Is Polyethylene Still the Best Prosthetic Bearing Surface?

Amis, Andrew A.

doi:10.1302/0301-620x.78b3.0780345

Cited by 11 publications

(4 citation statements)

References 24 publications

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“…For this reason, a number of years ago, it was questioned whether this material should be retained or withdrawn (Amis 1996). Fortunately, over the recent decades, several processing techniques have been developed to improve the mechanical and tribological performance of UHMWPE.…”

Section: Advances In Polyethylenementioning

confidence: 99%

Aseptic Loosening of Total Hip Arthroplasty as a Result of Local Failure of Tissue Homeostasis

Gallo¹,

Konttinen²,

Goodman³

et al. 2012

Recent Advances in Arthroplasty

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Section: Advances In Polyethylenementioning

confidence: 99%

Aseptic Loosening of Total Hip Arthroplasty as a Result of Local Failure of Tissue Homeostasis

Gallo¹,

Konttinen²,

Goodman³

et al. 2012

Recent Advances in Arthroplasty

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“…The wear of ultra high molecular weight polyethylene (UHMWPE) is a major contributor to premature failure of THAs. For this reason, a number of years ago, it was questioned whether this material should be retained or withdrawn (Amis 1996). Fortunately, over the recent decades, several processing techniques have been developed to improve the mechanical and tribological performance of UHMWPE.…”

Section: Advances In Polyethylenementioning

confidence: 99%

Recent Advances in Arthroplasty

2012

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Surgery induced stress response leads to [1] the activation of the sympathetic nervous system, [2] increased secretion of pituitary hormones, and [3] immunological as well as hematological changes (Desborough, 2000). Activation of the sympathetic nervous system leads to an increased secretion of catecholamines from the adrenal medulla and of norepinephrine from presynaptic nerve terminals. It results in such cardiovascular effects as tachycardia and hypertension (Desborough, 2000). The secretion of adrenocorticothropic hormone (corticotrophin, ACTH), growth hormone (GH) and arginine vasopressin (AVP) increases; the secretion of thyroid-stimulating hormone (TSH) as well as of follicle-stimulating hormone (FSH) and luteinizing hormone (LH) may increase or decrease. As a result, the secretion of cortisol and aldosterone increases; that of insulin often decreases, while that of glucagone usually decreses; and, finally, decreases, and the secretion of thyroxine and tri-iodothyronine decreases. All those changes influence the metabolism of carbohydrates, proteins and fat as well as that of salt and water (Desborough, 2000). Immunological and hematological changes include cytokine production, acute phase reaction, neutrophil leucocytosis and lymphocyte proliferation (Desborough, 2000). Cytokines -mainly interleukin-1 (IL-1), tumor necrosis factor-α (TNF-α) and IL-6, released from activated leukocytes, fibroblasts and endothelial cells -play an important role in the systemic inflammatory reaction (Desborough, 2000). Some authors (Blaise, et al., 2007; Singh & Antognini, 2010; Van Munster et al., 2009) suggest that inflammation plays a substantial role in the pathogenesis of POCD. Their claim was supported by the observation that cyclooxygenase-2 (COX-2) inhibitors protect the amyloid β-induced memory disturbances in mice (Blaise, et al., 2007). The animal studies also showed that the development of POCD in rats was associated with glial activation and the expression of proinflammatory cytokines within the hippocampal region (Blaise, et al., 2007). Some studies revealed the role of interleukin-18 (IL-18) in the neuroinflammation and neurodegeneration of the central nervous system. Patients with a defect in the IL-18 cytokine promoter gene had a higher concentration of serum amyloid peptides (Fodale, et al., 2010). The amyloid β peptide concentration was related to learning and memory deficiences as well as to neurodegeneration. Continuous infusion of amyloid β peptide in rats resulted in learning and memory impairments. Higher levels of amyloid β peptide in the hippocampus were observed in older rats when compared to those in younger ones (Fodale, et al., 2010). Some anesthetic agents can influence the amyloid β production. Isoflurane increases the amyloid β production through an alteration in the processing of amyloid precursor protein; desflurane also causes an increase, but only in the presence of hypoxia. Propofol and thiopental do not significantly change the amyloid precursor protein (Fodale, et al., 2010). The f...

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“…Wear particles consist of different chemical compositions depending upon the prosthesis material. Both polyethylene and metal particles were shown to elicit inflammatory (7,20,81,82) and cytokine upregulation in vitro and in vivo (19,42,(83)(84)(85). Polyethylene and metal debris, generated at the liner-cup interface of the acetabular component, may be pumped by cyclical loading through the holes in the metal cup into the prosthetic-bone interface where they may induce an osteolytic response (86).…”

Section: Wear Particlesmentioning

confidence: 99%

“…Locking mechanisms in new prosthesis designs have been proposed in order to reduce micromotion and thus debris formation (86). Work is currently in progress regarding acetabular cup design with much softer bearing surfaces than polyethylene that would create an efficient fluid film lubrication, hence reducing wear (81). Studies upon the effects of different biomaterial types and characteristics on osteoclast function pointed out the need for a better understanding of pathological bone resorption in aseptic loosening, and possible future therapeutic interventions to modulate it (89).…”

Section: Perspectives and Future Studiesmentioning

confidence: 99%

A Review of Aseptic Loosening in Total Hip Arthroplasty

El-Warrak¹,

Olmstead²,

Rechenberg³

et al. 2001

Vet Comp Orthop Traumatol

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SummaryTotal hip arthroplasty has gained worldwide acceptance over the last few decades in humans and in dogs. Although long-term success is high in most studies, aseptic loosening of components is still a serious complication. Aseptic loosening can affect either the acetabular or femoral component of both cemented and cementless systems. The process is usually characterized by an interface membrane which develops between the adjacent bone and bone cement of the prosthesis, or in cementless components, between the bone and the implant itself. The process leading to the formation of this interface membrane and its function is still unclear; although much has been written about this topic in recent years. Biomechanical factors including: prosthesis design and material composition and cellular mechanisms such as signaling pathways of cytokines, local mediators or matrix metalloproteinases, have been incriminated to be responsible for the process. None of these factors, alone, have been conclusively proven to be the cause of aseptic loosening.Aseptic loosening is the major cause of implant failure in total hip arthroplasty. The controversial aspects of the pathogenesis of the process are reviewed. The role of biomechanical factors, including prosthesis design, material composition and biological factors, such as inflammatory mediators, cellular mechanisms, cytokines and matrix metalloproteinases, are detailed.

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Is Polyethylene Still the Best Prosthetic Bearing Surface?

Cited by 11 publications

References 24 publications

Aseptic Loosening of Total Hip Arthroplasty as a Result of Local Failure of Tissue Homeostasis

Aseptic Loosening of Total Hip Arthroplasty as a Result of Local Failure of Tissue Homeostasis

Recent Advances in Arthroplasty

A Review of Aseptic Loosening in Total Hip Arthroplasty

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