Distribution of UHMWPE Wear Particles in Periprosthetic Tissues of Total Hip Replacements

Pokorný, D; Šlouf, Miroslav; Veselý, F; Fulín, P; Jahoda, D; Sosna, A

doi:10.55095/achot2010/017

Cited by 17 publications

(1 citation statement)

References 13 publications

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“…Povrch částic byl stanoven jak výpočtem na základě získaných morfologických dat pomocí programu MDISTR ( 6), tak experimentálně pomocí standardní metody BET (Brunauer-Emmet-Teller) (4). Reálné otěrové částice UHMWPE byly izolovány z periprotetických tkání náhrady kyčelního kloubu v rámci našich předchozích prací (6,7,20,23). Pro účely této práce postačovalo stanovit jejich velikosti, tvary a průměrný počet uvolněný z kyčelní kloubní náhrady za rok.…”

Section: Materiál a Metodikaunclassified

The Risk of Total Joint Replacement Infectious Complications in Relation to the UHMWPE Particle Adhesion Area

Fulín¹,

Šlouf²,

Krejčíková³

et al. 2019

ACHOT

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PURPOSE OF THE STUDYPeriprosthetic joint infection is a major complication which in most of the cases requires a long-term administration of antibiotics and often necessitates undergoing multiple challenging surgeries. Bacterial adhesion to foreign material is one of the key risk factors associated with periprosthetic joint infection. The foreign material with large adhesion area might be also the UHMWPE (Ultrahigh molecular weight polyethylene) particles released during the wear process from the surface of articulating components. The purpose of this study is to evaluate potential adhesion areas of wear particles in relation to diverse distribution of the size and shapes of wear particles in periprosthetic tissue and to assess an increase in the risk of infectious complications associated with an increase in the adhesion area of wear particles. MATERIAL AND METHODSThe size and morphology of model and real UHMWPE particles were determined with the use of light microscopy and scanning electron microscopy. By determining the morphological descriptors, the surfaces of individual particles for different distributions of polyethylene particles were calculated. When measuring the model wear particles, 6 model situations were simulated, in which comparisons with the control measurement by the BET (Brunauer-Emmet-Teller) method were made. RESULTSThe variability of individual morphological descriptors demonstrates the effect on the total surface of particles. The calculated coefficient defines how many times the particle surface increases when corrected to the given descriptor (elongation, flattening, roughness, porosity). The total area of real wear particles at 1 year is 4,622 cm 2 , at 20 years it is 92,440 cm 2 . Based on our calculations, the area of particles where a biofilm is actually formed (approximately 50 bacteria may adhere to a particle of 3µm in diameter) is 809.5 cm2 at 1 year and 16,190 cm 2 at 20 years. DISCUSSIONAccording to the measurements, the size of the potential adhesion area of metal parts and polyethylene particles becomes equal already after several weeks of endoprosthesis usage and after a few years it is many times larger. The question is whether the risk of bacterial adhesion, i.e. also the risk of infectious complications of TEP actually increases. The clinical practice suggests that the number of infections e.g. 10, 15 or 20 years after the primary implantation is not statistically higher, despite the confirmed growth of potential adhesion area in the form of UHMWPE particles. This fact could be explained by a partially equal regulatory pathway of infection and polyethylene disease. The immune system stimulated by wear particles might better resist the hematogenic infection. CONCLUSIONSThe study outcomes clearly indicate that the area of polyethylene wear particles considerably increases over time. In spite of the fact that only approximately 10% of wear particles show parameters (also with respect to the size of particles and bacteria) for potential bacterial adhesion, this area is many t...

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Section: Materiál a Metodikaunclassified

The Risk of Total Joint Replacement Infectious Complications in Relation to the UHMWPE Particle Adhesion Area

Fulín¹,

Šlouf²,

Krejčíková³

et al. 2019

ACHOT

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Low intrapatient variability of histomorphological findings in periprosthetic tissues from revised metal/ceramic on polyethylene joint arthroplasties

et al. 2017

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The type of tissue response to implant by-products can be determined by examination of periprosthetic tissues. However, little is known about the most suitable location for tissue sampling. The main goal of this study was to evaluate the extent of variability in tissue response in relation to location of tissue sampling, implant fixation, age and sex in total joint arthroplasties with metal-on-polyethylene or ceramic-on-polyethylene bearing pairs. We processed 236 histology slides from 21 patients and focused on the association between the location of tissue samples and histological features. The presence of the synovial hyperplasia showed a significant association with the particular sampling site. A higher density of high endothelial cell venules was seen in the samples from around the joint, and polyethylene particles were more abundant in noncemented TJA but both findings did not show statistically significant association with the sampling site. The results showed a relatively small variance in the tissue response to prosthetic by-products among tissues sampled from the same patient. Our findings indicate that tissue samples retrieved from similar distance from around the TJA during the revision operation show comparable results of histological analysis. © 2017 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 106B: 2008-2018, 2018.

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Poor performance of Enduron polyethylene liner in total hip arthroplasty: a minimum ten-year follow up and ultra-morphological analysis of wear particles

Yan

Chen

Feng

et al. 2016

International Orthopaedics (SICOT)

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Distribution of UHMWPE Wear Particles in Periprosthetic Tissues of Total Hip Replacements

Cited by 17 publications

References 13 publications

The Risk of Total Joint Replacement Infectious Complications in Relation to the UHMWPE Particle Adhesion Area

The Risk of Total Joint Replacement Infectious Complications in Relation to the UHMWPE Particle Adhesion Area

Low intrapatient variability of histomorphological findings in periprosthetic tissues from revised metal/ceramic on polyethylene joint arthroplasties

Poor performance of Enduron polyethylene liner in total hip arthroplasty: a minimum ten-year follow up and ultra-morphological analysis of wear particles

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