Applications and challenges of ultra-high molecular weight polyethylene fibers in minimally invasive medical devices_Journal of Biomedical Engineering

Authors：

SHI Shuangyou ¹ , SHI Yongming ¹ , ZHU Jintang ¹ , SHI Xianning ¹ , CUI Ning ¹ ,  CUI Huashuai ¹ , ZHANG Zetian ¹ , HOU Zongzi ¹ , WU Weixin ¹ ,  WU Pengfei ^1,2

1. State Key Laboratory of Bio-based Fiber Materials, China Textile Academy Co. Ltd., Beijing 100025, P. R. China;
2. College of Materials Science and Engineering, Donghua University, Shanghai 201620, P. R. China;

Corresponding?author：

CUI Huashuai, Email: cuihuashuai@gt.cn

Keywords：

Ultra-high molecular weight polyethylene fiber; Minimally invasive medical devices; Surface functionalization; Intelligent fiber; Standardization

DOI：

10.7507/1001-5515.202511021

Video：

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Abstract Full text Figures/Tables Video References Cited by

Ultra-high molecular weight polyethylene (UHMWPE) fiber has emerged as a critical material advancing the development of minimally invasive medical devices, owing to its exceptional specific strength, outstanding wear resistance, and inherent bio-inertia. We systematically review the current application landscape of UHMWPE fibers in minimally invasive medicine, highlighting their broad use in orthopedic sutures and fixation systems, reinforcement layers for cardiovascular interventional devices, cables to drive surgical robots, and materials in frontier neural interfaces. These applications underscore the material’s core advantages across diverse scenarios. However, its broader clinical translation faces multiple challenges, including surface bio-inertia, long-term dynamic durability, difficulty in processing, and a lack of standardization. To address these challenges, this article delves into comprehensive strategies encompassing surface engineering, composite material development, structural optimization, and intelligent control algorithms. Looking forward, UHMWPE fibers are poised to evolve towards intelligence and functional integration. Through deep convergence with flexible electronics and data-driven research, coupled with the establishment of robust standardization systems, UHMWPE fibers are expected to play an even more pivotal role in the next generation of advanced minimally invasive medical devices, ultimately propelling the field towards greater precision and personalization.

Citation： SHI Shuangyou, SHI Yongming, ZHU Jintang, SHI Xianning, CUI Ning, CUI Huashuai, ZHANG Zetian, HOU Zongzi, WU Weixin, WU Pengfei. Applications and challenges of ultra-high molecular weight polyethylene fibers in minimally invasive medical devices. Journal of Biomedical Engineering, 2026, 43(3): 644-653. doi: 10.7507/1001-5515.202511021 Copy

1.	Patil N A, Njuguna J, Kandasubramanian B. UHMWPE for biomedical applications: performance and functionalization. Eur Polym J, 2020, 125: 109529.
2.	Kurtz S M, Muratoglu O K, Evans M, et al. Advances in the processing, sterilization, and crosslinking of ultra-high molecular weight polyethylene for total joint arthroplasty. Biomaterials, 1999, 20(18): 1659-1688.
3.	Bastiaansen C W M. Tensile strength of solution-spun, ultra-drawn ultra-high molecular weight polyethylene fibres: 1. influence of fibre diameter. Polymer, 1992, 33(8): 1649-1652.
4.	Yeh J T, Wang C K, Huang L K, et al. Ultradrawing and ultimate tenacity properties of ultrahigh molecular weight polyethylene composite fibers filled with nanosilica particles with varying specific surface areas. J Nanomater, 2015, 2015(1): 146718.
5.	Park J H, Rutledge G C. Ultrafine high performance polyethylene fibers. J Mater Sci, 2018, 53(4): 3049-3063.
6.	Siskey R, Smelt H, Boon-Ceelen K, et al. UHMWPE biomaterials handbook. London: William Andrew Publishing, 2016: 398-411.
7.	Savage E, Hurren C J, Rajmohan G D, et al. Arthroscopic knots: suture and knot characterisation of modern polyblend suture materials. Heliyon, 2023, 9(9): e19391.
8.	Cheppalli N S, Metikala S, Purudappa P P, et al. High-tensile strength suture materials in orthopaedics. JBJS Rev, 2025, 13(3): e24.00193.
9.	Vlasblom M. Handbook of properties of textile and technical fibres. Cambridge: Woodhead Publishing, 2018: 699-755.
10.	Weiler A, Hoffmann R F G, Bail H J, et al. Tendon healing in a bone tunnel. part II. Arthroscopy, 2002, 18(2): 124-135.
11.	Shetye S S, Miller K S, Hsu J E, et al. Comprehensive biomaterials II. Netherlands: Elsevier, 2017: 314-340.
12.	Sundaram K, Siddiqi A, Kamath A F, et al. Trochanteric osteotomy in revision total hip arthroplasty. EFORT Open Rev, 2020, 5(8): 477-485.
13.	Li Y, Meng Q, Chen S, et al. Advances, challenges, and prospects for surgical suture materials. Acta Biomater, 2023, 168: 78-112.
14.	Jingushi S, Kawano T, Iida H, et al. Reattachment of the osteotomized greater trochanter in hip surgery using an ultrahigh molecular weight polyethylene fiber cable: a multi-institutional study. Open J Orthop, 2013, 3(6): 283-289.
15.	Oe K, Iida H, Kobayashi F, et al. Reattachment of an osteotomized greater trochanter in total hip arthroplasty using an ultra-high molecular weight polyethylene fiber cable. J Orthop Sci, 2018, 23(6): 992-999.
16.	Okazaki Y, Hosoba M, Miura S, et al. Effects of knee simulator control method and radiation dose on UHMWPE wear rate, and relationship between wear rate and clinical revision rate in National Joint Registry. J Mech Behav Biomed Mater, 2019, 90: 182-190.
17.	Rodts T, Schmid S R, Selles M A, et al. Selective laser fiber welding on woven polymer fabrics for biomedical applications. Mater Sci Eng C, 2019, 94: 628-634.
18.	Wahed S B, Dunstan C R, Boughton P C, et al. Functional ultra-high molecular weight polyethylene composites for ligament reconstructions and their targeted applications in the restoration of the anterior cruciate ligament. Polymers, 2022, 14(11): 2189.
19.	Wang Z, Liu G, Qian S, et al. Tracking control with external force self-sensing ability based on position/force estimators and non-linear hysteresis compensation for a backdrivable cable-pulley-driven surgical robotic manipulator. Mech Mach Theory, 2023, 183: 105259.
20.	Clegg B A, Shrestha D R, Emami N. Tribo-mechanical properties and bioactivity of additively manufactured PAEK materials for load bearing medical applications: a systematic review. Biotribology, 2023, 35-36: 100263.
21.	Abdelaziz M E M K, Tian L, Hamady M, et al. X-ray to MR: the progress of flexible instruments for endovascular navigation. Prog Biomed Eng, 2021, 3(3): 032004.
22.	Clogenson H C M, Van Lith J Y, Dankelman J, et al. Multi-selective catheter for MR-guided endovascular interventions. Med Eng Phys, 2015, 37(7): 623.
23.	Emolaga C S, Ara?ez S A C, de Yro P A N, et al. Surface design of 3D-printed PEEK by controlling slicing parameters. Int J Mech Eng Robot Res, 2022, 11(3): 181-186.
24.	Carter T R. Report on evolving indications, technique, and outcomes of novel and surgical procedures-NUsurface. Curr Rev Musculoskelet Med, 2025, 18(4): 115-122.
25.	Polikov V S, Tresco P A, Reichert W M. Response of brain tissue to chronically implanted neural electrodes. J Neurosci Methods, 2005, 148(1): 1-18.
26.	Purcell E K, Thompson D E, Ludwig K A, et al. Flavopiridol reduces the impedance of neural prostheses in vivo without affecting recording quality. J Neurosci Methods, 2009, 183(2): 149-157.
27.	Hussain M, Naqvi R A, Abbas N, et al. Ultra-high-molecular-weight-polyethylene (UHMWPE) as a promising polymer material for biomedical applications: a concise review. Polymers, 2020, 12(2): 323.
28.	Basir A, Grobben R B, Cramer M J, et al. Flexible mechanoprosthesis made from woven ultra-high-molecular-weight polyethylene fibres: proof of concept in a chronic sheep model. Interact Cardiovasc Thorac Surg, 2017, 25(6): 942-949.
29.	Wang B, Yang P, Ding Y, et al. Improvement of the biocompatibility and potential stability of chronically implanted electrodes incorporating coating cell membranes. ACS Appl Mater Interfaces, 2019, 11(9): 8807-8817.
30.	Lermontov S A, Maksimkin A V, Sipyagina N A, et al. Ultra-high molecular weight polyethylene with hybrid porous structure. Polymer, 2020, 202: 122744.
31.	Ustyugov A A, Sipyagina N A, Malkova A N, et al. 3D neuronal cell culture modeling based on highly porous ultra-high molecular weight polyethylene. Molecules, 2022, 27(7): 2087.
32.	Santo D, Castro J D, Cruz S, et al. Customisation of PVD coatings for biomedical devices. Surf Coat Technol, 2025, 512: 132277.
33.	Zhang B, Leng J, Ouyang Z, et al. Superhydrophilic and topography-regulatable surface grafting on PEEK to improve cellular affinity. Biomater Adv, 2023, 146: 213310.
34.	Manzoor F, Golbang A, Jindal S, et al. 3D printed PEEK/HA composites for bone tissue engineering applications: effect of material formulation on mechanical performance and bioactive potential. J Mech Behav Biomed Mater, 2021, 121: 104601.
35.	Otto A, McCarthy M B R, Baldino J B, et al. Biologically augmented suture for ligament bracing procedures positively affects human ligamentocytes and osteoblasts in vitro. Arthroscopy, 2022, 38(2): 498-505.
36.	Fairbanks B D, Thissen H, Maurdev G, et al. Inhibition of protein and cell attachment on materials generated from N-(2-hydroxypropyl) acrylamide. Biomacromolecules, 2014, 15(9): 3259-3266.
37.	Jayakumar K, Lielpetere A, Domingo-Lopez D A, et al. Tethering zwitterionic polymer coatings to mediated glucose biosensor enzyme electrodes can decrease sensor foreign body response yet retain sensor sensitivity to glucose. Biosens Bioelectron, 2023, 219: 114815.
38.	Mariello M, E? I, Proctor C M. Soft and flexible bioelectronic micro‐systems for electronically controlled drug delivery. Adv Healthc Mater, 2024, 13(24): 2302969.
39.	Sohal H S, Clowry G J, Jackson A, et al. Mechanical flexibility reduces the foreign body response to long-term implanted microelectrodes in rabbit cortex. PLoS One, 2016, 11(10): e0165606.
40.	Jensen M J, Claussen A D, Higgins T, et al. Cochlear implant material effects on inflammatory cell function and foreign body response. Hear Res, 2022, 426: 108597.
41.	Wehr M, Pott A, Wehking K H. Bending fatigue strength and lifetime of fiber ropes//Gosselin C, Cardou P, Bruckmann T, et al. Cable-driven parallel robots. Cham: Springer, 2018: 73-84.
42.	Coffey R J. Deep brain stimulation devices: a brief technical history and review. Artif Organs, 2009, 33(3): 208-220.
43.	Yoon J W, Park T W, Yim H J. Fatigue life prediction of a cable harness in an industrial robot using dynamic simulation. J Mech Sci Technol, 2008, 22(3): 484-489.
44.	Turicek J, Ratts N, Kaltchev M, et al. Surface treatment of ultra-high molecular weight polyethylene (UHMWPE) by cold atmospheric plasma (CAP) for biocompatibility enhancement. Appl Sci (Basel), 2021, 11(4): 1703.
45.	Wu M, Jia L, Lu S, et al. Interfacial performance of high-performance fiber-reinforced composites improved by cold plasma treatment: a review. Surf Interfaces, 2021, 24: 101077.
46.	Yu J, Chen S, Huang H, et al. A universal strategy for rapid and scalable surface modification of ultra high molecular weight polyethylene fiber. Compos Struct, 2024, 334: 117935.
47.	Huang B, Yang M, Kou Y, et al. Absorbable implants in sport medicine and arthroscopic surgery: a narrative review of recent development. Bioact Mater, 2024, 31: 272-283.
48.	Wei T, Tang Z, Yu Q, et al. Smart antibacterial surfaces with switchable bacteria-killing and bacteria-releasing capabilities. ACS Appl Mater Interfaces, 2017, 9(43): 37511-37523.
49.	Yang M, Chen P, Qu X, et al. Robust neural interfaces with photopatternable, bioadhesive, and highly conductive hydrogels for stable chronic neuromodulation. ACS Nano, 2023, 17(2): 885-895.

1. Patil N A, Njuguna J, Kandasubramanian B. UHMWPE for biomedical applications: performance and functionalization. Eur Polym J, 2020, 125: 109529.
2. Kurtz S M, Muratoglu O K, Evans M, et al. Advances in the processing, sterilization, and crosslinking of ultra-high molecular weight polyethylene for total joint arthroplasty. Biomaterials, 1999, 20(18): 1659-1688.
3. Bastiaansen C W M. Tensile strength of solution-spun, ultra-drawn ultra-high molecular weight polyethylene fibres: 1. influence of fibre diameter. Polymer, 1992, 33(8): 1649-1652.
4. Yeh J T, Wang C K, Huang L K, et al. Ultradrawing and ultimate tenacity properties of ultrahigh molecular weight polyethylene composite fibers filled with nanosilica particles with varying specific surface areas. J Nanomater, 2015, 2015(1): 146718.
5. Park J H, Rutledge G C. Ultrafine high performance polyethylene fibers. J Mater Sci, 2018, 53(4): 3049-3063.
6. Siskey R, Smelt H, Boon-Ceelen K, et al. UHMWPE biomaterials handbook. London: William Andrew Publishing, 2016: 398-411.
7. Savage E, Hurren C J, Rajmohan G D, et al. Arthroscopic knots: suture and knot characterisation of modern polyblend suture materials. Heliyon, 2023, 9(9): e19391.
8. Cheppalli N S, Metikala S, Purudappa P P, et al. High-tensile strength suture materials in orthopaedics. JBJS Rev, 2025, 13(3): e24.00193.
9. Vlasblom M. Handbook of properties of textile and technical fibres. Cambridge: Woodhead Publishing, 2018: 699-755.
10. Weiler A, Hoffmann R F G, Bail H J, et al. Tendon healing in a bone tunnel. part II. Arthroscopy, 2002, 18(2): 124-135.
11. Shetye S S, Miller K S, Hsu J E, et al. Comprehensive biomaterials II. Netherlands: Elsevier, 2017: 314-340.
12. Sundaram K, Siddiqi A, Kamath A F, et al. Trochanteric osteotomy in revision total hip arthroplasty. EFORT Open Rev, 2020, 5(8): 477-485.
13. Li Y, Meng Q, Chen S, et al. Advances, challenges, and prospects for surgical suture materials. Acta Biomater, 2023, 168: 78-112.
14. Jingushi S, Kawano T, Iida H, et al. Reattachment of the osteotomized greater trochanter in hip surgery using an ultrahigh molecular weight polyethylene fiber cable: a multi-institutional study. Open J Orthop, 2013, 3(6): 283-289.
15. Oe K, Iida H, Kobayashi F, et al. Reattachment of an osteotomized greater trochanter in total hip arthroplasty using an ultra-high molecular weight polyethylene fiber cable. J Orthop Sci, 2018, 23(6): 992-999.
16. Okazaki Y, Hosoba M, Miura S, et al. Effects of knee simulator control method and radiation dose on UHMWPE wear rate, and relationship between wear rate and clinical revision rate in National Joint Registry. J Mech Behav Biomed Mater, 2019, 90: 182-190.
17. Rodts T, Schmid S R, Selles M A, et al. Selective laser fiber welding on woven polymer fabrics for biomedical applications. Mater Sci Eng C, 2019, 94: 628-634.
18. Wahed S B, Dunstan C R, Boughton P C, et al. Functional ultra-high molecular weight polyethylene composites for ligament reconstructions and their targeted applications in the restoration of the anterior cruciate ligament. Polymers, 2022, 14(11): 2189.
19. Wang Z, Liu G, Qian S, et al. Tracking control with external force self-sensing ability based on position/force estimators and non-linear hysteresis compensation for a backdrivable cable-pulley-driven surgical robotic manipulator. Mech Mach Theory, 2023, 183: 105259.
20. Clegg B A, Shrestha D R, Emami N. Tribo-mechanical properties and bioactivity of additively manufactured PAEK materials for load bearing medical applications: a systematic review. Biotribology, 2023, 35-36: 100263.
21. Abdelaziz M E M K, Tian L, Hamady M, et al. X-ray to MR: the progress of flexible instruments for endovascular navigation. Prog Biomed Eng, 2021, 3(3): 032004.
22. Clogenson H C M, Van Lith J Y, Dankelman J, et al. Multi-selective catheter for MR-guided endovascular interventions. Med Eng Phys, 2015, 37(7): 623.
23. Emolaga C S, Ara?ez S A C, de Yro P A N, et al. Surface design of 3D-printed PEEK by controlling slicing parameters. Int J Mech Eng Robot Res, 2022, 11(3): 181-186.
24. Carter T R. Report on evolving indications, technique, and outcomes of novel and surgical procedures-NUsurface. Curr Rev Musculoskelet Med, 2025, 18(4): 115-122.
25. Polikov V S, Tresco P A, Reichert W M. Response of brain tissue to chronically implanted neural electrodes. J Neurosci Methods, 2005, 148(1): 1-18.
26. Purcell E K, Thompson D E, Ludwig K A, et al. Flavopiridol reduces the impedance of neural prostheses in vivo without affecting recording quality. J Neurosci Methods, 2009, 183(2): 149-157.
27. Hussain M, Naqvi R A, Abbas N, et al. Ultra-high-molecular-weight-polyethylene (UHMWPE) as a promising polymer material for biomedical applications: a concise review. Polymers, 2020, 12(2): 323.
28. Basir A, Grobben R B, Cramer M J, et al. Flexible mechanoprosthesis made from woven ultra-high-molecular-weight polyethylene fibres: proof of concept in a chronic sheep model. Interact Cardiovasc Thorac Surg, 2017, 25(6): 942-949.
29. Wang B, Yang P, Ding Y, et al. Improvement of the biocompatibility and potential stability of chronically implanted electrodes incorporating coating cell membranes. ACS Appl Mater Interfaces, 2019, 11(9): 8807-8817.
30. Lermontov S A, Maksimkin A V, Sipyagina N A, et al. Ultra-high molecular weight polyethylene with hybrid porous structure. Polymer, 2020, 202: 122744.
31. Ustyugov A A, Sipyagina N A, Malkova A N, et al. 3D neuronal cell culture modeling based on highly porous ultra-high molecular weight polyethylene. Molecules, 2022, 27(7): 2087.
32. Santo D, Castro J D, Cruz S, et al. Customisation of PVD coatings for biomedical devices. Surf Coat Technol, 2025, 512: 132277.
33. Zhang B, Leng J, Ouyang Z, et al. Superhydrophilic and topography-regulatable surface grafting on PEEK to improve cellular affinity. Biomater Adv, 2023, 146: 213310.
34. Manzoor F, Golbang A, Jindal S, et al. 3D printed PEEK/HA composites for bone tissue engineering applications: effect of material formulation on mechanical performance and bioactive potential. J Mech Behav Biomed Mater, 2021, 121: 104601.
35. Otto A, McCarthy M B R, Baldino J B, et al. Biologically augmented suture for ligament bracing procedures positively affects human ligamentocytes and osteoblasts in vitro. Arthroscopy, 2022, 38(2): 498-505.
36. Fairbanks B D, Thissen H, Maurdev G, et al. Inhibition of protein and cell attachment on materials generated from N-(2-hydroxypropyl) acrylamide. Biomacromolecules, 2014, 15(9): 3259-3266.
37. Jayakumar K, Lielpetere A, Domingo-Lopez D A, et al. Tethering zwitterionic polymer coatings to mediated glucose biosensor enzyme electrodes can decrease sensor foreign body response yet retain sensor sensitivity to glucose. Biosens Bioelectron, 2023, 219: 114815.
38. Mariello M, E? I, Proctor C M. Soft and flexible bioelectronic micro‐systems for electronically controlled drug delivery. Adv Healthc Mater, 2024, 13(24): 2302969.
39. Sohal H S, Clowry G J, Jackson A, et al. Mechanical flexibility reduces the foreign body response to long-term implanted microelectrodes in rabbit cortex. PLoS One, 2016, 11(10): e0165606.
40. Jensen M J, Claussen A D, Higgins T, et al. Cochlear implant material effects on inflammatory cell function and foreign body response. Hear Res, 2022, 426: 108597.
41. Wehr M, Pott A, Wehking K H. Bending fatigue strength and lifetime of fiber ropes//Gosselin C, Cardou P, Bruckmann T, et al. Cable-driven parallel robots. Cham: Springer, 2018: 73-84.
42. Coffey R J. Deep brain stimulation devices: a brief technical history and review. Artif Organs, 2009, 33(3): 208-220.
43. Yoon J W, Park T W, Yim H J. Fatigue life prediction of a cable harness in an industrial robot using dynamic simulation. J Mech Sci Technol, 2008, 22(3): 484-489.
44. Turicek J, Ratts N, Kaltchev M, et al. Surface treatment of ultra-high molecular weight polyethylene (UHMWPE) by cold atmospheric plasma (CAP) for biocompatibility enhancement. Appl Sci (Basel), 2021, 11(4): 1703.
45. Wu M, Jia L, Lu S, et al. Interfacial performance of high-performance fiber-reinforced composites improved by cold plasma treatment: a review. Surf Interfaces, 2021, 24: 101077.
46. Yu J, Chen S, Huang H, et al. A universal strategy for rapid and scalable surface modification of ultra high molecular weight polyethylene fiber. Compos Struct, 2024, 334: 117935.
47. Huang B, Yang M, Kou Y, et al. Absorbable implants in sport medicine and arthroscopic surgery: a narrative review of recent development. Bioact Mater, 2024, 31: 272-283.
48. Wei T, Tang Z, Yu Q, et al. Smart antibacterial surfaces with switchable bacteria-killing and bacteria-releasing capabilities. ACS Appl Mater Interfaces, 2017, 9(43): 37511-37523.
49. Yang M, Chen P, Qu X, et al. Robust neural interfaces with photopatternable, bioadhesive, and highly conductive hydrogels for stable chronic neuromodulation. ACS Nano, 2023, 17(2): 885-895.

Journal of Biomedical Engineering

Applications and challenges of ultra-high molecular weight polyethylene fibers in minimally invasive medical devices

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