Polyethylene
Chemistry & Manufacture
- Basic Monomer: C2H4
- Manufactured by the Ziegler process:
- Ethylene gas is polymerized into a repeating chain through addition polymerization.
- Low temperature and low pressure conditions produce Polyethylene powder.
- Adjacent chains are held together by Van der Waals forces, resulting in High Density Polyethylene (HDP).
Polyethylene Architecture
Polyethylene consists of different structural areas: - Crystalline: Organized 3D patterns of chains. - Amorphous: Random entanglement of chains, offering: - More wear resistance. - A tendency to cross-link.
How to Increase Polyethylene Strength
- Increasing the number of chains (molecular weight).
- Creating cross-links between chains.
- Reducing crystallinity.
- Manufacturing method.
- Sterilization method.
- Storage method.
- Removing un-cross-linked free radicals.
- Longer chains lead to a greater proportion of amorphous areas, enhancing strength and wear resistance.
- This forms the basis for UHMWPE (Ultra High Molecular Weight Polyethylene):
- Increased chain length.
- Increased number of chains.
- Increased proportion of amorphous areas.
Cross-linking, Sterilization, and Storage
- Sterilization Methods:
- Traditionally via gamma irradiation in air.
- Radiation encourages cross-linking between polyethylene chains.
Effects of Oxidation
- Oxidation Issues:
- Degrades polyethylene, reducing wear properties due to less cross-linking and a higher proportion of crystalline areas.
- Occurs mainly within the subsurface white band (1-2 mm).
Reasons for Oxidation
- Polyethylene is sterilized in air or oxygen.
- Oxygen seeps into packaging over time (shelf life > 2 years).
- In vivo: Some degree of oxidation occurs naturally after implantation (minimal as synovial fluid has low oxygen content).
Better Sterilization Methods
- Gas plasma or ethylene oxide sterilization (no radiation) minimizes oxidation.
- Gamma irradiation in inert gas (argon or nitrogen) or in a vacuum is preferred.
Highly Cross-linked UHMWPE
- Made through prolonged irradiation, resulting in:
- Increased stiffness and hardness.
- Increased wear resistance.
Concerns with Highly Cross-linked Polyethylene
- Reduced fatigue resistance.
- Reduced fracture toughness (UTS).
- Risk in total knee replacements (TKR) due to fatigue fractures rather than wear.
Methods of Removing Residual Free Radicals
- Annealing:
- Heating to above or just below the melting point removes residual free radicals, reducing in vitro or shelf life oxidation.
- Prolonged annealing alters mechanical properties.
- Adding Vitamin E:
- Scavenges free radicals and may prevent long-term oxidation while in situ.
- X3 Poly:
- A modern type of highly cross-linked polyethylene produced by 3 short cycles of irradiation and annealing.
- Exhibits high wear resistance with minimal in vivo alterations in mechanical properties.
Polyethylene Manufacturing Methods
- RAM Bar Extrusion:
- Traditional method where a cylindrical ‘bar’ of polyethylene is machined into individual implants.
- Variability in properties based on the location in the bar.
- Addition of Calcium Stearate:
- Prevents yellowing and corrosion, but can lead to fusion defects and worse wear properties.
- Compression Moulding:
- Polyethylene produced in individual blocks, then machined to create the implant.
- Better than RAM bar extrusion but can produce sharp edges and stress risers.
- Direct Compression Moulding:
- The current gold standard, directly compressing polyethylene powder into pre-made molds of implants without further machining or additives.
- The final implant is irradiated to promote cross-linking.