Observation on retrieved Hylamer glenoids in shoulder arthroplasty: Problems associated with sterilization by gamma irradiation in air

Hylamer is an ultra-high molecular weight polyethylene that was used in the glenoid prosthesis of the Global Shoulder. It was developed from a joint venture with DePuy Orthopaedics, Inc, and E.I. DuPont Company. In presterilization evaluations it was noted to have improved mechanical strength with superior creep and wear resistance. However, after sterilization was performed with gamma irradiation in an air environment from 1990 to 1993, the Hylamer glenoids were affected by oxidation, which altered the mechanical properties, and they became brittle and eroded. From 1993 to 1995 Hylamer glenoids were sterilized by gamma irradiation in a nitrogen environment. From 1995 to 1998 sterilization was by gas plasma processes, which do not create the oxidation problem. Since 1998 the glenoid prosthesis of the Global Shoulder has been made exclusively of Enduron and is gas sterilized. The primary purpose of this article is to provide orthopaedic surgeons the best information available about Hylamer glenoids. We make suggestions concerning the diagnosis and treatment of the patients who had a Hylamer glenoid inserted between 1990 and 1993.