Contamination by metallic elements released from joint prostheses.

When a metallic implant is in contact with human tissues, the organism reacts and a corrosion process starts. Consequently, we might observe liberation of metallic debris and wear. Our purpose is to measure the contamination and the migration of these metallic elements in the surrounding tissues of the implant. Two types of samples have been studied. First type is sample taken on post-mortem tissues around prostheses to study contamination gradients. Second type is sample taken on pathologic joints on periprosthetic capsular tissues in surgical conditions. These allow estimating contamination degree. The experiments were made on a Van de Graaff accelerator located at CERI (Centre d'Etude et de Recherche par Irradiation, Orléans, France). We measure elemental concentrations resulting from the contamination of the surface of each sample. Results are analysed in function of the pathology and the type of implants. According to the pathology and the location of the sampling, these measurements show a very heterogeneous contamination by metallic elements under particles and/or ionic species which can migrate through soft tissues by various mechanisms.

Modelling by percolation theory of the behaviour of natural coral used as bone substitute.

We investigate the relevance of site-bond percolation theory to model the resorption and ossification of natural coral implanted in bones. The first step of the process is the vascularization of the implant seen here as a percolation threshold. The resorption and ossification can thus take place by activation of unoccupied sites. We compare our results with previously obtained experimental data on implants in porcine cortical bones. Very encouraging results are obtained.

Nuclear methods to characterize biomaterials.

Techniques using X-rays are often used to study biomaterials fields. However, when one is interested by quantitative and very sensitive measurements, it is valuable to develop nuclear instruments and methods, in addition and complement with others. Fast neutron activation is appropriate for non-destructive analysis. Thermal neutron activation can evaluate trace elements as a reference. Proton-induced X-rays emission is applied to cartography of heavy elements. If necessary, proton-induced gamma-rays emission and charged particles scattering are suitable for evaluation and cartography of light elements. Radioactivated nuclei and labelled molecules can tag element transfers and biofunctionality. In our work, these methods are related to biomaterials field.

Determination of metallic ion transfer from an implanted prosthesis by the PIXE method.

Prostheses can release some metallic elements to the surrounding tissues, particularly when they are not covered with a biomaterial layer and when an unsealing process happens. We try to measure major and trace elements in these tissues with an experimentally sensitive method. Proton-induced X-ray emission is used to detect about 10 elements in tissue. Tissues are calcinated and deposited in a thin layer before irradiation. Results are obtained in a standard and samples from three patients. We observe contamination by Ti, Cr, Ni, and Zn in the tissues. Correlations are to be studied between these atomic transfers and prosthesis in the patient.

Study of implanted biomaterial functionality by diphosphonate molecules labeled with radioactive 99mTc.

An implanted biomaterial can be transformed into young bone after some months, but it has not necessary reached full biofunctionality. Mineral concentration kinetics and crystal-structure studies, still being carried out in our group, are completed here by biofunctionality determinations. A natural coral is implanted in vivo at the cortical level of the femoral diaphyoff++ in rabbits. Diphosphonates molecules labeled with radioactive 99mTc are then injected in rabbits and the fixation of the radioactivity is analyzed in several sites for 8 mo after the implantation. Nuclear instruments and methods are used for the measurements. Four successive cycles of osseous remodeling are determined before reaching a biofunctional phase.

Osseointegration in cortical sheep bone of calcium phosphate implants evaluated by PIXE method and histology.

Osseointegration of porous calcium phosphate ceramics evolves in several stages once implanted. Histologic analysis has often been used to evaluate the mechanism of integration of this material. Histologic parameters can be completed by physical analysis to obtain a semiquantitative evaluation of the osseointegration process. The histologic observation of hydroxyapatite (HA)-ceramic-containing bone sections was associated with proton-induced X-ray emission (PIXE) analysis and the results obtained by both methods were compared. Porous HA-ceramic cylinders were implanted in cortical bone of sheep femurs for periods ranging from 2 to 36 weeks. Thick sections of the implant containing bone were made at the end of the implantation period. A scanning line with two proton impacts 0.5 mm apart was plotted from the edges of cortical bone across the implanted ceramic and the X-rays produced were determined. Calcium, phosphorus, zinc, strontium, and iron contents were measured. Following PIXE analysis, the sections were surface-stained and observed under a light microscope to define the osseointegration index. Two regions of the curves were identified for each element characterizing either the bone tissue or the ceramic. Zinc and strontium present in the bone tissue but absent from the ceramics appeared after the 8th and the 12th implantation weeks, respectively. Iron present in the implant decreased with time, and calcium and phosphorus contents tended to be the same at the end of the implantation period in both curve regions. Histologic observation showed that immature bone invaded the pores of the outer layer of the ceramic as early as 2 weeks after implantation. Ceramics were totally osseointegrated 20 weeks after implantation. Osseointegration was apparently still evolving as judged by the PIXE method when histologic integration was considered complete.

Resorption kinetics of osseous substitute: natural coral and synthetic hydroxyapatite.

Coral and hydroxyapatite may be used as substitution biomaterials for bone grafts. In this work, we extracted the implants from the femora to study the kinetics of elementary mineral transformation of the osseous substitutes. The use of physical analysis methods such as PIXE (particle-induced X-ray emission) shows that coral and hydroxyapatite, after their implantation in vivo, reach a mineral composition comparable with that of bone. For the first time we have measured the concentration of mineral elements, at different time intervals after implantation, along a cross-section. The distribution according to mineral elements (Ca, P, Sr, Zn, Fe) in the implant, in the receiver site and also at the interface, showed that the kinetics of coral resorption was faster than that of hydroxyapatite; in the same way, the osseous attack was not global but, rather, centripetal.

Diffusion of mineral elements evaluated by PIXE at the bone-coral interface.

Substituting the tissue of human organs with biomaterials is problematic. However, its importance and relevance justify all the efforts made. An interdisciplinary approach is required. We report on our study of a product for bone substitution. Coral is a natural product, the interest of which we have already demonstrated in our previous work. Following sterilization, natural coral was implanted in sheep femurs. We regularly extracted the implants from the femurs to study the kinetics of elemental mineral transformation of the bone substitutes. For the first time ever, and thanks to the PIXE method (particles induced X-ray emission), we were able to measure the concentration of mineral elements at different time intervals after implantation over a whole cross-section. We found a discontinuity of the mineral elements (Ca, P, Sr, Zn, Fe) at the interface between the implant and the receiver. This shows that the osseous attack is not global but, on the contrary, centripetal. Moreover, the fit of the concentration time course indicates that the kinetics of ossification are different for each atomic element and characterize a distinct biological phenomenon. Our analyses confirm the biocompatibility and the ossification of the implanted coral.

Quantitative study of the coral transformations 'in vivo' by several physical analytical methods.

Coral has been used for the last ten years as bone substitution in the body because of its mechanic and osteoconductor properties. Our primary studies have shown, for the first time, the quantitative behaviour of the atomic components.