ABSTRACT
INTRODUCTION: Aseptic loosening is the most common problem in total hip arthroplasty (THA). One main aspect is inflammatory reaction against wear particles of the prosthesis materials. Analysing failure mechanisms in THA analysis of the particles and their element distribution of revised granulomatous tissue is essential to improve materials used in THA. MATERIALS AND METHODS: 23 granulomas of revised THA due to aseptic loosening, 13 of which with metal on metal bearing (M/M), were analysed using inductively coupled plasma atomic emission spectrometry (ICP-OES). RESULTS: Elements Cr, Mn, Ni, Al, Cu, Zn, Cd, Ti, V, Zr, Nb and Fe could be detected. The maximum value of Cr was 23.88 ppb (parts per billion), Al 191.02 ppb, Ni 64.95 ppb and Zr 9.96 ppb. The highest value of Al could be found in cementless implants. The maximum value of the elements Cr and Ni could be detected in M/M. In cemented implants the highest value of Zr was found. DISCUSSION: The origin of Zr was the used bone cement in cemented THA. The elements Cr and Ni were significantly higher in M/M bearings. The highest value of Al was detected in granulomas of revised corund rough blasted cementless implants. The histopathologic findings of the revised M/M bearings have been published recently. Inductively Coupled Plasma Atomic Emission Spectrometry (ICP-OES) could not show any differences of the alloying constituents in cases with or without allergic reactions. ICP-OES analysis seems to be not useful examination of histologic sections using SEM with cryotransfer unit.
Subject(s)
Arthroplasty, Replacement, Hip/adverse effects , Foreign Bodies/classification , Granuloma/classification , Hip Joint/chemistry , Hip Joint/pathology , Metals/analysis , Prosthesis-Related Infections/classification , Arthroplasty, Replacement, Hip/methods , Cells, Cultured , Cementation , Equipment Failure Analysis/methods , Hip Joint/surgery , Humans , Prosthesis Failure , Prosthesis-Related Infections/etiology , Reoperation , Spectrophotometry, Atomic/methodsABSTRACT
INTRODUCTION: Blasting techniques using corundum to create rough surfaces are used in many different processes for the surface treatment of hip implants. Recent evidence points an association between residual particles and early loosenings in the sense of third-body wear. MATERIALS AND METHOD: The surfaces of five unused, original-packaged CLS stems and ARR-Titan supporting rings, respectively, were compared with five explanted CLS stems and ARR-Titan supporting rings. RESULTS: The surface of the ARR-Titan supporting rings was adhered to Al2O3 particles at 23.2+/-2.5% on the implants and 12.3+/-3.0% on the explants (P < 0.0001). For the CLS stem, the surface to which Al2O3 particles adhered was 16.4+/-2.2 % on the implants, whereas the surface to which Al2O3 particles adhered was 12.4+/-3.3% on the explants (P = 0.0275). DISCUSSION: The results of this study show that corundum particles can be found to cover a high percentage on rough-blasted titanium surfaces of ready-to-use devices. In contrast, this contamination is significantly less on the explants treated in an identical fashion prior to implantation.
Subject(s)
Aluminum Oxide/adverse effects , Arthroplasty, Replacement, Hip/instrumentation , Biocompatible Materials/adverse effects , Hip Prosthesis , Prosthesis Failure , Biocompatible Materials/therapeutic use , Device Removal , Equipment Failure Analysis , Humans , Prosthesis Design , Surface Properties , Titanium/therapeutic useABSTRACT
INTRODUCTION: Shot peening is widely used for surface treatment of hip implants. Shot peening with steel balls followed by a cleaning process with glass beads is used for introduction of negative stress in the production of morse taper junctions of the MRP-Titan stem. An increasing number of publications in maxillofacial surgery and orthopaedic surgery show that there is a significant contamination of Alumina or glass blasted surfaces. Latest research suggested an association between contaminant particles with early loosening of endoprostheses (third body wear). The aim of this study is to evaluate the amount and the effects of surface contamination with glass particles on morse taper junctions of implants and explants of the MRP-Titan stem. MATERIAL AND METHOD: The surface of morse taper junctions of the MRP-Titan stem (5 original-package implants and explants each) are analysed for glass particle contamination. A field emission scanning electron microscopy (LEO 1525) is used for the detection of the glass-particles on the implant surface with a backscattered electron detector. The relative surface area covered by particles was calculated by means of an image analyzing software (analySIS, Soft Imaging System GmbH). RESULTS: The surface of the implants showed a considerable contamination with glass particles with a mean of 6.67 +/- 0.82% compared to 2.06 +/- 0.74% on the surface of the explants. The difference was statistically significant (p<0.0001). DISCUSSION: The results of this study show that there is a relative high percentage of contamination with glass particles on shot peened morse taper junctions of the MRP-Titan stem. This contamination is significantly lower on the surface of the explants. With respect to third body wear and osteolysis in total hip arthroplasty further studies are necessary to minimize contamination while maintaining adequate surface quality.
