{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,23]],"date-time":"2026-08-23T16:04:31Z","timestamp":1787501071923,"version":"build-2736575974"},"reference-count":52,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2025,8,26]],"date-time":"2025-08-26T00:00:00Z","timestamp":1756166400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Biomed Mater Res"],"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Joint arthroplasty bearing materials must maintain a balance between wear resistance, toughness, and oxidation resistance. Antioxidant\u2010doped polyethylene has been introduced to stabilize free radicals resulting from the cross\u2010linking process while avoiding mechanical property losses associated with previous generations of highly cross\u2010linked polyethylene. Furthermore, the antioxidant should prevent or greatly reduce oxidation occurring in\u00a0vivo. The purpose of this study is to understand the extent to which retrieved, antioxidant\u2010doped UHMWPE devices exhibit chemical and microstructural signs of oxidation. A group of 261 antioxidant knee bearings from an IRB\u2010approved retrieval database were assessed for oxidation and microstructural changes that would be expected with oxidation. Three different antioxidant materials were included in this study, including diffused vitamin E (VE\u2010D), blended vitamin E (VE\u2010B) and pentaerythritol tetrakis[3\u2010(3,5\u2010 di\u2010tert\u2010butyl\u20104\u2010hydroxyphenyl)] propionate (PBHP), with an emphasis on the latter. Ketone oxidation index (KOI) and crystallinity were assessed for all materials, while crosslink density was assessed for the PBHP materials. In\u00a0vivo durations were 0\u2013107\u2009months, making this the largest and longest known study of antioxidant efficacy in retrieved devices. Increases to KOI with in\u00a0vivo duration were minimal, with nearly all values remaining below 0.2 out to the maximum duration observed. These increases were largely attributed to the presence of absorbed species near the material surface, where maximum KOI occurred in most devices. Microstructural changes typically associated with oxidation did not yield any meaningful changes, indicating that polymer degradation is not occurring in these materials to any significant extent. Subsurface KOI peaks were noted in five devices, suggesting that small amounts of polymer oxidation may develop in these materials given the right conditions. However, unlike subsurface ketone peaks associated with oxidation in previous generations of UHMWPE, these were very small and pose no threat to the mechanical properties of the materials. In retrievals evaluated to date, all antioxidant formulations appear to be effectively controlling in\u00a0vivo oxidation. Small amounts of polymer oxidation observed in several devices are not likely to have clinical relevance. Continued monitoring over the long term will be necessary to ensure this remains the case.<\/jats:p>","DOI":"10.1002\/jbm.b.35627","type":"journal-article","created":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T03:58:54Z","timestamp":1756267134000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Antioxidant Performance in\n                    <scp>UHMWPE<\/scp>\n                    Knee Bearings: A Mid\u2010Term Retrieval Report"],"prefix":"10.1002","volume":"113","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2688-8453","authenticated-orcid":false,"given":"Peder","family":"Solberg","sequence":"first","affiliation":[{"name":"Thayer School of Engineering  Hanover New Hampshire USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kori","family":"Jevsevar","sequence":"additional","affiliation":[{"name":"Thayer School of Engineering  Hanover New Hampshire USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barbara","family":"Currier","sequence":"additional","affiliation":[{"name":"Thayer School of Engineering  Hanover New Hampshire USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander","family":"Orem","sequence":"additional","affiliation":[{"name":"Dartmouth Hitchcock Medical Center, One Medical Center Drive  Lebanon New Hampshire USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Jevsevar","sequence":"additional","affiliation":[{"name":"OrthoVirginia  Richmond Virginia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Douglas","family":"Van Citters","sequence":"additional","affiliation":[{"name":"Thayer School of Engineering  Hanover New Hampshire USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,8,26]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.biomaterials.2010.05.041"},{"key":"e_1_2_10_3_1","first-page":"46","article-title":"The Problem Is Osteolysis","volume":"311","author":"Harris W. 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