1
|
Halma JJ, Eshuis R, Vogely HC, van Gaalen SM, de Gast A. An uncemented iso-elastic monoblock acetabular component: preliminary results. J Arthroplasty 2015; 30:615-21. [PMID: 25496930 DOI: 10.1016/j.arth.2014.11.017] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2014] [Revised: 10/29/2014] [Accepted: 11/10/2014] [Indexed: 02/01/2023] Open
Abstract
Little is known about the clinical application of highly cross-linked polyethylene (HXLPE) blended with vitamin E. This study evaluates an uncemented iso-elastic monoblock cup with vitamin E blended HXLPE. 112 patients were followed up for 2years. 95.5% completed the follow-up. The mean VAS score for patient satisfaction was 8.8 and the mean Harris Hip Score was 94.2. In 7 cases initial gaps behind the cup were observed, which disappeared completely during follow-up in 6 cases. The mean femoral head penetration rate was 0.055mm/year. No adverse reactions or abnormal mechanical behavior was observed with the short term use of vitamin E blended HXLPE. This study shows the promising performance of this cup and confirms the potential of vitamin E blended HXLPE.
Collapse
Affiliation(s)
- Jelle J Halma
- Clinical Orthopedic Research Center-midden Nederland (CORC-mN) Department of Orthopedics, Diakonessenhuis Hospital, Utrecht, The Netherlands
| | - Rienk Eshuis
- Clinical Orthopedic Research Center-midden Nederland (CORC-mN) Department of Orthopedics, Diakonessenhuis Hospital, Utrecht, The Netherlands
| | - H Charles Vogely
- Department of Orthopedics, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Steven M van Gaalen
- Clinical Orthopedic Research Center-midden Nederland (CORC-mN) Department of Orthopedics, Diakonessenhuis Hospital, Utrecht, The Netherlands
| | - Arthur de Gast
- Clinical Orthopedic Research Center-midden Nederland (CORC-mN) Department of Orthopedics, Diakonessenhuis Hospital, Utrecht, The Netherlands
| |
Collapse
|
2
|
Bladen CL, Teramura S, Russell SL, Fujiwara K, Fisher J, Ingham E, Tomita N, Tipper JL. Analysis of wear, wear particles, and reduced inflammatory potential of vitamin E ultrahigh-molecular-weight polyethylene for use in total joint replacement. J Biomed Mater Res B Appl Biomater 2013; 101:458-66. [PMID: 23436622 PMCID: PMC3798093 DOI: 10.1002/jbm.b.32904] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2012] [Revised: 11/27/2012] [Accepted: 01/10/2013] [Indexed: 11/12/2022]
Abstract
Vitamin E (VE) has been added to ultrahigh-molecular-weight polyethylene (UHMWPE) acetabular cups and tibial trays primarily to reduce oxidative damage to the polymer. The aim of this study was to investigate the relative wear rates of UHMWPE-containing VE compared with virgin UHMWPE. The ability of VE to reduce the amount of inflammatory cytokines produced from stimulated peripheral blood mononuclear cells (PBMNCs) was also investigated. Stimulation was achieved by exposure of PBMNCs to either lipoplysaccharide (LPS) or VE-containing UHMWPE (VE-UHMWPE). In the present study, results showed that the wear rates of UHMWPE with or without VE were not significantly different. Particles generated by UHMWPE with and without VE were not significantly different in size distribution. The production of osteolytic mediators, tumor necrosis factor-alpha, interleukin 1β (IL-β), IL-6, and IL-8 were significantly reduced in (PBMNCs) stimulated with either LPS + VE compared with LPS or VE-UHMWPE particles compared to virgin UHMWPE particles. This trend was also observed when VE was added as a liquid to UHMWPE wear particle-stimulated PBMNCs. The exact mechanism of how VE affects the release of inflammatory mediators from particle-stimulated macrophages is not yet understood. It is likely to involve the anti-inflammatory and/or antioxidant effects of VE.
Collapse
Affiliation(s)
- C L Bladen
- Institute of Medical and Biological Engineering, University of Leeds, UK.
| | | | | | | | | | | | | | | |
Collapse
|
3
|
Free Radical Production in Immune Cell Systems Induced by Ti, Ti6Al4V and SS Assessed by Chemiluminescence Probe Pholasin Assay. Int J Biomater 2012; 2012:380845. [PMID: 22778739 PMCID: PMC3388343 DOI: 10.1155/2012/380845] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2012] [Accepted: 05/13/2012] [Indexed: 12/13/2022] Open
Abstract
The oxidative burst of human blood cells in the presence of different metal materials was investigated using chemiluminescence assay. Commercial pure titanium (Ti), titanium alloy (Ti6Al4V), and stainless steel 316L (SS) in particulate form with <20 μm in size were used. The effect of particulate materials opsonisation on the upregulation of the respiratory burst production by blood cells was also assessed. The largest chemiluminescence response was achieved after simultaneous injection of the stimulants fMLP+PMA. Moreover, Ti and SS induced a greater inflammatory reaction compared to Ti6Al4V, since the respiratory burst mounted was higher for both materials after opsonisation treatment. These results suggest that in vitro chemiluminescence response and respiratory burst measurements proved to be composition and treatment dependent.
Collapse
|
4
|
Abstract
BACKGROUND Osteolysis due to wear of UHMWPE limits the longevity of joint arthroplasty. Oxidative degradation of UHMWPE gamma-sterilized in air increases its wear while decreasing mechanical strength. Vitamin E stabilization of UHMWPE was proposed to improve oxidation resistance while maintaining wear resistance and fatigue strength. QUESTIONS/PURPOSES We reviewed the preclinical research on the development and testing of vitamin E-stabilized UHMWPE with the following questions in mind: (1) What is the rationale behind protecting irradiated UHMWPE against oxidation by vitamin E? (2) What are the effects of vitamin E on the microstructure, tribologic, and mechanical properties of irradiated UHMWPE? (3) Is vitamin E expected to affect the periprosthetic tissue negatively? METHODS We performed searches in PubMed, Scopus, and Science Citation Index to review the development of vitamin E-stabilized UHMWPEs and their feasibility as clinical implants. RESULTS The rationale for using vitamin E in UHMWPE was twofold: improving oxidation resistance of irradiated UHMWPEs and fatigue strength of irradiated UHMWPEs with an alternative to postirradiation melting. Vitamin E-stabilized UHMWPE showed oxidation resistance superior to that of irradiated UHMWPEs with detectable residual free radicals. It showed equivalent wear and improved mechanical strength compared to irradiated and melted UHMWPE. The biocompatibility was confirmed by simulating elution, if any, of the antioxidant from implants. CONCLUSIONS Vitamin E-stabilized UHMWPE offers a joint arthroplasty technology with good mechanical, wear, and oxidation properties. CLINICAL RELEVANCE Vitamin E-stabilized, irradiated UHMWPEs were recently introduced clinically. The rationale behind using vitamin E and in vitro tests comparing its performance to older materials are of great interest for improving longevity of joint arthroplasties.
Collapse
Affiliation(s)
- Pierangiola Bracco
- Dipartimento di Chimica IFM and NIS Centre of Excellence, Università di Torino, Via Pietro Guria, 7, 10125 Torino, Italy
| | - Ebru Oral
- Harris Orthopaedic Laboratory, Massachusetts General Hospital, Boston, MA USA
| |
Collapse
|
5
|
Rocha MFG, Mansur AAP, Martins CPS, Barbosa-Stancioli EF, Mansur HS. Macrophage Response to UHMWPE Submitted to Accelerated Ageing in Hydrogen Peroxide. Open Biomed Eng J 2010; 4:107-12. [PMID: 20721321 PMCID: PMC2923342 DOI: 10.2174/1874120701004010107] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2010] [Revised: 03/10/2010] [Accepted: 03/13/2010] [Indexed: 11/22/2022] Open
Abstract
Ultra-high molecular weight polyethylene (UHMWPE) has been the most commonly used bearing material in total joint arthroplasty. Wear and oxidation fatigue resistance of UHMWPE are regarded as two important properties to extend the longevity of knee prostheses. The present study investigated the accelerated ageing of UHMWPE in hydrogen peroxide highly oxidative chemical environment. The sliced samples of UHMWPE were oxidized in a hydrogen peroxide solution for 120 days with their total level of oxidation (Iox) characterized by Fourier Transformed Infrared Spectroscopy (FTIR). The potential inflammatory response, cell viability and biocompatibility of such oxidized UHMWPE systems were assessed by a novel biological in vitro assay based on the secretion of nitric oxide (NO) by activated murine macrophages with gamma interferon (IFN-γ) cytokine and lipopolysaccharide (LPS). Furthermore, macrophage morphologies in contact with UHMWPE oxidized surfaces were analyzed by cell spreading-adhesion procedure using scanning electron microscopy (SEM). The results have given significant evidence that the longer the period of accelerated aging of UHMWPE the higher was the macrophage inflammatory equivalent response based on NO secretion analysis.
Collapse
Affiliation(s)
- Magda F G Rocha
- Department of Metallurgical and Materials Engineering, Laboratory of Biomaterials and Tissue Engineering, Federal University of Minas Gerais, Av. Antônio Carlos, 6627, 31.270-901, Belo Horizonte, Brazil
| | | | | | | | | |
Collapse
|
6
|
|
7
|
Maitra R, Clement CC, Crisi GM, Cobelli N, Santambrogio L. Immunogenecity of modified alkane polymers is mediated through TLR1/2 activation. PLoS One 2008; 3:e2438. [PMID: 18560588 PMCID: PMC2413007 DOI: 10.1371/journal.pone.0002438] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2008] [Accepted: 05/10/2008] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND With the advancement of biomedical technology, artificial materials have been developed to replace diseased, damaged or nonfunctional body parts. Among such materials, ultra high molecular weight alkane or modified alkyl polymers have been extensively used in heart valves, stents, pacemakers, ear implants, as well as total joint replacement devices. Although much research has been undertaken to design the most non-reactive biologically inert polyethylene derivatives, strong inflammatory responses followed by rejection and failure of the implant have been noted. METHODOLOGY/PRINCIPAL FINDINGS Purification of the alkane polymers from the site of inflammation revealed extensive "in vivo" oxidation as detected by fourier transformed infra-red spectroscopy. Herein, we report the novel observation that oxidized alkane polymers induced activation of TLR1/2 pathway as determined by ligand dependent changes in intrinsic tyrosine fluorescence intensity and NF-kappaB luciferase gene assays. Oxidized polymers were very effective in activating dendritic cells and inducing secretion of pro-inflammatory cytokines. Molecular docking of the oxidized alkanes designated ligand specificity and polymeric conformations fitting into the TLR1/2 binding grooves. CONCLUSION/SIGNIFICANCE This is the first report of a synthetic polymer activating immune responses through TLR binding.
Collapse
Affiliation(s)
- Radhashree Maitra
- Department of Pathology, Albert Einstein College of Medicine, New York, New York, United States of America
| | - Cristina C. Clement
- Department of Pathology, Albert Einstein College of Medicine, New York, New York, United States of America
| | - Giovanna M. Crisi
- Department of Pathology, Baystate Medical Center, Springfield, Massachusetts, United States of America
| | - Neil Cobelli
- Division of Orthopedic Surgery, Montefiore Medical Center, New York, New York, United States of America
| | - Laura Santambrogio
- Department of Pathology, Albert Einstein College of Medicine, New York, New York, United States of America
- * E-mail:
| |
Collapse
|
8
|
Hemmer JD, Drews MJ, LaBerge M, Matthews MA. Sterilization of bacterial spores by using supercritical carbon dioxide and hydrogen peroxide. J Biomed Mater Res B Appl Biomater 2007; 80:511-8. [PMID: 16838346 DOI: 10.1002/jbm.b.30625] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
It was hypothesized that supercritical carbon dioxide (SC-CO(2)) treatment could serve as an alternative sterilization method at various temperatures (40-105 degrees C), CO(2) pressures (200-680 atm), and treatment times (25 min to 6 h), and with or without the use of a passive additive (distilled water, dH(2)O) or an active additive (hydrogen peroxide, H(2)O(2)). While previous researchers have shown that SC-CO(2) possesses antimicrobial properties, sterilization effectiveness has not been shown at sufficiently low treatment temperatures and cycle times, using resistant bacterial spores. Experiments were conducted using Geobacillus stearothermophilus and Bacillus atrophaeus spores. Spore strips were exposed to SC-CO(2) in commercially available supercritical fluid extraction and reaction systems, at varying temperatures, pressures, treatment times, and with or without the use of a passive additive, such as dH(2)O, or an active additive, such as H(2)O(2). Treatment parameters were varied from 40 to 105 degrees C, 200-680 atm, and from 25 min to 6 h. At 105 degrees C without H(2)O(2), both spore types were completely deactivated at 300 atm in 25 min, a shorter treatment cycle than is obtained with methods in use today. On the other hand, with added H(2)O(2) (<100 ppm), 6 log populations of both spore types were completely deactivated using SC-CO(2) in 1 h at 40 degrees C. It was concluded from the data that large populations of resistant bacterial spores can be deactivated with SC-CO(2) with added H(2)O(2)at lower temperatures and potentially shorter treatment cycles than in most sterilization methods in use today.
Collapse
Affiliation(s)
- Jason D Hemmer
- Department of Bioengineering, Clemson University, Clemson, South Carolina 29634, USA
| | | | | | | |
Collapse
|
9
|
Synthesis and characterisation of advanced UHMWPE/silver nanocomposites for biomedical applications. Eur Polym J 2007. [DOI: 10.1016/j.eurpolymj.2006.10.011] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
|
10
|
Oxidation of ultra high molecular weight polyethylene (UHMWPE) part 3: Decomposition of hydroperoxides with SO2 and its effect on the chemiluminescence signal. Polym Degrad Stab 2006. [DOI: 10.1016/j.polymdegradstab.2006.04.013] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
|
11
|
An YH, Alvi FI, Kang Q, Laberge M, Drews MJ, Zhang J, Matthews MA, Arciola CR. Effects of sterilization on implant mechanical property and biocompatibility. Int J Artif Organs 2006; 28:1126-37. [PMID: 16353119 DOI: 10.1177/039139880502801110] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
This article concisely reviews the effects of sterilization on the mechanical properties and surface chemistries of implantable biomaterials. This article also summarizes the biological effects of the sterilization-related changes in the implant. Because there are so many different types of implant materials currently in use (including metals, polymers, and diverse biological materials), the response of tissue to these different materials varies dramatically. This review further discusses the effects of sterilization on in vivo and in vitro tissue response specifically to implantable metals and polyethylene, with the possibility of future biocompatibility testing of the implants sterilized with supercritical phase carbon dioxide sterilization.
Collapse
Affiliation(s)
- Y H An
- Orthopedic Research Laboratory, Medical University of South Carolina, Charleston, SC 29425, USA.
| | | | | | | | | | | | | | | |
Collapse
|
12
|
Marques AP, Reis RL, Hunt JA. The effect of starch-based biomaterials on leukocyte adhesion and activation in vitro. JOURNAL OF MATERIALS SCIENCE. MATERIALS IN MEDICINE 2005; 16:1029-43. [PMID: 16388384 DOI: 10.1007/s10856-005-4757-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/27/2004] [Accepted: 03/11/2005] [Indexed: 05/06/2023]
Abstract
Leukocyte adhesion to biomaterials has long been recognised as a key element to determine their inflammatory potential. Results regarding leukocyte adhesion and activation are contradictory in some aspects of the material's effect in determining these events. It is clear that together with the wettability or hydrophilicity/hydrophobicity, the roughness of a substrate has a major effect on leukocyte adhesion. Both the chemical and physical properties of a material influence the adsorbed proteins layer which in turn determines the adhesion of cells. In this work polymorphonuclear (PMN) cells and a mixed population of monocytes/macrophages and lymphocytes (mononuclear cells) were cultured separately with a range of starch-based materials and composites with hydroxyapatite (HA). A combination of both reflected light microscopy and scanning electron microscopy (SEM) was used in order to study the leukocyte morphology. The quantification of the enzyme lactate dehydrogenase (LDH) was used to determine the number of viable cells adhered to the polymers. Cell adhesion and activation was characterised by immunocytochemistry based on the expression of several adhesion molecules, crucial in the progress of an inflammatory response. This work supports previous in vitro studies with PMN and monocytes/macrophages, which demonstrated that there are several properties of the materials that can influence and determine their biological response. From our study, monocytes/macrophages and lymphocytes adhere in similar amounts to more hydrophobic (SPCL) and to moderately hydrophilic (SEVA-C) surfaces and do not preferentially adhere to rougher substrates (SCA). Contrarily, more hydrophilic surfaces (SCA) induced higher PMN adhesion and lower activation. In addition, the hydroxyapatite reinforcement induces changes in cell behaviour for some materials but not for others. The observed response to starch-based biodegradable polymers was not significantly different from the control materials. Thus, the results reported herein indicate the low potential of the starch-based biodegradable polymers to induce inflammation especially the HA reinforced composite materials.
Collapse
Affiliation(s)
- A P Marques
- 3B's Research Group, Biomaterials, Biodegradables, Biomimetics, University of Minho, Campus de Gualtar, 4710-057 Braga, Portugal.
| | | | | |
Collapse
|
13
|
Kontio R. Treatment of orbital fractures: the case for reconstruction with autogenous bone. J Oral Maxillofac Surg 2004; 62:863-8. [PMID: 15218567 DOI: 10.1016/j.joms.2004.03.003] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Risto Kontio
- Department of Oral and Maxillofacial Surgery, Helsinki University Central Hospital, Helsinki, Finland.
| |
Collapse
|