Characterization and Comparison of Wear Debris from Failed Total Hip Implants of Different Types*

Hirakawa, Kazuhiko; Bauer, Thomas W.; Stulberg, Bernard N.; Wilde, Alan H.; Secic, Michelle

doi:10.2106/00004623-199608000-00014

Cited by 82 publications

(67 citation statements)

References 35 publications

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“…Wear of this oxide-phosphate layer produces particles predominantly of metal orthophosphate, oxides, and hydroxides, which is in agreement with published work on the nature of wear debris in vivo. [4][5][6][7][8][9][10][11][12][13] Wear at the joint interface may produce metal particles but dissemination to nonlocal tissues and organs 2,13 exposes the particles to nonsynovial environments. Transport is typically via vascular and lymph systems, which are both predominantly composed of serum.…”

Section: Discussionmentioning

confidence: 99%

“…Billions of particles 5 are produced during the life of an implant. Where failure occurs by aseptic loosening, the number of particles produced per year varies from 6.7 Â 10 12 to 2.5 Â 10 14 .…”

Section: Introductionmentioning

confidence: 99%

“…Particles originating from CoCr alloy implants are often Co deficient, and are frequently oxidized to hydroxides, phosphates, and oxides. [4][5][6][7][8][9][10][11][12][13] Transition metals, especially those in the trivalent state such as chromium, have a tendency of hydrolysis, the degree of which is dependent upon the pH of the environment where the metal is oxidized. Thus, where Jacobs et al 10 and Urban et al 13 infer the presence of particles of chromium orthophosphate hydrate-rich material from their energy dispersive X-ray spectroscopy (EDX), they are only stating the presence of the ions Cr 3þ and PO 4 3À in the material.…”

Section: Introductionmentioning

confidence: 99%

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The entrapment of corrosion products from CoCr implant alloys in the deposits of calcium phosphate: A comparison of serum, synovial fluid, albumin, EDTA, and water

Lewis

Kilburn

Heard

et al. 2006

Journal Orthopaedic Research

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Physical wear of orthopedic implants is inevitable. CoCr alloy samples, typically used in joint reconstruction, corrode rapidly after removal of the protective oxide layer. The behavior of CoCr pellets immersed in human serum, foetal bovine serum (FBS), synovial fluid, albumin in phosphate-buffered saline (PBS), EDTA in PBS, and water were studied using X-ray Photoelectron Spectroscopy (XPS) and Time-of-Flight Secondary Ion Mass Spectroscopy (ToF-SIMS). The difference in the corrosive nature of human serum, water, albumin in PBS and synovial fluid after 5 days of immersion was highlighted by the oxide layer, which was respectively 15, 3.5, 1.5, and 1.5 nm thick. The thickness of an additional calcium phosphate deposit from human serum and synovial fluid was 40 and 2 nm, respectively. Co and Cr ions migrated from the bulk metal surface and were trapped in this deposit by the phosphate anion. This may account for the composition of wear debris from CoCr orthopedic implants, which is known to consist predominantly of hydroxy-phosphate compounds. Known components of synovial fluid including proteoglycans, pyrophosphates, phospholipids, lubricin, and superficial zone protein (SZP), have been identified as possible causes for the lack of significant calcium phosphate deposition in this environment. Circulation of these compounds around the whole implant may inhibit calcium phosphate deposition. ß

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The entrapment of corrosion products from CoCr implant alloys in the deposits of calcium phosphate: A comparison of serum, synovial fluid, albumin, EDTA, and water

Lewis

Kilburn

Heard

et al. 2006

Journal Orthopaedic Research

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“…Our study extends these results and shows for the first time that not only TiAlV-, mixed-, or PMMA-particles [35,40], but also polyethylene-particles induce an activation of NF-KB signalling and the TNFa-promoter. Numerous studies of wear debris from periprosthetic tissues have underlined the key role of PE-particles demonstrating that 70-90% of the recovered particles are submicrometer polyethylene-particles [12, 24,34,46,47]. Metal-on-polyethylene and ceramic-on-polyethylene components are the most common bearing surfaces used in joint replacement leading predominantly to generation of polyethylene-particles.…”

Section: Discussionmentioning

confidence: 99%

Activation of NF-KB signalling and TNFα-expression in THP-1 macrophages by TiAlV- and polyethylene-wear particles

et al. 2005

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Wear particles are believed to induce periprosthetic inflammation which contributes to periprosthetic osteolysis. TNFu plays a pivotal role in the pathogenesis of this process. The molecular mechanisms leading to the development of periprosthetic inflammation with upregulated TNFa expression in monocytic cells in response to different wear particles have yet to be defined. 1n:this study we evaluated the effects of polyethylene-and TiAIV-particles on activation of NF-KB signalling pathways and TNFa biosynthesis and release in monocytic cells with respect to periprosthetic osteoclastogenesis. THP-1 monocytic cells were differentiated to macrophage-like cells and exposed to LPS-detoxified polyethylene and prosthesis-derived TiAlV-particles. TNFa release was analyzed in culture supernatant by ELISA. NF-KB activation was examined by electrophoretic mobility shift assay (EMSA), and NF-KB target promoter activities including transactivation of the TNFa promoter were determined by luciferase reporter gene assays. Differentiated THP-1 macrophages were exposed to increasing numbers of particles for 0, 60, 180 and 360 min. Both, polyethylene-and TiAIV-particles induced a significant activation of both NF-KB and TNFa promoters at 180 min. A significant TNFu release was detected after 360 min exposure to polyethylene-and TiAlV-particles in a dose dependent manner. In comparison, LPS induced a much greater activation of NF-KB and TNFa promoters, and TNFa secretion into the supernatant was strongly induced. These results provide evidence that induction of the NF-KB signal transduction pathway in macrophages plays a major role in initiating and mediating the inflammatory response leading to periprosthetic osteolysis.

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“…The cumulative biological reactions are diverse (Table 1) and include vascularized granulomatous tissue formation along the implant-to-bone interface [16], influx of inflammatory cells (macrophages, lymphocytes) [4], induction of inflammatory cytokines and chemokines [5,11,27,43,54], elicitation of antigen-specific immunity [21], promotion of angiogenic factors [51], bone resorption, and culminating with osteolysis and loss of prosthesis fixation. Although the precise aspects that lead to inflammatory osteolysis are not completely established, two major regulatory factors appear to dominate the process: (1) exceeding a threshold debris load; and (2) the accumulation of biologically stimulatory particles [18,19,25,30,36,41]. There is also evidence that the inflammatory factors within this process are under genetic regulation [23] including variants of the mannose binding lectin [46] and transforming growth factor-b1 signal sequence and interleukin-6 promoter transitions [42].…”

Section: Search Strategy and Criteriamentioning

confidence: 99%

How Has the Introduction of New Bearing Surfaces Altered the Biological Reactions to Byproducts of Wear and Modularity?

Wooley

2014

Clin Orthop Relat Res

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Background Biological responses to wear debris were largely elucidated in studies focused on conventional ultrahigh-molecular-weight polyethylene (UHMWPE) and some investigations of polymethymethacrylate cement and orthopaedic metals. However, newer bearing couples, in particular metal-on-metal but also ceramic-on-ceramic bearings, may induce different biological reactions. Questions/purposes Does wear debris from the newer bearing surfaces result in different biological responses compared with the known responses observed with conventional metal-on-UHMWPE bearings?Methods A Medline search of articles published after 1996 supplemented by a hand search of reference lists of included studies and relevant conference proceedings was conducted to identify the biological responses to orthopaedic wear debris with a focus on biological responses to wear generated from metal-on-highly crosslinked polyethylene, metal-on-metal, ceramic-on-ceramic, and ceramicon-polyethylene bearings. Articles were selected using criteria designed to identify reports of wear debris particles and biological responses contributing to prosthesis failure. Case reports and articles focused on either clinical outcomes or tribology were excluded. A total of 83 papers met the criteria and were reviewed in detail.

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Characterization and Comparison of Wear Debris from Failed Total Hip Implants of Different Types*

Cited by 82 publications

References 35 publications

The entrapment of corrosion products from CoCr implant alloys in the deposits of calcium phosphate: A comparison of serum, synovial fluid, albumin, EDTA, and water

The entrapment of corrosion products from CoCr implant alloys in the deposits of calcium phosphate: A comparison of serum, synovial fluid, albumin, EDTA, and water

Activation of NF-KB signalling and TNFα-expression in THP-1 macrophages by TiAlV- and polyethylene-wear particles

How Has the Introduction of New Bearing Surfaces Altered the Biological Reactions to Byproducts of Wear and Modularity?

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