Histopathological and microanalytical study of zirconium dioxide and barium sulphate in bone cement.

Keen, C E; Philip, G.; Brady, K C; Spencer, John D.; Levison, David A.

doi:10.1136/jcp.45.11.984

Cited by 16 publications

(17 citation statements)

References 12 publications

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“…First, the zirconium and metal particles detected could have originated from the original, infected prostheses, especially because Keen et al [29] reported detection of zirconium particles in the synovial membrane after many years of endoprosthesis implantation. Although this cannot be totally excluded, we assumed most of the abraded material we detected came from the spacers because part of the treatment of a periprosthetic infection usually involves radical débridement and synovectomy before the spacer is implanted [11,14,15,19,24,33,35].…”

Section: Discussionmentioning

confidence: 99%

“…However, it can be assumed all articulating cement surfaces, whether handmade or commercially produced (eg, the PROSTALAC 1 spacer used by Haddad et al [18] and Meek et al [35]) will generate abraded material. Keen et al [29] reported the presence of zirconium dioxide particles in the synovial membrane, and Schuh et al [42] reported the presence of these particles in granulomas of loosened hip arthroplasties after long-term implantation of cemented endoprostheses. Our data suggest articulating materials also can be abraded during a short, 6-week period of implantation of a cement spacer.…”

Section: Discussionmentioning

confidence: 99%

“…Human tissues contain minute amounts of chromium, copper, and manganese as essential trace elements [3,39]. In contrast, zirconium dioxide is not normally present in human tissue and is used in Palacos 1 R+G and Copal 1 as opaquing agents for purposes of radiographic detection [29].…”

Section: Methodsmentioning

confidence: 99%

“…We used xray fluorescence spectroscopy (XRF) [29][30][31]] to determine whether zirconium was present in the spacer membrane and xray diffraction (XRD) [25] to obtain structural evidence for the presence of zirconium dioxide in the spacer membrane. XRF functions by excitation of electrons in the innermost shells of elements with atomic numbers greater than 9.…”

Section: Methodsmentioning

confidence: 99%

“…As the atom returns to its stable condition, electrons from the outer shells are transferred to the inner shells, and in the process, give off a characteristic xray whose energy is the difference between the two binding energies of the corresponding shells. Each element has a unique set of energy levels so each element produces a unique set of xrays according to Moseley's law that then can be detected and analyzed [25,[29][30][31]. Thus, XRF can be used to detect the presence of elements with an atomic number greater than 9.…”

Section: Methodsmentioning

confidence: 99%

See 4 more Smart Citations

Articulating Spacers Used in Two-stage Revision of Infected Hip and Knee Prostheses Abrade with Time

Fink

Rechtenbach

Büchner

et al. 2011

Clinical Orthopaedics &Amp; Related Research

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Background Articulating spacers used in two-stage revision surgery of infected prostheses have the potential to abrade and subsequently induce third-body wear of the new prosthesis. Questions/purposes We asked whether particulate material abraded from spacers could be detected in the synovial membrane 6 weeks after implantation when the spacers were removed for the second stage of the revision. Patients and Methods Sixteen hip spacers (cemented prosthesis stem articulating with a cement cup) and four knee spacers (customized mobile cement spacers) were explanted 6 weeks after implantation and the synovial membranes were removed at the same time. The membranes were examined by xray fluorescence spectroscopy, xray diffraction for the presence of abraded particles originating from the spacer material, and analyzed in a semiquantitative manner by inductively coupled plasma mass spectrometry. Histologic analyses also were performed.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

See 3 more Smart Citations

Articulating Spacers Used in Two-stage Revision of Infected Hip and Knee Prostheses Abrade with Time

Fink

Rechtenbach

Büchner

et al. 2011

Clinical Orthopaedics &Amp; Related Research

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Characterization ofin vivo wear debris from ceramic?ceramic total hip arthroplasties

Lerouge

Huk

Yahia

et al. 1996

J. Biomed. Mater. Res.

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In contrast to the much-studied mechanism of aseptic loosening of the metal-polyethylene joint couple, the mechanism responsible for failure of ceramic-ceramic (CC) total hip arthroplasties (THAs) has not been evaluated. The aim of this study was to conduct a systematic characterization of the in vivo wear debris from 15 cases of CC THAs revised for aseptic loosening. Two methods were used to evaluate the wear debris; a semiquantitative histological analysis of H&E-stained periprosthetic pseudomembranes; and an evaluation of isolated debris particles using SEM, energy-dispersive X-ray analysis, and image analysis. The three main types of particulate debris identified were titanium alloy (TiAlV) and alumina ceramic (Al2O3) of prosthetic origin, and zirconium dioxide (ZrO2) from the contrast agent used in the cement for prosthetic fixation. Alumina debris was present in the smallest proportion (12%) and was consistent with the low wear rate of the CC joint couple. Zirconium dioxide debris was present in the greatest proportion (76%) and was an unexpected finding. The ZrO2 debris represented microstructural grains of the original ZrO2 particles added as contrast agent to the cement. The presence of a histiocytic foreign body reaction to ZrO2 debris on histologic sections leads us to believe that these particles play an important role in aseptic loosening of the CC THAs evaluated in this study.

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PMMA-based composite materials with reactive ceramic fillers: IV. Radiopacifying particles embedded in PMMA beads for acrylic bone cements

Abboud

Casaubieilh

Morvan

et al. 2000

J. Biomed. Mater. Res.

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New acrylic bone cements were prepared from alumina particles previously treated by 3-(trimethoxysilyl)propylmethacrylate (gamma-MPS) and embedded in poly(methylmethacrylate-co-ethylacrylate) beads with about 7 mol% of ethyl acrylate repeating units. The encapsulation was performed through a conventional suspension polymerization process. The influence of (i) the concentration of the dispersion stabilizer and (ii) the alumina content upon the shape, size, and size distribution of the acrylic beads was studied. Cements were prepared from each batch by hand-mixing alumina-filled acrylic beads with a liquid monomer mixture containing methyl methacrylate, n-butyl methacrylate, and N,N-dimethyl-p-toluidine. Benzoyl peroxide was previously added to the solid part. The powder-to-liquid ratio was equal to 2 for each formulation. Compressive strength of cured cement decreases with alumina content, whereas compressive modulus remains roughly constant. These results are in contradiction to those obtained for cements based on a mixture of gamma-MPS-treated alumina and unfilled acrylic beads. Nevertheless, they are interpreted in terms of alumina arrangement in the cement. In the first case, alumina particles contribute to the reinforcement of the dispersed acrylic phase, with poor benefits for the whole materials. In the second case, they allow the reinforcement of the continuous acrylic phase and, therefore, the cement's one.

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Histopathological and microanalytical study of zirconium dioxide and barium sulphate in bone cement.

Cited by 16 publications

References 12 publications

Articulating Spacers Used in Two-stage Revision of Infected Hip and Knee Prostheses Abrade with Time

Articulating Spacers Used in Two-stage Revision of Infected Hip and Knee Prostheses Abrade with Time

Characterization ofin vivo wear debris from ceramic?ceramic total hip arthroplasties

PMMA-based composite materials with reactive ceramic fillers: IV. Radiopacifying particles embedded in PMMA beads for acrylic bone cements

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