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de Souza W, Gemini-Piperni S, Ruivo C, Bastos N, Almeida S, Lopes D, Cardoso P, Oliveira MJ, Sumner DR, Ross RD, Jacobs JJ, Granjeiro JM, Fernandes MH, Rocha LA, Melo S, Ribeiro AR. Osteoblasts-derived exosomes as potential novel communicators in particle-induced periprosthetic osteolysis. Mater Today Bio 2024; 28:101189. [PMID: 39221219 PMCID: PMC11364904 DOI: 10.1016/j.mtbio.2024.101189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Revised: 07/12/2024] [Accepted: 08/05/2024] [Indexed: 09/04/2024] Open
Abstract
The inflammatory response to wear particles derived from hip prothesis is considered a hallmark of periprosthetic osteolysis, which can ultimately lead to the need for revision surgery. Exosomes (Exos) have been associated with various bone pathologies, and there is increasing recognition in the literature that they actively transport molecules throughout the body. The role of wear particles in osteoblast-derived Exos is unknown, and the potential contribution of Exos to osteoimmune communication and periprosthetic osteolysis niche is still in its infancy. Given this, we investigate how titanium dioxide nanoparticles (TiO2 NPs), similar in size and composition to prosthetic wear particles, affect Exos biogenesis. Two osteoblastic cell models commonly used to study the response of osteoblasts to wear particles were selected as a proof of concept. The contribution of Exos to periprosthetic osteolysis was assessed by functional assays in which primary human macrophages were stimulated with bone-derived Exos. We demonstrated that TiO2 NPs enter multivesicular bodies, the nascent of Exos, altering osteoblast-derived Exos secretion and molecular cargo. No significant differences were observed in Exos morphology and size. However, functional assays reveal that Exos cargo enriched in uPA stimulates macrophages to a mixed M1 and M2 phenotype, inducing the release of pro- and anti-inflammatory signals characteristic of periprosthetic osteolysis. In addition, we demonstrated the expression of uPA in exosomes derived from the urine of patients with osteolysis. These results suggest that uPA can be a potential biomarker of osteolysis. In the future, uPa may serve as a possible non-invasive biomarker to identify patients at risk for peri-implant osteolysis.
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Affiliation(s)
- Wanderson de Souza
- Directory of Life Sciences Applied Metrology, National Institute of Metrology Quality and Technology, Rio de Janeiro, Brazil
- Postgraduate Program in Biotechnology, National Institute of Metrology Quality and Technology, Rio de Janeiro, Brazil
| | - S. Gemini-Piperni
- Postgraduate Program in Translational Biomedicine, University Grande Rio, Duque de Caxias, Brazil
- Labεn Group, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
| | - Carolina Ruivo
- I3S-Institute for Research and Innovation in Health, University of Porto, Portugal, Porto, Portugal
| | - Nuno Bastos
- I3S-Institute for Research and Innovation in Health, University of Porto, Portugal, Porto, Portugal
| | - Sofia Almeida
- I3S-Institute for Research and Innovation in Health, University of Porto, Portugal, Porto, Portugal
| | - Daniel Lopes
- I3S-Institute for Research and Innovation in Health, University of Porto, Portugal, Porto, Portugal
| | - Patricia Cardoso
- I3S-Institute for Research and Innovation in Health, University of Porto, Portugal, Porto, Portugal
| | - Maria Jose Oliveira
- I3S-Institute for Research and Innovation in Health, University of Porto, Portugal, Porto, Portugal
| | - D. Rick Sumner
- Department of Orthopedic Surgery of RUSH University, Chicago, USA
| | - Ryan D. Ross
- Department of Orthopedic Surgery of RUSH University, Chicago, USA
| | - Joshua J. Jacobs
- Department of Anatomy & Cell Biology of RUSH University, Chicago, USA
| | - Jose Mauro Granjeiro
- Directory of Life Sciences Applied Metrology, National Institute of Metrology Quality and Technology, Rio de Janeiro, Brazil
- Postgraduate Program in Biotechnology, National Institute of Metrology Quality and Technology, Rio de Janeiro, Brazil
- Postgraduate Program in Translational Biomedicine, University Grande Rio, Duque de Caxias, Brazil
- Dental School, Fluminense Federal University, Niterói, Brazil
| | - Maria Helena Fernandes
- Faculty of Dental Medicine, University of Porto, Porto, Portugal
- LAQV/REQUIMTE, University of Porto, Porto, Portugal
| | - Luis A. Rocha
- proMetheus, Escola Superior de Tecnologia e Gestão, Instituto Politécnico de Viana do Castelo, Viana do Castelo, Portugal
- IBTN/EURO – European Branch of the Institute of Biomaterials, Tribocorrosion and Nanomedicine, Izmir Institute of Technology, Izmir, Turkey
| | - Sonia Melo
- I3S-Institute for Research and Innovation in Health, University of Porto, Portugal, Porto, Portugal
| | - Ana R. Ribeiro
- IBTN/EURO – European Branch of the Institute of Biomaterials, Tribocorrosion and Nanomedicine, Izmir Institute of Technology, Izmir, Turkey
- Nanosafety group, International Iberian Nanotechnology Laboratory (INL), Braga, Portugal
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Zhang G, Deng L, Jiang Z, Xiang G, Zeng Z, Zhang H, Wang Y. Titanium nanoparticles released from orthopedic implants induce muscle fibrosis via activation of SNAI2. J Nanobiotechnology 2024; 22:522. [PMID: 39215337 PMCID: PMC11363368 DOI: 10.1186/s12951-024-02762-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2024] [Accepted: 08/09/2024] [Indexed: 09/04/2024] Open
Abstract
Titanium alloys represent the prevailing material employed in orthopedic implants, which are present in millions of patients worldwide. The prolonged presence of these implants in the human body has raised concerns about possible health effects. This study presents a comprehensive analysis of titanium implants and surrounding tissue samples obtained from patients who underwent revision surgery for therapeutic reasons. The surface of the implants exhibited nano-scale corrosion defects, and nanoparticles were deposited in adjacent samples. In addition, muscle in close proximity to the implant showed clear evidence of fibrotic proliferation, with titanium content in the muscle tissue increasing the closer it was to the implant. Transcriptomics analysis revealed SNAI2 upregulation and activation of PI3K/AKT signaling. In vivo rodent and zebrafish models validated that titanium implant or nanoparticles exposure provoked collagen deposition and disorganized muscle structure. Snai2 knockdown significantly reduced implant-associated fibrosis in both rodent and zebrafish models. Cellular experiments demonstrated that titanium dioxide nanoparticles (TiO2 NPs) induced fibrotic gene expression at sub-cytotoxic doses, whereas Snai2 knockdown significantly reduced TiO2 NPs-induced fibrotic gene expression. The in vivo and in vitro experiments collectively demonstrated that Snai2 plays a pivotal role in mediating titanium-induced fibrosis. Overall, these findings indicate a significant release of titanium nanoparticles from the implants into the surrounding tissues, resulting in muscular fibrosis, partially through Snai2-dependent signaling.
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Affiliation(s)
- Gengming Zhang
- Department of Spine Surgery and Orthopaedics, Xiangya Hospital, Central South University, Changsha, Hunan, 410008, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, 410008, China
| | - Linhua Deng
- Department of Spine Surgery and Orthopaedics, Xiangya Hospital, Central South University, Changsha, Hunan, 410008, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, 410008, China
| | - Zhongjing Jiang
- Department of Spine Surgery and Orthopaedics, Xiangya Hospital, Central South University, Changsha, Hunan, 410008, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, 410008, China
| | - Gang Xiang
- Department of Spine Surgery and Orthopaedics, Xiangya Hospital, Central South University, Changsha, Hunan, 410008, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, 410008, China
| | - Zhuotong Zeng
- College of Environmental Science and Engineering, Key Laboratory of Environmental Biology and Pollution Control (Hunan University), Hunan University, Ministry of Education, Changsha, 410082, PR China
- Department of Dermatology, Second Xiangya Hospital, Central South University, Changsha, 410011, PR China
| | - Hongqi Zhang
- Department of Spine Surgery and Orthopaedics, Xiangya Hospital, Central South University, Changsha, Hunan, 410008, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, 410008, China
| | - Yunjia Wang
- Department of Spine Surgery and Orthopaedics, Xiangya Hospital, Central South University, Changsha, Hunan, 410008, China.
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, 410008, China.
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Fischer A, Telouk P, Beckmann C, Heermant S, Wittrock A, Debus J, Wimmer MA. Performance of Austenitic High-Nitrogen Steels under Gross Slip Fretting Corrosion in Bovine Serum. J Funct Biomater 2024; 15:110. [PMID: 38667567 PMCID: PMC11051106 DOI: 10.3390/jfb15040110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2024] [Revised: 04/08/2024] [Accepted: 04/09/2024] [Indexed: 04/28/2024] Open
Abstract
Modular artificial hip joints are a clinical standard today. However, the release of wear products from the head-taper interface, which includes wear particles in the nm size range, as well as metal ions, have raised concerns. Depending on the loading of such taper joints, a wide variety of different mechanisms have been found by retrieval analyses. From these, this paper concentrates on analyzing the contribution of gross slip fretting corrosion at ultra-mild wear rates using a bovine calf serum solution (BCS) as the lubricant. The parameters were chosen based on biomechanical considerations, producing wear rates of some ng/m wear path. In parallel, the evolution of tribomaterial (third bodies) was analyzed as to its constituents and generation rates. It has already been shown earlier that, by an advantageous combination of wear mechanisms and submechanisms, certain constituents of the tribomaterial remain inside the contact area and act like extreme-pressure lubricant additives. For the known wear and corrosion resistance of austenitic high-nitrogen steels (AHNSs), which outperform CoCrMo alloys even under inflammatory conditions, we hypothesized that such steels will generate ultra-mild wear rates under gross slip fretting. While testing AHNSs against commercially available biomedical-grade materials of CoCrMo and TiAlV alloys, as well as zirconia-toughened alumina (ZTA) and against itself, it was found that AHNSs in combination with a Ti6Al4V alloy generated the smallest wear rate under gross slip fretting corrosion. This paper then discusses the wear behavior on the basis of ex situ analyses of the worn surfaces as to the acting wear mechanisms and submechanisms, as well as to the tribological reaction products.
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Affiliation(s)
- Alfons Fischer
- Max Planck Institute for Sustainable Materials, Microstructure Physics and Alloy Design, 40237 Duesseldorf, Germany
- Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL 60612, USA;
| | - Philipe Telouk
- Laboratoire de Géologie, Université de Lyon, 69342 Lyon, France;
| | - Christian Beckmann
- Department of Physics, TU Dortmund University, 44227 Dortmund, Germany; (C.B.); (S.H.); (A.W.); (J.D.)
| | - Saskia Heermant
- Department of Physics, TU Dortmund University, 44227 Dortmund, Germany; (C.B.); (S.H.); (A.W.); (J.D.)
| | - Adrian Wittrock
- Department of Physics, TU Dortmund University, 44227 Dortmund, Germany; (C.B.); (S.H.); (A.W.); (J.D.)
| | - Jörg Debus
- Department of Physics, TU Dortmund University, 44227 Dortmund, Germany; (C.B.); (S.H.); (A.W.); (J.D.)
| | - Markus A. Wimmer
- Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL 60612, USA;
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Tan Z, Deng L, Jiang Z, Xiang G, Zhang G, He S, Zhang H, Wang Y. Selenium Nanoparticles Attenuate Cobalt Nanoparticle-Induced Skeletal Muscle Injury: A Study Based on Myoblasts and Zebrafish. TOXICS 2024; 12:130. [PMID: 38393225 PMCID: PMC10893304 DOI: 10.3390/toxics12020130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/25/2023] [Revised: 01/24/2024] [Accepted: 01/30/2024] [Indexed: 02/25/2024]
Abstract
Cobalt alloys have numerous applications, especially as critical components in orthopedic biomedical implants. However, recent investigations have revealed potential hazards associated with the release of nanoparticles from cobalt-based implants during implantation. This can lead to their accumulation and migration within the body, resulting in adverse reactions such as organ toxicity. Despite being a primary interface for cobalt nanoparticle (CoNP) exposure, skeletal muscle lacks comprehensive long-term impact studies. This study evaluated whether selenium nanoparticles (SeNPs) could mitigate CoNP toxicity in muscle cells and zebrafish models. CoNPs dose-dependently reduced C2C12 viability while elevating reactive oxygen species (ROS) and apoptosis. However, low-dose SeNPs attenuated these adverse effects. CoNPs downregulated myogenic genes and α-smooth muscle actin (α-SMA) expression in C2C12 cells; this effect was attenuated by SeNP cotreatment. Zebrafish studies confirmed CoNP toxicity, as it decreased locomotor performance while inducing muscle injury, ROS generation, malformations, and mortality. However, SeNPs alleviated these detrimental effects. Overall, SeNPs mitigated CoNP-mediated cytotoxicity in muscle cells and tissue through antioxidative and antiapoptotic mechanisms. This suggests that SeNP-coated implants could be developed to eliminate cobalt nanoparticle toxicity and enhance the safety of metallic implants.
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Affiliation(s)
- Zejiu Tan
- Department of Spine Surgery and Orthopaedics, Xiangya Hospital, Central South University, Changsha 410008, China; (Z.T.); (L.D.); (Z.J.); (G.X.); (G.Z.); (S.H.); (H.Z.)
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha 410008, China
| | - Linhua Deng
- Department of Spine Surgery and Orthopaedics, Xiangya Hospital, Central South University, Changsha 410008, China; (Z.T.); (L.D.); (Z.J.); (G.X.); (G.Z.); (S.H.); (H.Z.)
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha 410008, China
| | - Zhongjing Jiang
- Department of Spine Surgery and Orthopaedics, Xiangya Hospital, Central South University, Changsha 410008, China; (Z.T.); (L.D.); (Z.J.); (G.X.); (G.Z.); (S.H.); (H.Z.)
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha 410008, China
| | - Gang Xiang
- Department of Spine Surgery and Orthopaedics, Xiangya Hospital, Central South University, Changsha 410008, China; (Z.T.); (L.D.); (Z.J.); (G.X.); (G.Z.); (S.H.); (H.Z.)
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha 410008, China
| | - Gengming Zhang
- Department of Spine Surgery and Orthopaedics, Xiangya Hospital, Central South University, Changsha 410008, China; (Z.T.); (L.D.); (Z.J.); (G.X.); (G.Z.); (S.H.); (H.Z.)
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha 410008, China
| | - Sihan He
- Department of Spine Surgery and Orthopaedics, Xiangya Hospital, Central South University, Changsha 410008, China; (Z.T.); (L.D.); (Z.J.); (G.X.); (G.Z.); (S.H.); (H.Z.)
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha 410008, China
| | - Hongqi Zhang
- Department of Spine Surgery and Orthopaedics, Xiangya Hospital, Central South University, Changsha 410008, China; (Z.T.); (L.D.); (Z.J.); (G.X.); (G.Z.); (S.H.); (H.Z.)
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha 410008, China
| | - Yunjia Wang
- Department of Spine Surgery and Orthopaedics, Xiangya Hospital, Central South University, Changsha 410008, China; (Z.T.); (L.D.); (Z.J.); (G.X.); (G.Z.); (S.H.); (H.Z.)
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha 410008, China
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5
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Döring J, Basten S, Ecke M, Herbster M, Kirsch B, Halle T, Lohmann CH, Bertrand J, Aurich J. Surface integrity modification of CoCrMo alloy by deep rolling in combination with sub-zero cooling as potential implant application. J Biomed Mater Res B Appl Biomater 2023; 111:946-957. [PMID: 36479964 DOI: 10.1002/jbm.b.35204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Revised: 10/05/2022] [Accepted: 11/16/2022] [Indexed: 12/14/2022]
Abstract
Alloys made of CoCrMo are well established as implants materials since decades in orthopedic surgery. The good mechanical properties, biocompatibility and especially the corrosion resistance are important rationales for the use of these alloys. Nevertheless, retrieved implants from revision surgery showed the occurrence of abrasion and corrosion. The wear mechanisms and the occurring corrosion processes might be reduced with a functionalization of the surface. The hexagonal phase of the cobalt chromium matrix plays an important role in the surface functionalization. It can be specifically transformed and set during the manufacturing process. One possibility for the induction of the transformation is the use of a deep rolling process in combination with a novel "sub-zero" cooling strategy during machining. The influence of force and temperature during the deep rolling process on the formation of the hexagonal Co-phase is examined in this study. The results from the targeted setting of the hexagonal Co-phase in the subsurface are shown. For this purpose, EBSD studies have been carried out to detect and quantify the proportion of Co-hex phase in the subsurface of the modified alloys. To analyze the mechanical properties, we measured the residual stress and hardness in the near surface layer under conditions close to the application. Furthermore, we performed biological tests to show a potential influence of the modification on the biocompatibility when using the sub-zero cooling approach. We observed no negative effect on the osteoblastic cell line which attached similarly to all tested surfaces. The investigations provide first insights into the potential use of "sub-zero" cooling in modifying orthopedic implant materials, but also the respective limits with regard to the surface functionalization. Deep rolling in combination with an innovative cooling strategy has a great potential to improve the mechanical properties of CoCr28Mo6 wrought alloy, by subsurface hardening and phase transformation.
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Affiliation(s)
- Joachim Döring
- Department of Orthopaedic Surgery, Medical Faculty, Otto-von-Guericke-University Magdeburg, Magdeburg, Germany
| | - Stephan Basten
- Institute for Manufacturing Technology and Production Systems, TU Kaiserslautern, Kaiserslautern, Germany
| | - Martin Ecke
- Institute of Materials and Joining Technology, Otto-von-Guericke-University Magdeburg, Magdeburg, Germany
| | - Maria Herbster
- Department of Orthopaedic Surgery, Medical Faculty, Otto-von-Guericke-University Magdeburg, Magdeburg, Germany.,Institute of Materials and Joining Technology, Otto-von-Guericke-University Magdeburg, Magdeburg, Germany
| | - Benjamin Kirsch
- Institute for Manufacturing Technology and Production Systems, TU Kaiserslautern, Kaiserslautern, Germany
| | - Thorsten Halle
- Institute of Materials and Joining Technology, Otto-von-Guericke-University Magdeburg, Magdeburg, Germany
| | - Christoph H Lohmann
- Department of Orthopaedic Surgery, Medical Faculty, Otto-von-Guericke-University Magdeburg, Magdeburg, Germany
| | - Jessica Bertrand
- Department of Orthopaedic Surgery, Medical Faculty, Otto-von-Guericke-University Magdeburg, Magdeburg, Germany
| | - Jan Aurich
- Institute for Manufacturing Technology and Production Systems, TU Kaiserslautern, Kaiserslautern, Germany
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Gustafson JA, Mell S, Levine BR, Pourzal R, Lundberg HJ. Interaction of surface topography and taper mismatch on head-stem modular junction contact mechanics during assembly in modern total hip replacement. J Orthop Res 2023; 41:418-425. [PMID: 35488727 PMCID: PMC9617811 DOI: 10.1002/jor.25357] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Revised: 04/11/2022] [Accepted: 04/28/2022] [Indexed: 02/04/2023]
Abstract
Implant failure due to fretting corrosion at the head-stem modular junction is an increasing problem in modular total hip arthroplasty. The effect of varying microgroove topography on modular junction contact mechanics has not been well characterized. The aim of this study was to employ a novel, microgrooved finite element (FEA) model of the hip taper interface and assess the role of microgroove geometry and taper mismatch angle on the modular junction mechanics during assembly. A two-dimensional, axisymmetric FEA model was created using a modern 12/14 taper design of a CoCrMo femoral head taper and Ti6Al4V stem taper. Microgrooves were modeled at the contacting interface of the tapers and varied based on height and spacing measurements obtained from a repository of measured retrievals. Additionally, taper angular mismatch between the head and stem was varied to simulate proximal- and distal-locked engagement. Forty simulations were conducted to parametrically evaluate the effects of microgroove surface topography and angular mismatch on predicted contact area, contact pressure, and equivalent plastic strain. Multiple linear regression analysis was highly significant (p < 0.001; R2 > 0.74) for all outcome variables. The regression analysis identified microgroove geometry on the head taper to have the greatest influence on modular junction contact mechanics. Additionally, there was a significant second order relationship between both peak contact pressure (p < 0.001) and plastic strain (p < 0.001) with taper mismatch angle. These modeling techniques will be used to identify the implant parameters that maximize taper interference strength via large in-silico parametric studies.
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Affiliation(s)
| | - Steven Mell
- Department of Orthopedic Surgery, Rush University Medical Center, Chicago, Illinois
| | - Brett R. Levine
- Department of Orthopedic Surgery, Rush University Medical Center, Chicago, Illinois
| | - Robin Pourzal
- Department of Orthopedic Surgery, Rush University Medical Center, Chicago, Illinois
| | - Hannah J. Lundberg
- Department of Orthopedic Surgery, Rush University Medical Center, Chicago, Illinois
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Pan H, Miao X, Deng J, Pan C, Cheng X, Wang X. Bimetallic Metal-Organic Framework for Mitigating Aseptic Osteolysis. ACS APPLIED MATERIALS & INTERFACES 2023; 15:4935-4946. [PMID: 36657969 DOI: 10.1021/acsami.2c19449] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
The disability rate of joint diseases can be reduced by the use of artificial joints, but joint loosening at a late state limits the lifespan and surgical efficacy of the joints. Wear particles can be recognized by macrophages and induce cells to produce reactive oxygen species (ROS) and inflammatory factors, causing persistent inflammation and decreased osteogenic activity, which ultimately leads to loosening of joint prostheses. Here, the platinum (Pt) nanozymes with excellent ROS scavenging and anti-inflammatory capabilities were encapsulated in zinc imidazolium zeolite framework-8 (ZIF-8), and then the osteogenic active element lanthanum (La) was introduced through ion exchange to finally construct a bimetallic metal-organic framework (Pt@ZIF-8@La). In vitro and in vivo experiments demonstrated that this multifunctional nanoplatform possessed the functions of efficient scavenging of ROS, immune regulation, and promotion of osteogenic differentiation. Meanwhile, the mechanism is explored that Pt@ZIF-8@La can also promote osteogenic mineralization by upregulating the ratio of the osteoprotegerin (OPG)/receptor activator of the NF-κB ligand (RANKL), which can achieve a synergistic therapeutic effect of immunomodulation and osteogenesis, thereby realizing the purpose of relieving aseptic osteolysis.
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Affiliation(s)
- Huajun Pan
- Department of Orthopedics, the Second Affiliated Hospital of Nanchang University, Nanchang University, Nanchang, Jiangxi330006, P. R. China
| | - Xinxin Miao
- Department of Orthopedics, the Second Affiliated Hospital of Nanchang University, Nanchang University, Nanchang, Jiangxi330006, P. R. China
| | - Jianjian Deng
- Department of Orthopedics, the Second Affiliated Hospital of Nanchang University, Nanchang University, Nanchang, Jiangxi330006, P. R. China
| | - Chongzhi Pan
- Department of Orthopedics, the Second Affiliated Hospital of Nanchang University, Nanchang University, Nanchang, Jiangxi330006, P. R. China
| | - Xigao Cheng
- Department of Orthopedics, the Second Affiliated Hospital of Nanchang University, Nanchang University, Nanchang, Jiangxi330006, P. R. China
| | - Xiaolei Wang
- National Engineering Research Center for Bioengineering Drugs and the Technologies, Institute of Translational Medicine, Nanchang University, Nanchang, Jiangxi330088, P. R. China
- School of Chemistry and Chemical Engineering, Nanchang University, Nanchang, Jiangxi330088, P. R. China
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Bormann T, Müller U, Gibmeier J, Mai PT, Renkawitz T, Kretzer JP. Insights into Imprinting: How Is the Phenomenon of Tribocorrosion at Head-Neck Taper Interfaces Related to Corrosion, Fretting, and Implant Design Parameters? Clin Orthop Relat Res 2022; 480:1585-1600. [PMID: 35383614 PMCID: PMC9278900 DOI: 10.1097/corr.0000000000002202] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Accepted: 03/15/2022] [Indexed: 01/31/2023]
Abstract
BACKGROUND Wear and corrosion at modular neck tapers in THA can lead to major clinical implications such as periprosthetic osteolysis, adverse local tissue reactions, or implant failure. The material degradation processes at the taper interface are complex and involve fretting corrosion, third-body abrasion, as well as electrochemical and crevice corrosion. One phenomenon in this context is imprinting of the head taper, where the initially smooth surface develops a topography that reflects the rougher neck taper profile. The formation mechanism of this specific phenomenon, and its relation to other observed damage features, is unclear. An analysis of retrieved implants may offer some insights into this process. QUESTIONS/PURPOSES (1) Is imprinting related to time in situ of the implants and to the taper damage modes of corrosion and fretting? (2) Are implant design parameters like neck taper profile, stem material, or head seating associated with the formation of imprinting? (3) Is imprinting created by an impression of the neck taper profile or can a different mechanistic explanation for imprinting be derived? METHODS Thirty-one THAs with cobalt-chromium-molybdenum-alloy (CoCrMo) heads retrieved between 2013 and 2019 at revision surgery from an institutional registry were investigated. Inclusion criteria were: 12/14 tapers, a head size of 36 mm or smaller, time in situ more than 1 year, and intact nonmodular stems without sleeve adaptors. After grouping the residual THAs according to stem type, stem material, and manufacturer, all groups of three or more were included. Of the resulting subset of 31 retrievals, nine THAs exhibited a still assembled head-neck taper connection. The median (range) time in situ was 5 years (1 to 23). Two stem materials (21 titanium-alloy and 10 stainless steel), three kinds of bearing couples (11 metal-on-metal, 13 metal-on-polyethylene, and seven dual-mobility heads), and two different neck taper profiles (six wavy profile and 25 fluted profile) were present in the collection. Four THAs exhibited signs of eccentric head seating. The 31 investigated THAs represented 21% of the retrieved THAs with a CoCrMo alloy head during the specified period.At the head tapers, the damage modes of corrosion, fretting, and imprinting were semiquantitatively rated on a scale between 0 (no corrosion/fretting/imprinting) and 3 (severe corrosion/fretting/imprinting). Corrosion and fretting were assessed applying the Goldberg score, with the modification that the scale started at 0 and not at 1. Imprinting was assessed with a custom scoring system. Rating was done individually at the proximal and distal head taper half and summed to one total damage score for each retrieval and damage mode. Correlations between the damage modes and time in situ and between the damage modes among each other, were assessed using the Spearman rank order correlation coefficient (ρ). Associations between imprinting and implant design parameters were investigated by comparing the total imprinting score distributions with the Mann-Whitney U-test. Metallographically prepared cross-sections of assembled head-neck taper connections were examined by optical microscopy and disassembled head and neck taper surfaces were assessed by scanning electron microscopy (SEM). RESULTS The imprinting damage score increased with time in-situ (ρ = 0.72; p < 0.001) and the corrosion damage score (ρ = 0.63; p < 0.001) but not with the fretting damage score (ρ = 0.35; p = 0.05). There was no difference in total imprinting score comparing neck taper profiles or stem materials, with the numbers available. Eccentric head seating had elevated total imprinting score (median 6 [interquartile range 0]) compared with centric seating (median 1 [2]; p = 0.001). Light optical investigations showed that imprinting can be present on the head taper surfaces even if the depth of abraded material exceeds the neck taper profile height. SEM investigations showed bands of pitting corrosion in the imprinted grooves. CONCLUSION The microscopic investigations suggest that imprinting is not an independent phenomenon but a process that accompanies the continuous material degradation of the head taper surface because of circular damage on the passive layer induced by grooved neck tapers. CLINICAL RELEVANCE Material loss from head-neck taper connections involving CoCrMo alloy heads is a source of metal ions and could potentially be reduced if hip stems with smooth neck tapers were used. Surgeons should pay attention to the exact centric seating of the femoral head onto the stem taper during joining of the parts.
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Affiliation(s)
- Therese Bormann
- Laboratory of Biomechanics and Implant Research, Department of Orthopaedic Surgery, Heidelberg University Hospital, Heidelberg, Germany
| | - Ulrike Müller
- Laboratory of Biomechanics and Implant Research, Department of Orthopaedic Surgery, Heidelberg University Hospital, Heidelberg, Germany
| | - Jens Gibmeier
- Institute for Applied Materials, Karlsruhe Institute of Technology, Karlsruhe, Germany
| | - Phuong Thao Mai
- Institute for Applied Materials, Karlsruhe Institute of Technology, Karlsruhe, Germany
| | - Tobias Renkawitz
- Department of Orthopaedic Surgery, Heidelberg University Hospital, Heidelberg, Germany
| | - Jan Philippe Kretzer
- Laboratory of Biomechanics and Implant Research, Department of Orthopaedic Surgery, Heidelberg University Hospital, Heidelberg, Germany
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Mai PT, Bormann T, Müller U, Kretzer JP, Gibmeier J. Effect of surface topography and residual stress on the taper connection stability in total hip arthroplasty. J Mech Behav Biomed Mater 2022; 128:105119. [DOI: 10.1016/j.jmbbm.2022.105119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Revised: 01/10/2022] [Accepted: 02/03/2022] [Indexed: 11/26/2022]
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Fang K, Shen Y, Ru Yie KH, Zhou Z, Cai L, Wu S, Al-Bishari AM, Al-Baadani MA, Shen X, Ma P, Liu J. Preparation of Zirconium Hydrogen Phosphate Coatings on Sandblasted/Acid-Etched Titanium for Enhancing Its Osteoinductivity and Friction/Corrosion Resistance. Int J Nanomedicine 2022; 16:8265-8277. [PMID: 35002230 PMCID: PMC8729793 DOI: 10.2147/ijn.s337028] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Accepted: 12/14/2021] [Indexed: 01/01/2023] Open
Abstract
Background Sandblasted/acid-etched titanium (SLA-Ti) implants are widely used for dental implant restoration in edentulous patients. However, the poor osteoinductivity and the large amount of Ti particles/ions released due to friction or corrosion will affect its long-term success rate. Purpose Various zirconium hydrogen phosphate (ZrP) coatings were prepared on SLA-Ti surface to enhance its friction/corrosion resistance and osteoinduction. Methods The mixture of ZrCl4 and H3PO4 was first coated on SLA-Ti and then calcined at 450°C for 5 min to form ZrP coatings. In addition to a series of physiochemical characterization such as morphology, roughness, wettability, and chemical composition, their capability of anti-friction and anti-corrosion were further evaluated by friction-wear test and by potential scanning. The viability and osteogenic differentiation of MC3T3-E1 cells on different substrates were investigated via MTT, mineralization and PCR assays. Results The characterization results showed that there were no significant changes in the morphology, roughness and wettability of ZrP-modified samples (SLA-ZrP0.5 and SLA-ZrP0.7) compared with SLA group. The results of electrochemical corrosion displayed that both SLA-ZrP0.5 and SLA-ZrP0.7 (especially the latter) had better corrosion resistance than SLA in normal saline and serum-containing medium. SLA-ZrP0.7 also exhibited the best friction resistance and great potential to enhance the spreading, proliferation and osteogenic differentiation of MC3T3-E1 cells. Conclusion We determined that SLA-ZrP0.7 had excellent comprehensive properties including anti-corrosion, anti-friction and osteoinduction, which made it have a promising clinical application in dental implant restoration.
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Affiliation(s)
- Kai Fang
- School and Hospital of Stomatology, Wenzhou Medical University, Wenzhou, 325000, People's Republic of China
| | - Yiding Shen
- School and Hospital of Stomatology, Wenzhou Medical University, Wenzhou, 325000, People's Republic of China
| | - Kendrick Hii Ru Yie
- School and Hospital of Stomatology, Wenzhou Medical University, Wenzhou, 325000, People's Republic of China
| | - Zixin Zhou
- School and Hospital of Stomatology, Wenzhou Medical University, Wenzhou, 325000, People's Republic of China
| | - Lei Cai
- School and Hospital of Stomatology, Wenzhou Medical University, Wenzhou, 325000, People's Republic of China
| | - Shuyi Wu
- School and Hospital of Stomatology, Wenzhou Medical University, Wenzhou, 325000, People's Republic of China
| | - Abdullrahman M Al-Bishari
- School and Hospital of Stomatology, Wenzhou Medical University, Wenzhou, 325000, People's Republic of China
| | - Mohammed A Al-Baadani
- School and Hospital of Stomatology, Wenzhou Medical University, Wenzhou, 325000, People's Republic of China
| | - Xinkun Shen
- School and Hospital of Stomatology, Wenzhou Medical University, Wenzhou, 325000, People's Republic of China
| | - Pingping Ma
- School and Hospital of Stomatology, Wenzhou Medical University, Wenzhou, 325000, People's Republic of China
| | - Jinsong Liu
- School and Hospital of Stomatology, Wenzhou Medical University, Wenzhou, 325000, People's Republic of China
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Herbster M, Berth A, Märtens N, Robra M, Welzel F, Dallmann F, Lohmann CH, Halle T, Bertrand J, Döring J. Intraoperative assembly of anatomical shoulder prosthesis frequently results in malalignment of the modular taper junction. J Orthop Res 2021; 39:2485-2496. [PMID: 33368644 DOI: 10.1002/jor.24975] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 12/08/2020] [Accepted: 12/14/2020] [Indexed: 02/04/2023]
Abstract
Anatomical shoulder arthroplasties (ASA) may fail because of micromotion at the modular taper junction causing wear due to fretting. Sufficient taper strength can reduce micromotion and potential reasons for failure. However, there are no normative standards for a safe assembly process performed intraoperatively by the surgeon. The purpose of this study is to determine the effect of common intraoperative assembly strategies and to identify critical influencing factors on taper stability. ASA with standard and stemless humeral component in combination with concentric Al2 O3 heads and eccentric CoCr28Mo6 alloyed humeral heads were tested. Taper angles and surface roughness were determined. Force magnitudes and impact directions were recorded using a sensorized head impactor and a three-dimensional force measuring platform. Subsequently, the axial pull-off forces were measured and taper engagement areas were macroscopically evaluated. In comparison to standard stem tapers that were impacted with an assembly device, stemless tapers were impacted into the artificial bone with significantly lower forces. Taper strength correlates to maximum impact force and was higher for CoCr28Mo6 heads with a mean pull-off ratio of 0.56 than for Al2 O3 heads with 0.37. Interestingly, all tapers showed an asymmetric clamping behavior, due to tilting during impaction. This is caused by the variation of the resulting force vector and further promoted by humeral head eccentricity. Assembly technique markedly influences the force magnitude, impact direction, impulse, and consequently taper strength. The resulting force vector and head eccentricity were identified as potential risk factors for taper malalignment.
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Affiliation(s)
- Maria Herbster
- Institute of Materials and Joining Technology, Otto-von-Guericke University, Magdeburg, Germany
| | - Alexander Berth
- Department of Orthopaedic Surgery, Otto-von-Guericke University, Magdeburg, Germany
| | - Nicole Märtens
- Department of Orthopaedic Surgery, Otto-von-Guericke University, Magdeburg, Germany
| | - Marcel Robra
- Department of Orthopaedic Surgery, Otto-von-Guericke University, Magdeburg, Germany
| | - Florian Welzel
- GFE-Gesellschaft für Fertigungstechnik und Entwicklung Schmalkalden e.V., Schmalkalden, Germany
| | | | - Christoph H Lohmann
- Department of Orthopaedic Surgery, Otto-von-Guericke University, Magdeburg, Germany
| | - Thorsten Halle
- Institute of Materials and Joining Technology, Otto-von-Guericke University, Magdeburg, Germany
| | - Jessica Bertrand
- Department of Orthopaedic Surgery, Otto-von-Guericke University, Magdeburg, Germany
| | - Joachim Döring
- Department of Orthopaedic Surgery, Otto-von-Guericke University, Magdeburg, Germany
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Reiner T, Haubenreisser H, Tripel E, Rosshirt N, Sorbi R, Nees TA, Gotterbarm T, Merle C, Moradi B, Hagmann S. Peripheral Blood Lymphocyte Subpopulations in Patients Following Small Diameter Metal-On-Metal Total Hip Replacement at Long-Term Follow-Up. J Clin Med 2020; 9:jcm9092877. [PMID: 32899901 PMCID: PMC7564376 DOI: 10.3390/jcm9092877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Accepted: 09/03/2020] [Indexed: 11/22/2022] Open
Abstract
(1) Background: The objective of the present study was to investigate peripheral blood lymphocyte subpopulations in patients with small diameter metal-on-metal total hip arthroplasty (MoM THA) and elevated blood metal ion concentrations at long-term follow-up. The hypothesis was that increased blood metal ion levels or the presence of adverse local tissue reactions (ALTR) would be associated with changes in the peripheral expression of lymphocyte subpopulations, which could potentially serve as early diagnostic markers for metal wear related complications. (2) Methods: Peripheral blood samples were analyzed for leucocyte subgroups (CD3+, CD4+, CD8+, CD14+, CD16+/CD56+, CD25+/CD127−, CD19+, IFN-γ+, IL-4+ and IL-17A+ cells) in 34 patients with elevated blood metal ion levels (combined cobalt and chromium levels >2 µg/L) following small head MoM THA at a mean follow-up of 15.6 years. Fifteen patients with small head MoM THA and blood metal ion levels within the normal range and 15 patients with conventional ceramic-on-polyethylene THA served as control groups. In addition, blood metal ion levels and leucocyte subpopulations were compared between patients with and without adverse local tissue reactions (ALTR), which was investigated by MRI in 27 patients of the study cohort. (3) Results: There was a significant decrease in the levels of IFN-γ+ Type-1 T helper cells (Th1) in patients with MoM THA compared to the ceramic-on-polyethylene control group (p < 0.001). No statistically significant differences in the cell counts of other lymphocyte subpopulations were found between the three groups. Cobalt ion levels were significantly higher in patients with ALTR (p < 0.001) compared to the non-ALTR group, but no differences in the levels of lymphocyte subsets were found between the two groups. (4) Conclusions: No adverse systemic effects with respect to peripheral blood leucocyte subpopulations could be detected in the present study in patients following THA with a small diameter MoM articulation at long-term follow-up. We found a significant decrease of IFN-γ+ Th1 cells in patients with MoM THA compared to the control group, but no differences in the peripheral expression of leucocyte subpopulations were seen between patients with and without ALTR. Future studies with larger patient cohorts and additional histopathological investigations could help to better understand the role of Th1 cells and other cell lines of the adaptive immune system in the development of metal wear related complications after total joint replacement.
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Affiliation(s)
- Tobias Reiner
- Center for Orthopedics, Trauma Surgery and Spinal Cord Injury, Heidelberg University Hospital, Schlierbacher Landstraße 200a, 69118 Heidelberg, Germany; (H.H.); (E.T.); (N.R.); (R.S.); (T.A.N.); (C.M.); (B.M.)
- Correspondence: (T.R.); (S.H.); Tel.: +49-6221-5634803 (T.R.); +49-6221-5626289 (S.H.); Fax: +49-6221-5626179 (T.R.); +49-6221-5626348 (S.H.)
| | - Hester Haubenreisser
- Center for Orthopedics, Trauma Surgery and Spinal Cord Injury, Heidelberg University Hospital, Schlierbacher Landstraße 200a, 69118 Heidelberg, Germany; (H.H.); (E.T.); (N.R.); (R.S.); (T.A.N.); (C.M.); (B.M.)
| | - Elena Tripel
- Center for Orthopedics, Trauma Surgery and Spinal Cord Injury, Heidelberg University Hospital, Schlierbacher Landstraße 200a, 69118 Heidelberg, Germany; (H.H.); (E.T.); (N.R.); (R.S.); (T.A.N.); (C.M.); (B.M.)
| | - Nils Rosshirt
- Center for Orthopedics, Trauma Surgery and Spinal Cord Injury, Heidelberg University Hospital, Schlierbacher Landstraße 200a, 69118 Heidelberg, Germany; (H.H.); (E.T.); (N.R.); (R.S.); (T.A.N.); (C.M.); (B.M.)
| | - Reza Sorbi
- Center for Orthopedics, Trauma Surgery and Spinal Cord Injury, Heidelberg University Hospital, Schlierbacher Landstraße 200a, 69118 Heidelberg, Germany; (H.H.); (E.T.); (N.R.); (R.S.); (T.A.N.); (C.M.); (B.M.)
| | - Timo Albert Nees
- Center for Orthopedics, Trauma Surgery and Spinal Cord Injury, Heidelberg University Hospital, Schlierbacher Landstraße 200a, 69118 Heidelberg, Germany; (H.H.); (E.T.); (N.R.); (R.S.); (T.A.N.); (C.M.); (B.M.)
| | - Tobias Gotterbarm
- Department for Orthopaedics and Traumatology, Kepler University Hospital GmbH, Johannes Kepler University Linz, 4020 Linz, Austria;
| | - Christian Merle
- Center for Orthopedics, Trauma Surgery and Spinal Cord Injury, Heidelberg University Hospital, Schlierbacher Landstraße 200a, 69118 Heidelberg, Germany; (H.H.); (E.T.); (N.R.); (R.S.); (T.A.N.); (C.M.); (B.M.)
| | - Babak Moradi
- Center for Orthopedics, Trauma Surgery and Spinal Cord Injury, Heidelberg University Hospital, Schlierbacher Landstraße 200a, 69118 Heidelberg, Germany; (H.H.); (E.T.); (N.R.); (R.S.); (T.A.N.); (C.M.); (B.M.)
| | - Sébastien Hagmann
- Center for Orthopedics, Trauma Surgery and Spinal Cord Injury, Heidelberg University Hospital, Schlierbacher Landstraße 200a, 69118 Heidelberg, Germany; (H.H.); (E.T.); (N.R.); (R.S.); (T.A.N.); (C.M.); (B.M.)
- Correspondence: (T.R.); (S.H.); Tel.: +49-6221-5634803 (T.R.); +49-6221-5626289 (S.H.); Fax: +49-6221-5626179 (T.R.); +49-6221-5626348 (S.H.)
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