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Aspherical Femoral Head with Highly Cross-Linked Ultra-High Molecular Weight Polyethylene Surface CrackingA Case Report
Jevan Furmanski, MS1; Shikha Gupta, BS; Arun Chawan, MS1; Andrew Kohm, PhD2; John Lannutti, PhD3; Brian Jewett, MD4; Lisa A. Pruitt, PhD1; Michael D. Ries, MD5
1 Department of Mechanical Engineering (J.F., A.C., and L.A.P.) and Applied Science and Technology (S.G.), University of California, Berkeley, 2121 Etcheverry Hall, Berkeley, CA 94720
2 Research and Development, Kyphon Corporation, 1221 Crossman Avenue, Sunnyvale, CA 94089
3 Department of Materials Science and Engineering, Ohio State University, 477 Watts Hall, 2041 College Road, Columbus, OH 43210
4 Orthopaedic Healthcare Northwest, 1200 Hilyard Street, Suite 600, Eugene, OR 97401
5 Department of Orthopedic Surgery, University of California, 500 Parnassus Avenue, MU-320 West, San Francisco, San Francisco, CA 94143. E-mail address: riesm@orthosurg.ucsf.edu
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Disclosure: The authors did not receive any outside funding or grants in support of their research for or preparation of this work. Neither they nor a member of their immediate families received payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity. No commercial entity paid or directed, or agreed to pay or direct, any benefits to any research fund, foundation, division, center, clinical practice, or other charitable or nonprofit organization with which the authors, or a member of their immediate families, are affiliated or associated.
Investigation performed at the University of California at Berkeley, Berkeley, California

The Journal of Bone and Joint Surgery, Incorporated
J Bone Joint Surg Am, 2007 Oct 01;89(10):2266-2270. doi: 10.2106/JBJS.F.00428
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Hip simulator and early clinical studies of highly cross-linked ultra-high molecular weight polyethylene have demonstrated less wear and less femoral head penetration when compared with conventional ultra-high molecular weight polyethylene1-6. However, cross-linking also alters some of the mechanical properties of ultra-high molecular weight polyethylene, including its ultimate tensile strength, strain to failure, fracture toughness, and fatigue crack propagation resistance7-9. Analyses of early retrieved highly cross-linked components have shown initiation of surface cracking, which is possibly related to the decrease in ductility caused by cross-linking10. A reduction in ductility, fracture, and fatigue properties is the hallmark of material embrittlement. Accordingly, newer so-called second-generation highly cross-linked polyethylenes have been developed in an effort to better retain the desirable mechanical properties of conventional ultra-high molecular weight polyethylene as well as the benefits of cross-linking11.
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    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
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