resistance in vitamin E-diffused UHMWPE retrievals[J]. Journal of Biomedical Materials Research. Part B, Applied Biomaterials, 2015, 104(6): 1132-1140.
[19] Greenbaum E, Muratoglu O, Burroughs B, et al. Lipid absorption into conventional and highly crosslinked UHMWPE: an in vitro model[C]//48th Annual Meeting of the Orthopaedic Research Society. Dallas, TX, USA: Orthopaedic Research Society, 2002: 1028.
[20] Bergvinsson H, Zampelis V, Sundberg M, et al. Vitamin E infused highly cross-linked cemented cups in total hip arthroplasty show good wear pattern and stabilize satisfactorily: a randomized, controlled RSA trial with 5-year follow-up[J]. Acta orthopaedica,2022,93:249-255.
[21] Rochcongar G, Remazeilles M, Bourroux E, et al. Reduced wear in vitamin E-infused highly cross-linked polyethylene cups: 5-year results of a randomized controlled trial[J]. Acta Orthopaedica, 2020, 92(2): 151-155.
[22] Massier J, van Erp J, Snijders T, et al. A vitamin E blended highly cross-linked polyethylene acetabular cup results in less wear: 6-year results of a randomized controlled trial in 199 patients[J]. Acta Orthopaedica, 2020, 91(6): 705-710.
[23] Galea VP, Rojanasopondist P, Laursen M, et al. Evaluation of vitamin E-diffused highly crosslinked polyethylene wear and porous titanium-coated shell stability: a seven-year randomized control trial using radiostereometric analysis[J]. The Bone & Joint Journal, 2019, 101-B(7): 760-767.
[24] Busch A, J?ger M, Klebingat S, et al. Vitamin E-blended highly cross-linked polyethylene liners in total hip arthroplasty: a randomized, multicenter trial using virtual CAD-based wear analysis at 5-year follow-up[J]. Archives of Orthopaedic and Trauma Surgery, 2020, 140(12): 1859-1866.
[25] Kjrgaard K, Ding M, Jensen C, et al. Vitamin E-doped total hip arthroplasty liners show similar head penetration to highly cross-linked polyethylene at five years: a multi-arm randomized controlled trial[J]. ?Bone and Joint Journal, 2020, 102-B(10): 1303-1310.
[26] Thoen PS, Nordsletten L, Pripp AH, et al. Results of a randomized controlled trial with five-year radiostereometric analysis results of vitamin E-infused highly crosslinked versus moderately crosslinked polyethylene in reverse total hip arthroplasty[J]. The Bone & Joint Journal, 2020, 102-B(12): 1646-1653.
[27] Dumbleton J, Manley M, Edidin A. A literature review of the association between wear rate and osteolysis in total hip arthroplasty[J]. The Journal of Arthroplasty, 2002,17(5): 649-661.
[28] Leramura S, Sakoda H, Terao T, et al. Reduction of wear volume from accelerated aged UHMWPE knee components by the addition of vitamin E[J]. Journal of Biomechanical Science and Engineering, 2009, 4(4): 589-596.
[29] Teramura S, Sakoda H, Terao T, et al. Reduction of wear volume from ultrahigh molecular weight polyethylene knee components by the addition of vitamin E[J]. Journal of Orthopaedic Research, 2008, 26(4): 460-464.
[30] Bichara DA, Malchau E, Sillesen NH, et al. Vitamin E-diffused highly cross-linked UHMWPE particles induce less osteolysis compared to highly cross-linked virgin UHMWPE particles in vivo[J]. The Journal of Arthroplasty, 2014, 29(9 Suppl): 232-237.
[31] Galliera E, Ragone V, Marazzi MG, et al. Vitamin E-stabilized UHMWPE: biological response on human osteoblasts to wear debris[J]. Clinica Chimica Acta: International Journal of Clinical Chemistry and Applied Molecular Biology, 2018, 486: 18-25.
[32] Bladen C, Teramura S, Russell S, et al. Analysis of wear, wear particles, and reduced inflammatory potential of vitamin E ultrahigh-molecular-weight polyethylene for use in total joint replacement[J]. Journal of Biomedical Materials Research. Part B, Applied Biomaterials, 2013,101(3): 458-466.
[33] Orita K, Minoda Y, Sugama R, et al. Vitamin E-infused highly cross-linked polyethylene did not reduce the number of in vivo wear particles in total knee arthroplasty[J]. The Bone & Joint Journal, 2020,102-B(11): 1527-1534.
[34] Kobayashi A, Freeman MA, Bonfield W, et al. Number of polyethylene particles and osteolysis in total joint replacements. A quantitative study using a tissue-digestion method[J]. The Journal of Bone and Joint Surgery. British Volume, 1997, 79(5): 844-848.

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