UHMWPE in total knee arthroplasty: successes and failures
DOI:
https://doi.org/10.17533/udea.rcm.n16a01Palabras clave:
polietileno de ultra alto peso molecular (UHMWPE), desgaste de UHMWPE, materiales compuestos de UHMWPE, reemplazo total de rodillaResumen
El polietileno de ultra alto peso molecular (UHMWPE por sus siglas en inglés) ha sido el estándar de oro para los reemplazos de rodilla durante más de cinco décadas. Este biomaterial, utilizado ampliamente en el sector ortopédico, ha sido constantemente modificado para disminuir su tasa de desgaste en las prótesis de rodilla. Hoy en día, los reemplazos totales de rodilla tienen una tasa de supervivencia del 95 % después de 10 años, 88.7 % después de 15, y 82 % después de 25 años. Sin embargo, la vida útil del componente de UHMWPE a menudo se limita entre los 15 a 20 años, ya que el daño por desgaste de las superficies del UHMWPE es inevitable. En pacientes más jóvenes y más activos, el desgaste puede acelerarse, generando una cantidad considerable de partículas y provocando una falla prematura. Se han reportado reacciones adversas en el tejido circundante de la articulación de la rodilla debido a la presencia de estas partículas, especialmente en el rango de 0.3 to 2 μm, que a menudo conducen a un aflojamiento aséptico inducido por osteólisis. Las investigaciones se han centrado en mejorar la resistencia al desgaste y el rendimiento del UHMWPE. En este trabajo, se analiza el comportamiento de desgaste y el rendimiento clínico del UHMWPE desde el punto de vista de la ciencia de los materiales, así como las modificaciones existentes para mejorar la resistencia al desgaste de este polímero; la reticulación mediante irradiación gamma, la estabilización de vitamina E y la incorporación de diferentes nanopartículas.
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