Wear particles and ions from cemented and uncemented titanium‐based hip prostheses—A histological and chemical analysis of retrieval material

Abstract

Wear debris-induced inflammation is considered to be the main cause for periprosthetic osteolysis in total hip replacements (THR). The objective of this retrieval study was to examine the tissue reactions and exposure to metal ions and wear particles in periprosthetic tissues and blood samples from patients with titanium (Ti)-based hip prostheses that were revised due to wear, osteolysis, and/or aseptic loosening. Semiquantitative, histological tissue evaluations in 30 THR-patients revealed numerous wear debris-loaded macrophages, inflammatory cells, and necrosis in both groups. Particle load was highest in tissues adjacent to loosened cemented Ti stems that contained mainly submicron zirconium (Zr) dioxide particles. Particles containing pure Ti and Ti alloy elements were most abundant in tissues near retrieved uncemented cups. Polyethylene particles were also detected, but accounted only for a small portion of the total particle number. The blood concentrations of Ti and Zr were highly elevated in cases with high abrasive wear and osteolysis. Our findings indicate that wear particles of different chemical composition induced similar inflammatory responses, which suggests that particle size and load might be more important than the wear particle composition in periprosthetic inflammation and osteolysis. © 2014 The Authors. Journal of Biomedical Materials Research Part B: Applied Biomaterials Published by Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 103B:709–717, 2015.

TiO2 nanoparticles disrupt cell adhesion and the architecture of cytoskeletal networks of human osteoblast‐like cells in a size dependent manner

“…Titanium and its alloys are commonly used biomaterials in oral and orthopedic implants owing to their biocompatibility and good mechanical properties . However, upon abrasion of the titanium dioxide (TiO 2 ) layer formed on implants’ surfaces, TiO 2 particles ranging from nano‐ to micron‐sizes can be released, which may lead to adverse effects . Being nondegradable, TiO 2 particles can represent a long‐term hazard when released in tissues and previous reports from our lab reported cellular uptake and transfer of these particles between cells via endosomes and lysosomes .…”

From Dose to Response: In Vivo Nanoparticle Processing and Potential Toxicity

“…Such in vivo biotransformation processes are known to occur with implanted orthopedic materials that can lead to both pathologic and beneficial patient outcomes. For example, nanoparticle wear debris formed from articulating prosthetic surfaces can lead to osteolysis [29], whereas the successful adherence and osteoinduction of amorphous bioactive glass results from a dissolution and re-precipitation reaction and induces a material phase change to crystalline hydroxyapatite [35, 39]. …”

Recovery of low volumes of wear debris from rat stifle joint tissues using a novel particle isolation method

“…The CoCrMo and Ti-6Al-4V particles used in this study were similar in size and shape to those retrieved from periprosthetic tissues and those generated by physiological hip simulators [19,24,[44][45][46]. The size and shape of CoCrMo and Ti-6Al-4V particles showed slight variation between the validation study [34] and the rat study.…”