Six decades of UHMWPE in reconstructive surgery

ABSTRACT

Ultra-high molecular weight polyethylene (UHMWPE) materials have played a significant role in the field of reconstructive surgery, particularly as acetabular liners/sockets for total hip joint replacement (THR), and tibial inserts for total knee joint replacement (TKR). This review aims to provide a perspective on key elements regarding the processing–structure–property relationship of UHMWPE and derivatives. Much emphasis will be provided to discuss the clinically relevant properties of UHMWPE blend/composite formulation, Vitamin-E reinforced or highly crosslinked variants. In addition, we provide clinical insights into the role of wear debris in inflammation and osteolysis. The relatively unexplored domain of UHMWPE additive manufacturing. Finally, the relatively unexplored domain of UHMWPE additive manufacturing and the opportunities associated with the next generation of UHMWPE implants are highlighted.

GRAPHICAL ABSTRACT

KEYWORDS:

• UHMWPE
• osteolysis
• aseptic loosening
• additive manufacturing
• implant failure
• biological response
• processing

Acknowledgements

The authors acknowledge the Department of Biotechnology (DBT), [Ministry of Science & Technology, Govt. of India] through the programme, ‘Programme support on translational research on biomaterials for orthopedic and dental applications’ (No. BT/PR13466/COE/34/26/2015). We would also like to acknowledge the Science and Engineering Research board (SERB) for an ongoing IMPRINT project (IMP/2018/000622) and the Abdul Kalam National Innovation Fellowship (Sp/INAE-19-0001) funded by the Department of Science and Technology (Government of India) and the Indian National Academy of Engineering. The funding sources had no involvement in design, writing, data interpretation and the decision to submit this manuscript for publication.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This work was supported by Department of Science and Technology, Ministry of Science and Technology [grant number IMP/2018/000622], Government of India; Department of Biotechnology, Ministry of Science & Technology, Government of India [grant number BT/PR13466/COE/34/26/2015], through the programme ‘Programme support on translational research on biomaterials for orthopedic and dental applications’.