Macrophage Response to UHMWPE Submitted to Accelerated Ageing in Hydrogen Peroxide

Abstract

Ultra-high molecular weight polyethylene (UHMWPE) has been the most commonly used bearing material in total joint arthroplasty. Wear and oxidation fatigue resistance of UHMWPE are regarded as two important properties to extend the longevity of knee prostheses. The present study investigated the accelerated ageing of UHMWPE in hydrogen peroxide highly oxidative chemical environment. The sliced samples of UHMWPE were oxidized in a hydrogen peroxide solution for 120 days with their total level of oxidation (Iox) characterized by Fourier Transformed Infrared Spectroscopy (FTIR). The potential inflammatory response, cell viability and biocompatibility of such oxidized UHMWPE systems were assessed by a novel biological in vitro assay based on the secretion of nitric oxide (NO) by activated murine macrophages with gamma interferon (IFN-γ) cytokine and lipopolysaccharide (LPS). Furthermore, macrophage morphologies in contact with UHMWPE oxidized surfaces were analyzed by cell spreading-adhesion procedure using scanning electron microscopy (SEM). The results have given significant evidence that the longer the period of accelerated aging of UHMWPE the higher was the macrophage inflammatory equivalent response based on NO secretion analysis.

Magnetic particle imaging: advancements and perspectives for real-time in vivo monitoring and image-guided therapy

“…Studies have shown that polyethylene wear patterns in articial joint replacements are not always identical and cannot be explained exclusively by mechanical factors, such as the weight and degree of physical activity of the patients. [115][116][117] In cases of premature and excessive wear of polyethylene bearings, chemical degradation and oxidation of the polymer can signicantly lower its mechanical resistance and result in an accelerated wear-off process. 118,119 Polymer oxidation, which results in the embrittlement of the prosthetic material, can generate wear debris that eventually triggers an immune response and subsequent implant loosening (Fig.…”

Ultra High Molecular Weight Polyethylene is Cytotoxic and Causes Oxidative Stress, Even When Modified

“…Now it is well known that the severe PE particle disease is due to UHMWPE oxidative degradation caused by a ysterilization in air (1)(2)(3)(4). In order to solve this problem, the evolution of the conventional UHMWPE drove to alternative sterilization methods (ethylene oxide and gas plasma) and to the development of new PE derivatives with a supposed increased resistance to abrasion in vivo, such as the crosslinked PE (X-PE) and the vitamin Estabilized PE (E-PE), Unfortunately, particle disease and periprosthetic osteolysis still remain an unsolved problem (5)(6)(7)(8)(9). The osteolysis is an inflammatory process caused by a foreign body (10), wherein the particles trigger monocyte recruitment and macrophage activation, leading to chronic inflammation, with release of cytokines and proteases, and bone reabsorption (8).…”

“…In order to solve this problem, the evolution of the conventional UHMWPE drove to alternative sterilization methods (ethylene oxide and gas plasma) and to the development of new PE derivatives with a supposed increased resistance to abrasion in vivo, such as the crosslinked PE (X-PE) and the vitamin Estabilized PE (E-PE), Unfortunately, particle disease and periprosthetic osteolysis still remain an unsolved problem (5)(6)(7)(8)(9). The osteolysis is an inflammatory process caused by a foreign body (10), wherein the particles trigger monocyte recruitment and macrophage activation, leading to chronic inflammation, with release of cytokines and proteases, and bone reabsorption (8). It is well recognized that PE particles induce different reactions according to dimension (fragments larger than 10 J.1m produce foreign body-induced giant cell granuloma, whereas smaller fragments are phagocytized), number, shape, superficial hydrophobicity and oxidation (11)(12)(13)(14).…”

Severe Impingement of Lumbar Disc Replacements Increases the Functional Biological Activity of Polyethylene Wear Debris

“…At present, the biological activity model does not include the contributions of pro-inflammatory factors in vivo (e.g., adsorption of endotoxin/protein [75][76][77][78][79][80] and/or the extent of polyethylene particle oxidation [81][82][83] ), so further investigation of the inflammatory cytokine responses to wear debris in the spine is warranted. Nevertheless, these results lend support to the use of biological activity calculations in combination with particle size and number in individual size ranges to illustrate differences in total disc replacement wear modes.…”