Characterization of wear debris released from alumina-on-alumina hip prostheses: Analysis of retrieved femoral heads and peri-prosthetic tissues

Rony, Louis; Hermine, Pierre De Sainte; Steiger, Vincent; Mallet, Romain; Hubert, Laurent; Chappard, Daniel

doi:10.1016/j.micron.2017.11.002

Cited by 14 publications

(9 citation statements)

References 24 publications

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“…The previously reported incidence of ceramic fracture after C-O-C THA varied between 0.26% and 13.4% [34], whereas that of squeaking ranged from 0% to 10.7% [34]. In (36)(37)(38)(39)(40)(41)(42)(43)(44)(45)(46)(47) .961 Vertical (mm)…”

Section: Discussionmentioning

confidence: 97%

“…Ceramic hip implants have generally been considered to be inert, and they do not produce osteolysis caused by wear particles [17]. Rony et al [46] and Bertand et al [47], however, described that the generation of wear particles from C-O-C articulations may be biologically active. Bertrand et al [47] found that the fibrotic response was more pronounced in C-O-C bearings compared with the tissues obtained from metal-on-metal or ceramic-onpolyethylene pairings.…”

Section: Discussionmentioning

confidence: 99%

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Eighteen-Year Follow-Up Study of 2 Alternative Bearing Surfaces Used in Total Hip Arthroplasty in the Same Young Patients

Kim

Park

2020

The Journal of Arthroplasty

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Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

Eighteen-Year Follow-Up Study of 2 Alternative Bearing Surfaces Used in Total Hip Arthroplasty in the Same Young Patients

Kim

Park

2020

The Journal of Arthroplasty

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“…A low periprosthetic osteolysis rate is evidenced but fibrosis around the alumina particles is reported 14,29–31 . Histological analysis of prosthetic periprosthetic tissues is difficult in cases of alumina‐on‐alumina prosthesis because the particles are often not easily visible 12 . For this reason, histochemical identification by lumogallion appears to be very valuable 14 .…”

Section: Discussionmentioning

confidence: 99%

“…The wear of polyethylene cups produces nondegradable particles that also remain locally and can generate inflammation leading to aseptic loosening of the prosthesis 9,10 . Aluminium‐on‐alumina prostheses can also degrade and release particles 11,12 . Finally, methacrylic cements can fragment and release polymer fragments containing zirconia particles used as a radio opacifier 13 …”

Section: Introductionmentioning

confidence: 99%

Wear debris released by hip prosthesis analysed by microcomputed tomography

Chappard

Rony

Ducellier

et al. 2020

Journal of Microscopy

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Summary Total hip arthroplasty uses commercial devices that combine different types of biomaterials. Among them, metals, ceramics and metal oxides can be used either in the prosthesis itself or in the cement used to anchor them in the bone. Over time, all of these materials can wear out and release particles that accumulate in the periprosthetic tissues or can migrate away. We used histology blocks from 15 patients (5 titanium metallosis, 5 alumina prostheses, 5 with altered methacrylic cement) to perform a microCT study and compare it with conventional histology data. An EDS‐SEM analysis was done to characterise the atomic nature of the materials involved. A morphometric analysis was also performed in 3D to count the particles and assess their density and size. The metallic particles appeared to be the largest and the ceramic particles the finest. However, microCT could not reveal the wear particles of radiolucent biomaterials such as polyethylene and the very fine zirconia particles from cement fragmentation. MicroCT analysis can reveal the extent of the accumulation of these debris in the periprosthetic tissues. Layout Description Hip prostheses progressively degrade in the body by releasing wear debris. They accumulate in the periprosthetic tissues. Microcomputed tomography was used to image three types of radio‐opaque wear debris: metal, ceramic and zirconia used in the bone cements.

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“…Previous studies have shown that the treatment of Al 2 O 3 FPs induced activation of human macrophages, which produced higher levels of tumor necrosis factor-α (TNF-α) [ 7 , 8 , 9 , 10 ]. These inflammatory responses are capable of causing disastrous situation such as aseptic loosening [ 11 ]. However, the effects of Al 2 O 3 FPs on the other immune cells, and in vivo effects in mouse models, have not been studied.…”

Section: Introductionmentioning

confidence: 99%

Alumina Ceramic Exacerbates the Inflammatory Disease by Activation of Macrophages and T Cells

Lim

Hwang

Park

et al. 2020

IJMS

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(1) Background: Aluminum oxide (Al2O3) ceramic is one of the materials used for artificial joints, and it has been known that their fine particles (FPs) are provided by the wear of the ceramic. Al2O3 FPs have been shown to induce macrophage activation in vitro; however, the inflammatory effect in vivo has not been studied. (2) Methods: We examined the in vivo effect of Al2O3 FPs on the innate and adaptive immune cells in the mice. (3) Results: Al2O3 FPs promoted the activation of spleen macrophages; however, conventional dendritic cells (cDCs), plasmacytoid DCs (pDCs), and natural killer (NK) cells were not activated. In addition, increases in the CD4 and CD8 T cells was induced in the spleens of the mice treated with Al2O3 FPs, which differentiated into interferon-gamma (IFN-γ)-producing helper T1 (Th1) and cytotoxic T1 (Tc1) cells. Finally, the injection of Al2O3 FPs exacerbated dextran sulfate sodium (DSS)-induced inflammation in the colon, mediated by activated and increased number of CD4 and CD8 T cells. (4) Conclusions: These data demonstrate that FPs of Al2O3 ceramic may contribute to the exacerbation of inflammatory diseases in the patients.

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Characterization of wear debris released from alumina-on-alumina hip prostheses: Analysis of retrieved femoral heads and peri-prosthetic tissues

Cited by 14 publications

References 24 publications

Eighteen-Year Follow-Up Study of 2 Alternative Bearing Surfaces Used in Total Hip Arthroplasty in the Same Young Patients

Eighteen-Year Follow-Up Study of 2 Alternative Bearing Surfaces Used in Total Hip Arthroplasty in the Same Young Patients

Wear debris released by hip prosthesis analysed by microcomputed tomography

Alumina Ceramic Exacerbates the Inflammatory Disease by Activation of Macrophages and T Cells

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