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E-MAX Highly Crosslinked Polyethylene

E-MAX is a step forward in the evolution of highly crosslinked polyethylene (XLPE) for orthopedic total joint bearing surfaces.

  • Highly crosslinked
    • A proven strategy for reducing in vivo wear [1-10]
  • Mechanically annealed
    • Eliminates* free radicals without the problems of melting [11,12]
  • Vitamin E blended
    • Intended to provide oxidative stability over time in vivo [12,13]

Like first-generation XLPE, E-MAX is highly crosslinked to reduce wear. However, E-MAX incorporates two new technologies—mechanical-anneal and Vitamin E—which address known problems with melt-annealed XLPE. Laboratory tests have verified the superior oxidative stability and improved tensile strength and toughness of E-MAX.[14,15]

Learn more about the E-MAX for Hip and E-MAX for Knee.

*Free radicals are eliminated to a level at or near the detection limit of ESR measurement equipment.

  1. Kurtz S, Medel FJ, MacDonald D, Rimnac CM. In vivo oxidation, oxidation potential, and clinical performance of highly crosslinked UHMWPEs implanted for up to 8 years. 4th International Meeting UHMWPE for arthroplasty: From Powder to Debris 2009; Torino, Italy.
  2. Digas G, Karrholm J, Thanner J, Herberts P. 5-year experience of highly cross-linked polyethylene in cemented and uncemented sockets: Two randomized studies using radiostereometric analysis. Acta Orthop 2007; 78(6): 746-54.
  3. D’Antonio JA, Manley MT, Capello WN, et al. Five-year experience with Crossfire highly cross-linked polyethylene. Clin Orthop Relat Res 2005; 441: 143-50.
  4. Engh CA, Stepniewski AS, Ginn SD, et al. A randomized prospective evaluation of outcomes after total hip Arthroplasty using crosslinked marathon and non-cross-linked Enduron polyethylene liners. J Arthroplasty 2006; 21(6): 17-25.
  5. Olyslaegers C, Defoort K, Simon JP, Vandenberghe L. Wear in conventional and highly cross-linked polyethylene cups: a 5-year follow-up study. J Arthroplasty 2008; 23(4): 489-94.
  6. Garcia-Rey E, Garcia-Cimbrelo E, Cruz-Pardos A, Ortega-Chamarro J. New polyethylenes in total hip replacement: a prospective, comparative clinical study of two types of liner. J Bone Joint Surg Br 2008; 90(2): 149-53.
  7. Geerdink CH, Grimm B, Vencken W, Heyligers IC, Tonino AJ. Cross-linked compared with historical polyethylene in THA: An 8-year clinical study. Clin Orthop Relat Res 2009; 467(4): 979-84.
  8. Glyn-Jones S, Isaac S, Hauptfleisch J, McLardy-Smith P, Murray DW, Gill HS. Does highly cross-linked polyethylene wear less than conventional polyethylene in total hip arthroplasty? A doubleblind, randomized, and controlled trial using roentgen stereophotogrammetric analysis. J Arthroplasty 2008; 23(3): 337-43.
  9. Kurtz SM, Medel FJ, MacDonald DW, Parvizi J, Kraay MJ, Rimnac CM. Reasons for revision of first-generation highly cross-linked polyethylenes. J Arthroplasty. 2010 Sep;25(6 Suppl):67-74.
  10. Kurtz SM. Chapter 8 The clinical performance of UHMWPE in knee replacements. In UHMWPE Biomaterials Handbook Second Edition (ed. Kurtz SM). Elsevier: Amsterdam, 2009.
  11. Bhattacharyya S, Matrisciano L, Spiegelberg S, Harris W, Muratoglu O. Mechanical elimination of residual free radicals in an irradiated UHMWPE rod: advantages over melting. 50th annual meeting of the orthopaedic research society. 2004:1474.
  12. Wannomae KK, Micheli BR, Lozynsky AJ, Muratoglu OK. A New Method of Stabilizing Irradiated UHMWPE Using Vitamin E and Mechanical Annealing. 11th Congress EFFORT. Madrid, Spain. June 2010.
  13. Costa L, Bracco P. Chapter 21 Mechanisms of crosslinking, oxidative degradation, and stabilization of UHMWPE. In UHMWPE Biomaterials Handbook Second Edition (ed. Kurtz SM). Elsevier: Amsterdam, 2009.
  14. Materials Characterization testing. Test report TP0322. On file with KYOCERA Medical Technologies, Inc.
  15. Cambridge Polymer Group. Analysis of CIMA and E-CIMA Material. Test report dated July 15, 2011. On file with KYOCERA Medical Technologies, Inc.