Mixed material wear particle isolation from periprosthetic tissue surrounding total joint replacements

Abstract

Submicron-sized wear particles are generally accepted as a potential cause of aseptic loosening when produced in sufficient volumes. With the accelerating use of increasingly wear-resistant biomaterials, identifying such particles and evaluating their biological response is becoming more challenging. Highly sensitive wear particle isolation methods have been developed but these methods cannot isolate the complete spectrum of particle types present in individual tissue samples. Two established techniques were modified to create one novel method to isolate both high-and low-density materials from periprosthetic tissue samples. Ten total hip replacement and eight total knee replacement tissue samples were processed. All particle types were characterized using high resolution scanning electron microscopy. UHMWPE and a range of high-density materials were isolated from all tissue samples, including: polymethylmethacrylate, zirconium dioxide, titanium alloy, cobalt chromium alloy and stainless steel. This feasibility study demonstrates the coexistence of mixed particle types in periprosthetic tissues and provides researchers with high-resolution images of clinically relevant wear particles that could be used as a reference for future in vitro biological response studies.

Isolation and Characterisation of Wear Debris Surrounding Failed Total Ankle Replacements

“…The different particle types produced by TAR had a slightly different size distribution. Only 28% of high-density wear particles were in the submicron range for TAR, compared to 51% for THR and 57% for TKR [38] . Although, this is unlikely to have a meaningful impact on biological reactivity because a similar proportion of wear particles ( ∼90%) for all three joint types were in the phagocytosable size range ( < 10 μm).…”

“…The UHMWPE particles produced by TAR appear to be consistent with those produced by THR and TKR. The authors of this study have previously used the same method to isolate and characterise UHMWPE and high-density wear parti-cles from tissue surrounding failed THRs and TKRs [38] . The size and shape of UHMWPE particles were comparable between TAR, THR and TKR with about 72% of particles being in the submicron size range.…”

“…A modified method capable of isolating UHMWPE and highdensity wear particles from the same periprosthetic tissue sample was used. The details of this method are explained in Stratton-Powell, et al [38] . Only two procedural changes were made.…”

“…A method to isolate and characterise mixed-material particle populations from individual tissue samples has recently been de-veloped and validated by the authors of this article [38] . Given the perceived relevance of both bearing wear and other wear modes to the failure of TAR, this modified method was applied to tissue samples retrieved from failed TARs.…”

“…The aim of this study was to identify which materials comprise the wear particle burden surrounding failed TARs and to determine their characteristics. The results were then compared to previously published literature, including the results from a study using the same isolation method for failed total hip replacements (THRs) and TKRs [38] .…”