Ultra high molecular weight polyethylene is cytotoxic and causes oxidative stress, even when modified

Ultra High Molecular Weight (UHMW) Polyethylene (PE) is the most used biomaterial for articulating surface of total joint replacements (TJR). Since its introduction decades ago, many efforts have been made to improve its properties and to understand its behaviour with the final goal to provide a longer duration of the implants. Mechanical abrasion with particles production is an unavoidable process, but catastrophic PE wear with a huge quantity of PE reactive debris production was observed in the last years, with consequent severe periprosthetic osteolysis and aseptic loosenings.