In the 1990s, polyethylene was widely regarded as the "villain"
in total joint arthroplasty, largely due to its prominent role in aseptic
loosening and periprosthetic osteolysis, the most common causes for implant
failure. In this book, Dr. Steven Kurtz reminds us that ultra-high molecular
weight polyethylene (UHMWPE) is truly a remarkable material, the use of which
in total joint arthroplasty has revolutionized the treatment of end-stage
joint disease. In fact, polyethylene currently dominates the market for
bearing surfaces in hip arthroplasty and is universally used in total knee
arthroplasty. This is likely to be the case for the foreseeable future.
The UHMWPE Handbook is a comprehensive yet concise presentation of
the important role that polyethylene has played and continues to play in the
treatment armamentarium of the orthopaedic surgeon. The comprehensiveness of
this volume is evidenced by the broad range of topics addressed—from the
history of the clinical introduction and clinical performance of ultra-high
molecular weight polyethylene in hip and knee arthroplasty to the complexities
of polyethylene synthesis and processing, resin nomenclature, material
degradation, analytic modeling, biomechanical and structural characterization,
and currently available highly cross-linked products. Even though each one of
these topics could not be dealt with in great depth, the breadth of the
subject matter gives the reader an excellent overview of the field that will
stimulate further reading and research. One subject that is not discussed in
detail is in vitro wear simulation. Although this is a complex topic, some
discussion of the current state of the art of wear simulation would have been
a useful adjunct to this otherwise comprehensive text.
The author, Steven Kurtz, PhD, is a polymer materials scientist who is a
well-recognized international authority on ultra-high molecular weight
polyethylene. He has an excellent command of the subject matter because he is
involved in both basic and clinical ultra-high molecular weight polyethylene
research. Since Dr. Kurtz has written most of the chapters, there is a
consistent writing style with little redundancy. The author has sought the
assistance of his expert colleagues in certain highly technical areas,
providing an authoritative source for topics such as small punch testing,
oxidative degradation, and computer modeling. Clinicians will be able to read
most of the chapters easily; however, a background in mechanical engineering
and materials science would be very helpful in reading the highly technical
material covered in some of the chapters. Particularly interesting to this
reader was the original material tracing the history of the development of
polyethylene in total knee arthroplasty. Much of this information has not been
published and was gathered by personal interviews of the individuals involved
at the earliest stages of the development process.
Portions of this book will be of great interest to orthopaedic residents
and orthopaedic surgeons, providing them with a basic framework to understand
the performance of ultra-high molecular weight polyethylene in a variety of
clinical settings, including arthroplasty of the hip, knee, shoulder, and
disc. This book should be read by individuals who are involved in clinical and
basic research concerning polyethylene performance as well as by biomedical
engineering trainees who intend to pursue a career in the orthopaedic device
industry. The author and his colleagues are to be commended for compiling this
information and producing an authoritative and useful resource for our
specialty.