e+™
![e+™](https://enovis.widen.net/content/5e80a3bd-4d86-4fb9-8577-28467921a0e6/web/eplus_tear.jpg?w=720&itok=xgYVzviO)
![AltiVate](https://enovis.widen.net/content/ba461348-019f-4897-a987-f1f573dbeeaf/web/AltiVate_front_3_4.jpg?w=720&itok=gsITe3ZQ)
![Bioxlow xalt wtih Alpha](https://enovis.widen.net/content/b906efb2-34fc-461c-a178-d46c8e17100c/web/biolox_xalt_wAlpha.jpg?w=720&itok=CcuHFblS)
![Empowr PS - Insert](https://enovis.widen.net/content/9c416498-a1b7-4ca2-a14c-3542eed056b9/web/empowr_PS_3qt-insert-only.jpg?w=720&itok=3tpjFTvE)
![Empowr 3D - Insert](https://enovis.widen.net/content/7f895155-840a-4e9a-a009-f8d7322a4b20/web/empowr_CR_insert-03.jpg?w=720&itok=5tR81YZh)
![Empowr CR - Insert](https://enovis.widen.net/content/3928fbbc-2063-4e63-9ef5-c95b82f85b41/web/empowr-cr-insert-v02.jpg?w=720&itok=EbpdM76T)
![e+?, AltiVate, Bioxlow xalt wtih Alpha, Empowr PS - Insert, Empowr 3D - Insert, Empowr CR - Insert, , , , e+ Patellar](https://enovis.widen.net/content/be1cd656-60cc-49e6-978c-00741e9967f4/web/e_acetabular-01.jpg?w=720&itok=TIvMBbB9)
![e+?, AltiVate, Bioxlow xalt wtih Alpha, Empowr PS - Insert, Empowr 3D - Insert, Empowr CR - Insert, , , , e+ Patellar](https://enovis.widen.net/content/ecd9e11f-89eb-4c7e-86b1-5e4514014fc9/web/TuronKeeledGlenoid-02.jpg?w=720&itok=ScTh9T-3)
![e+?, AltiVate, Bioxlow xalt wtih Alpha, Empowr PS - Insert, Empowr 3D - Insert, Empowr CR - Insert, , , , e+ Patellar](https://enovis.widen.net/content/34ac3a9a-7029-4e8c-872b-e312dc3fd063/web/glenoid_anatomic-02.jpg?w=720&itok=bAWSRPBt)
![e+™](https://enovis.widen.net/content/5e80a3bd-4d86-4fb9-8577-28467921a0e6/png/eplus_tear.jpg?w=80&itok=dTrYsidW)
![AltiVate](https://enovis.widen.net/content/ba461348-019f-4897-a987-f1f573dbeeaf/png/AltiVate_front_3_4.jpg?w=80&itok=zVM6YaTD)
![Bioxlow xalt wtih Alpha](https://enovis.widen.net/content/b906efb2-34fc-461c-a178-d46c8e17100c/png/biolox_xalt_wAlpha.jpg?w=80&itok=_9fDzH6U)
![Empowr PS - Insert](https://enovis.widen.net/content/9c416498-a1b7-4ca2-a14c-3542eed056b9/png/empowr_PS_3qt-insert-only.jpg?w=80&itok=TGthgADr)
![Empowr 3D - Insert](https://enovis.widen.net/content/7f895155-840a-4e9a-a009-f8d7322a4b20/png/empowr_CR_insert-03.jpg?w=80&itok=Zu2W0z0_)
![Empowr CR - Insert](https://enovis.widen.net/content/3928fbbc-2063-4e63-9ef5-c95b82f85b41/png/empowr-cr-insert-v02.jpg?w=80&itok=sdYSVPX8)
![e+?, AltiVate, Bioxlow xalt wtih Alpha, Empowr PS - Insert, Empowr 3D - Insert, Empowr CR - Insert, , , , e+ Patellar](https://enovis.widen.net/content/be1cd656-60cc-49e6-978c-00741e9967f4/png/e_acetabular-01.jpg?w=80&itok=mxVwnrpb)
![e+?, AltiVate, Bioxlow xalt wtih Alpha, Empowr PS - Insert, Empowr 3D - Insert, Empowr CR - Insert, , , , e+ Patellar](https://enovis.widen.net/content/ecd9e11f-89eb-4c7e-86b1-5e4514014fc9/png/TuronKeeledGlenoid-02.jpg?w=80&itok=_xBbU5ro)
![e+?, AltiVate, Bioxlow xalt wtih Alpha, Empowr PS - Insert, Empowr 3D - Insert, Empowr CR - Insert, , , , e+ Patellar](https://enovis.widen.net/content/34ac3a9a-7029-4e8c-872b-e312dc3fd063/png/glenoid_anatomic-02.jpg?w=80&itok=fHvnWH_o)
e+™
e+ Polyethylene
2 Formulas, 1 Solution
DJO Surgical is proud to offer its e+ vitamin E blended polyethylene across all product lines. Two highly specialized formulas have been developed: a moderately-cross linked formula for sliding and gliding kinematics and a highly-cross linked formula for ball and socket type kinematics. Both formulations have been demonstrated to significantly reduce oxidation and long-term wear.1
Moderately cross-linked products:
- EMPOWR Knee System™
- 3DKnee™ System
- EXPRT™ Revision Knee
- Movation™ Knee
- AltiVate™ Anatomic Shoulder System
- Turon® Shoulder System
Highly cross-linked products:
- FMP® Acetabular Hip System
- AltiVate Reverse® Shoulder System
- RSP® Shoulder System
- Overview
- References
Re-Melting Not Required
In the case of most highly cross-linked polyethylenes, an anneal or re-melt step occurs following cross-linking to link free radicals (created by the irradiation). Annealing or re-melting polyethylene can reduce mechanical strength properties.2
Because vitamin E neutralizes the negative effects of free radicals,2 an anneal or re-melt step is rendered unnecessary. In a material yield strength test, compression molded samples and e+ samples performed statistically the same, while a highly cross-linked re- melted sample exhibited a 12% drop in yield strength.1
Maximum Mechanical Strength
The impact of oxygen exposure to e+ samples was evaluated in accelerated aging tests. Un-aged and aged e+ samples yielded the same results during yield strength testing.
Impact testing for the aged e+ sample actually revealed slightly better results than the un-aged sample1, indicating that oxygen has no negative impact on e+.
Blended In
Vitamin E is blended right into the resin, assuring complete homogeneous distribution. Scatter Electron Microscope (SEM) and polarized light microscopy from freeze fracture specimen show that e+ has equivalent consolidation as conventional compression molded UHMWPE.1
Accelerated Aging Performance
Infrared spectroscopy (FTIR) analysis showed no detectable oxidation in un-aged and intensely aged e+ samples.1 This explains why intense aging appears to have no effect on test samples.
Naturally Occurring Anti-Oxidant
Vitamin E (α-tocopherol) is the most effective naturally occurring anti-oxidant in the human body.2
- e+ testing data on file. Bench test results not necessarily indicative of clinical performance.
- S.M. Kurtz. “The UHMWPE Handbook: Ultra-high Molecular Weight Polyethylene in Total Joint Replacement”. Elsevier Academic Press, 2009.Jennings et al. The influence of femoral condylar lift-off on the wear of artificial knee joints. Proc Inst Mech Eng [H]. 2007 Apr;221(3):305-14.