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Atchuta A, Reddy A, Bhadauriya S, Beeravolu M, Vasudevan S. Characterization of Titanium Corrosion and Its Association With Peri-Implantitis Using Energy Dispersive X-ray Spectroscopy: A Case Report. Cureus 2024; 16:e60533. [PMID: 38887364 PMCID: PMC11181099 DOI: 10.7759/cureus.60533] [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] [Accepted: 05/17/2024] [Indexed: 06/20/2024] Open
Abstract
Dental implant corrosion is now being recognized as a contributing factor in the onset and advancement of peri-implantitis, posing significant challenges to both the durability of implants and the well-being of patients. The dissemination of titanium microparticles due to corrosion raises concerns about plausible toxicity and biological effects, especially for patients with long-standing implant prostheses. This case report focuses on the release of titanium particles in the peri-implant mucosa due to corrosion and its association with peri-implantitis. It emphasizes the critical need for strategies to minimize corrosion and alleviate its detrimental effects in order to optimize patient outcomes in the field of implant dentistry. Additionally, there is a call for research into the increasing biochemical effects of these microparticles on oral soft tissues surrounding metallic implants to enhance the longevity and clinical outcomes of implants.
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Affiliation(s)
- Abhinav Atchuta
- Periodontology, Army College of Dental Sciences, Secunderabad, IND
| | - Ajay Reddy
- Periodontology, Army College of Dental Sciences, Secunderabad, IND
| | | | - Mounika Beeravolu
- Periodontology, Kamineni Institute of Dental Sciences, Nalgonda, IND
| | - Sanjay Vasudevan
- Periodontology, Army College of Dental Sciences, Secunderabad, IND
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2
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Skedros AJ, Skedros JG, Richards BW, Cronin JT. Sea Urchin Spine Embedded in the Sole of the Foot: Eight-Year Radiographic Follow-Up Without Removal. Cureus 2024; 16:e56261. [PMID: 38623121 PMCID: PMC11017367 DOI: 10.7759/cureus.56261] [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] [Accepted: 03/16/2024] [Indexed: 04/17/2024] Open
Abstract
When sea urchin puncture injuries occur during coastal recreation or work activities, they often affect extremities, such as hands and feet. There is a plethora of information on treatments for these puncture injuries, with the most common among medical professionals being the removal of all partially embedded spines and the removal of as many fully embedded spines as possible. When the spines are deeply embedded and/or fragmented, they might not be removed, especially when they are not located in critical areas such as tendons or joints. This reflects the generally held notion that smaller spines and spine fragments will eventually dissolve or be absorbed. Here we report an unusual case where the tip of a sea urchin spine became embedded in the soft tissue of the sole of the foot of a 21-year-old male after he stepped on one after falling off a kayak off the coast of Oahu, Hawai'i. The deeply embedded spine was not removed. By three weeks after the injury, the patient did not have any symptoms, and eight years later, he was still symptom-free. Radiographs taken one year after the injury showed that the spine had fragmented into two pieces. The smaller piece was about 15% of the size of the original embedded spine, and it had apparently been absorbed (it was not seen on final radiographs eight years later). Analysis of radiographs eight years after the injury showed that the main or large spine fragment was still distinctly detectable in the soft tissue; there was no visible evidence that it had undergone significant absorption or migrated from the original location. The absence of any obvious radiographic rarefaction over eight years is contrary to the lore that sea urchin spines that remain in human soft tissue will exhibit significant, or complete, absorption or dissolution over months to a few years.
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Affiliation(s)
| | - John G Skedros
- Orthopaedic Surgery, Utah Orthopaedic Specialists, Salt Lake City, USA
| | - Brett W Richards
- Orthopaedic Surgery, Utah Orthopaedic Specialists, Salt Lake City, USA
| | - John T Cronin
- Orthopaedic Surgery, Utah Orthopaedic Specialists, Salt Lake City, USA
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3
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Insua A, Galindo-Moreno P, Miron RJ, Wang HL, Monje A. Emerging factors affecting peri-implant bone metabolism. Periodontol 2000 2024; 94:27-78. [PMID: 37904311 DOI: 10.1111/prd.12532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Revised: 08/05/2023] [Accepted: 09/10/2023] [Indexed: 11/01/2023]
Abstract
Implant dentistry has evolved to the point that standard implant osseointegration is predictable. This is attributed in part to the advancements in material sciences that have led toward improvements in implant surface technology and characteristics. Nonetheless, there remain several cases where implant therapy fails (specifically at early time points), most commonly attributed to factors affecting bone metabolism. Among these patients, smokers are known to have impaired bone metabolism and thus be subject to higher risks of early implant failure and/or late complications related to the stability of the peri-implant bone and mucosal tissues. Notably, however, emerging data have unveiled other critical factors affecting osseointegration, namely, those related to the metabolism of bone tissues. The aim of this review is to shed light on the effects of implant-related factors, like implant surface or titanium particle release; surgical-related factors, like osseodensification or implanted biomaterials; various drugs, like selective serotonin reuptake inhibitors, proton pump inhibitors, anti-hypertensives, nonsteroidal anti-inflammatory medication, and statins, and host-related factors, like smoking, diet, and metabolic syndrome on bone metabolism, and aseptic peri-implant bone loss. Despite the infectious nature of peri-implant biological complications, these factors must be surveyed for the effective prevention and management of peri-implantitis.
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Affiliation(s)
- Angel Insua
- Department of Periodontology and Oral Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - Pablo Galindo-Moreno
- Department of Periodontology and Oral Medicine, University of Michigan, Ann Arbor, Michigan, USA
- Department of Oral Surgery and Implant Dentistry, University of Granada, Granada, Spain
| | - Richard J Miron
- Department of Periodontology, University of Bern, Bern, Switzerland
| | - Hom-Lay Wang
- Department of Periodontology and Oral Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - Alberto Monje
- Department of Periodontology and Oral Medicine, University of Michigan, Ann Arbor, Michigan, USA
- Department of Periodontology, University of Bern, Bern, Switzerland
- Department of Periodontology, Universitat Internacional de Catalunya, Barcelona, Spain
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4
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Yu X, Hu J, Yang X, Xu Q, Chen H, Zhan P, Zhang B. Sesamin inhibits RANKL-induced osteoclastogenesis and attenuates LPS-induced osteolysis via suppression of ERK and NF-κB signalling pathways. J Cell Mol Med 2024; 28:e18056. [PMID: 37988238 PMCID: PMC10828734 DOI: 10.1111/jcmm.18056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Revised: 11/09/2023] [Accepted: 11/14/2023] [Indexed: 11/23/2023] Open
Abstract
Infection by bacterial products in the implant and endotoxin introduced by wear particles activate immune cells, enhance pro-inflammatory cytokines production, and ultimately promote osteoclast recruitment and activity. These factors are known to play an important role in osteolysis as well as potential targets for the treatment of osteolysis. Sesamin has been shown to have a variety of biological functions, such as inhibiting inflammation, anti-tumour and involvement in the regulation of fatty acid and cholesterol metabolism. However, the therapeutic effect of sesamin on osteolysis and its mechanism remain unclear. Present studies shown that in the condition of in vitro, sesamin could inhibit osteoclastogenesis and bone resorption, as well as suppressing the expression of osteoclast-specific genes. Further studies on the mechanism suggest that the effect of sesamin on human osteoclasts was mediated by blocking the ERK and NF-κB signalling pathways. Besides, sesamin was found to be effective in treating LPS-induced osteolysis by decreasing the production of pro-inflammatory cytokines and inhibiting osteoclastogenesis in vivo. Sesamin was non-toxic to heart, liver, kidney, lung and spleen. Therefore, sesamin is a promising phytochemical agent for the therapy of osteolysis-related diseases caused by inflammation and excessive osteoclast activation.
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Affiliation(s)
- Xiaolong Yu
- Orthopedics DepartmentThe First Affiliated Hospital of Nanchang University, Artificial Joints Engineering and Technology Research CenterNanchangChina
| | - Jiawei Hu
- Orthopedics DepartmentThe First Affiliated Hospital of Nanchang University, Artificial Joints Engineering and Technology Research CenterNanchangChina
| | - Xinming Yang
- Orthopedics DepartmentThe First Affiliated Hospital of Nanchang University, Artificial Joints Engineering and Technology Research CenterNanchangChina
| | - Qiang Xu
- Orthopedics DepartmentThe First Affiliated Hospital of Nanchang University, Artificial Joints Engineering and Technology Research CenterNanchangChina
| | - Hangjun Chen
- Orthopedics DepartmentThe First Affiliated Hospital of Nanchang University, Artificial Joints Engineering and Technology Research CenterNanchangChina
| | - Ping Zhan
- Orthopedics DepartmentThe First Affiliated Hospital of Nanchang University, Artificial Joints Engineering and Technology Research CenterNanchangChina
| | - Bin Zhang
- Orthopedics DepartmentThe First Affiliated Hospital of Nanchang University, Artificial Joints Engineering and Technology Research CenterNanchangChina
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Kapustina I, Ali Y, Kallen ME, Hasan SA, Davis DL. Arthroplasty-Related Pseudotumor of the Scapula: Case Report and Review of the Literature. Indian J Radiol Imaging 2024; 34:163-166. [PMID: 38106871 PMCID: PMC10723976 DOI: 10.1055/s-0043-1772692] [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] [Indexed: 12/19/2023] Open
Abstract
Arthroplasty-related pseudotumors are nonneoplastic and noninfectious inflammatory masses that are typically associated with adverse reaction to metal debris. Pseudotumors most commonly occur in the setting of metal-on-metal joint replacements at the hip. However, the presentation of pseudotumor at the shoulder is exceedingly rare. In this article, we reported a case of arthroplasty-related pseudotumor of the scapula. Clinical history, radiologic signs, and tissue analysis are described. Knowledge of this rare diagnosis will support clinical decision making for teams of radiologists, pathologists, oncologists, and orthopaedic surgeons who provide care for patients presenting with suspicious shoulder masses.
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Affiliation(s)
- Irina Kapustina
- Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland Medical Center, Baltimore, Maryland, United States
| | - Youssef Ali
- University of Maryland School of Medicine, Baltimore, Maryland, United States
| | - Michael E. Kallen
- Department of Pathology, University of Maryland School of Medicine, Baltimore, Maryland, United States
| | - S. Ashfaq Hasan
- Department of Orthopaedics, University of Maryland School of Medicine, Baltimore, Maryland, United States
| | - Derik L. Davis
- Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland Medical Center, Baltimore, Maryland, United States
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Cheng KY, Gupta P, Kanniyappan H, Zahurullah H, Sun Y, Alhamad M, Mathew MT. Survivability of Titanium Implant Materials: In Vitro Simulated Inflammatory and Infectious Environment. Ann Biomed Eng 2023; 51:2749-2761. [PMID: 37530907 PMCID: PMC10834857 DOI: 10.1007/s10439-023-03330-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Accepted: 07/22/2023] [Indexed: 08/03/2023]
Abstract
Titanium-based implants utilized in total joint arthroplasties could restore primary musculoskeletal function to patients suffering from osteoarthritis and other conditions. Implants are susceptible to failure stemming from aseptic loosening and infection at the joint site, eventually requiring revision surgery. We hypothesized that there might be a feedback loop by which metal degradation particles and ions released from the implant decrease cell viability and increase immune response, thereby creating biochemical conditions that increase the corrosion rate and release more metal ions. This study focused on the synergistic process through cell viability assays and electrochemical tests. From the results, inflammatory conditions from ion release resulting in cell death would further increase the corrosion rate at the metal implant site. The synergistic interaction in the implant surroundings in which infectious conditions produce Ti ions that contribute to more infection, creating a potential cycle of accelerating corrosion.
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Affiliation(s)
- Kai Yuan Cheng
- Regenerative Medicine and Disability Research Lab, University of Illinois College of Medicine, Rockford, IL, USA
| | - Puranjay Gupta
- Regenerative Medicine and Disability Research Lab, University of Illinois College of Medicine, Rockford, IL, USA
| | - Hemalatha Kanniyappan
- Regenerative Medicine and Disability Research Lab, University of Illinois College of Medicine, Rockford, IL, USA
| | - Hamza Zahurullah
- Regenerative Medicine and Disability Research Lab, University of Illinois College of Medicine, Rockford, IL, USA
| | - Yani Sun
- Department of Biomedical Engineering, College of Engineering, University of Illinois , Chicago, IL, USA
| | - Mostafa Alhamad
- Department of Restorative Dentistry, College of Dentistry, University of Illinois at Chicago, Chicago, IL, USA
- Department of Restorative Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, Ad Dammām, Saudi Arabia
| | - Mathew T Mathew
- Regenerative Medicine and Disability Research Lab, University of Illinois College of Medicine, Rockford, IL, USA.
- Department of Restorative Dentistry, College of Dentistry, University of Illinois at Chicago, Chicago, IL, USA.
- Department of Biomedical Engineering, College of Engineering, University of Illinois , Chicago, IL, USA.
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Pegios VF, Kenanidis E, Tsotsolis S, Potoupnis M, Tsiridis E. Bisphosphonates' use and risk of aseptic loosening following total hip arthroplasty: a systematic review. EFORT Open Rev 2023; 8:798-808. [PMID: 37909705 PMCID: PMC10646521 DOI: 10.1530/eor-22-0121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2023] Open
Abstract
Purpose The main indication of bisphosphonates (BPs) is osteoporosis treatment. However, there is growing interest in the peri- and postoperative use of BPs to mitigate total hip arthroplasty (THA) aseptic loosening (AL) risk. This systematic review aimed to evaluate the implant survival and the AL rate in patients with elective THA receiving BPs compared to those that do not receive BPs. Secondary outcomes included the comparison of revision rate, postoperative complications, and patients' functional scores. Methods This systematic review was conducted under the PRISMA 2020 guidelines with a pre-registered PROSPERO protocol. Three engines and grey literature were searched up until May 2022. Randomized and nonrandomized controlled trials and comparative cohort studies assessing BP and control therapy impact on THA survival were included. Results Twelve studies embraced the inclusion criteria. A total of 99 678 patients and 99 696 THAs were included; 10 025 patients received BPs (BP group), and 89 129 made up the control group. The overall revision and AL rates were lower in the BP group (2.17% and 1.85%) than in the control group (4.06% and 3.2%). Periprosthetic fracture (PPF) cases were higher in the BP group (0.24%) than in the control group (0.04%); however, the majority of PPF cases were derived from a single study. Further complication risk was similar between groups. Most studies reported comparable functional scores between groups. Conclusion BP treatment after elective THA seems to reduce the overall revision and AL risk. Other complications' risk and functional scores were similar between groups. Further high-quality studies are needed to validate the results due to the multifactorial AL pathogenesis.
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Affiliation(s)
- Vasileios F Pegios
- Academic Orthopaedic Department, Aristotle University Medical School, General Hospital Papageorgiou, Thessaloniki, Greece
- Centre of Orthopaedic and Regenerative Medicine (CORE), Center for Interdisciplinary Research and Innovation (CIRI)-Aristotle University of Thessaloniki (AUTH), Balkan Center, Thessaloniki, Greece
| | - Eustathios Kenanidis
- Academic Orthopaedic Department, Aristotle University Medical School, General Hospital Papageorgiou, Thessaloniki, Greece
- Centre of Orthopaedic and Regenerative Medicine (CORE), Center for Interdisciplinary Research and Innovation (CIRI)-Aristotle University of Thessaloniki (AUTH), Balkan Center, Thessaloniki, Greece
| | - Stavros Tsotsolis
- Centre of Orthopaedic and Regenerative Medicine (CORE), Center for Interdisciplinary Research and Innovation (CIRI)-Aristotle University of Thessaloniki (AUTH), Balkan Center, Thessaloniki, Greece
- Department of Trauma and Orthopaedics, Guy’s and St Thomas’ NHS Foundation Trust, London, UK
| | - Michael Potoupnis
- Academic Orthopaedic Department, Aristotle University Medical School, General Hospital Papageorgiou, Thessaloniki, Greece
- Centre of Orthopaedic and Regenerative Medicine (CORE), Center for Interdisciplinary Research and Innovation (CIRI)-Aristotle University of Thessaloniki (AUTH), Balkan Center, Thessaloniki, Greece
| | - Eleftherios Tsiridis
- Academic Orthopaedic Department, Aristotle University Medical School, General Hospital Papageorgiou, Thessaloniki, Greece
- Centre of Orthopaedic and Regenerative Medicine (CORE), Center for Interdisciplinary Research and Innovation (CIRI)-Aristotle University of Thessaloniki (AUTH), Balkan Center, Thessaloniki, Greece
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BMP-2 functional polypeptides relieve osteolysis via bi-regulating bone formation and resorption coupled with macrophage polarization. NPJ Regen Med 2023; 8:6. [PMID: 36759627 PMCID: PMC9911742 DOI: 10.1038/s41536-023-00279-2] [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: 06/01/2022] [Accepted: 01/25/2023] [Indexed: 02/11/2023] Open
Abstract
Osteolysis caused by wear debris around the prosthesis is the main reason for aseptic loosening. Extending prosthetic service life is still challenging. In this study, we first synthesized a bone morphogenetic protein-2 (BMP-2) functional polypeptide (BMP2pp), and evaluated the effects of BMP2pp on macrophage polarization and impaired osteogenesis caused by titanium (Ti) particles in vitro. Then, we delineated the impact of BMP2pp on bone formation and resorption in a mouse calvarial bone osteolysis model induced by Ti particles. The results showed that BMP2pp not only alleviated the Ti-induced inhibition of osteoblastic differentiation in human placenta-derived mesenchymal stem cells (hPMSCs) but also prevented Ti-induced M1 macrophage polarization and promoted M2 macrophage differentiation in mice. Conditioned medium from BMP2pp-activated macrophages increased the osteogenesis of hPMSCs. The western blot results indicated a significant decrease in the expression of NF-κB inducing kinase (NIK) and phospho-NF-κB p65 in bone marrow-derived macrophages treated with BMP2pp. Furthermore, we clarified the protective effect of BMP2pp on bone formation and the reduction in bone resorption coupled with the immunomodulatory properties of calvarial osteolysis in mice. In summary, BMP2pp ameliorated the Ti-mediated impairment in osteogenic potential of hPMSCs, suppressed the M1 polarization of macrophages by inhibiting the activation of the NF-κB signaling pathway, and ameliorated Ti-induced bone osteolysis. Our research suggests that BMP2pp may be a potential option for treating prosthetic loosening induced by wear debris from prostheses.
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Oestreich K, Lindau T. A "Congenitally Adapted" TFCC Tear in Radial Longitudinal Deficiency: Case Report and Review of Literature. J Wrist Surg 2022; 11:445-449. [PMID: 36339077 PMCID: PMC9633140 DOI: 10.1055/s-0041-1735303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Accepted: 07/27/2021] [Indexed: 10/20/2022]
Abstract
We present a case of chronic wrist pain in a 14-year-old child with mild radial longitudinal deficiency and radiographic carpal collapse due to the absence of the scaphoid. Wrist arthroscopy demonstrated synovitis and a tear to the TFCC, which would be called "degenerative," according to the Palmer classification. This was debrided, and the patient is still asymptomatic at long-term follow-up. Review of the literature found one paper with a similar observation in a 17-year-old adolescent. We propose that paediatric "degenerative" tears ought to be called "congenitally adapted" tears.
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Affiliation(s)
- Kerstin Oestreich
- Department of Plastic Surgery, Hand & Upper Limb Service, Birmingham Children's Hospital, Birmingham, United Kingdom
| | - T.R. Lindau
- Pulvertaft Hand Center, Royal Derby Hospital, Derby, United Kingdom
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10
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Ghijsen SC, Nap FJ, Schuurman AH. Pseudotumor after Total Wrist Arthroplasty Mimicking a Neoplasm. J Wrist Surg 2022; 11:441-444. [PMID: 36339072 PMCID: PMC9633145 DOI: 10.1055/s-0041-1742282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Accepted: 07/27/2021] [Indexed: 12/26/2022]
Abstract
Background Total wrist arthroplasty can lead to a variation of complications. One of these is the formation of a pseudotumor. Although this complication is well known after total hip arthroplasty, it is rare in patients with wrist implants. Case Description A 55-year-old man with a Universal 2 (Integra, Plainsboro, NJ) wrist prosthesis was seen with a progressive mass on the radial side of his wrist since 1 year, initially suspicious for a neoplasm. However, after exploration, histopathology confirmed a particle-induced foreign body reaction. Literature Review There is little literature on pseudotumor formation after total wrist arthroplasty. Currently, there is no clear consensus about the etiology of pseudotumors but possible causes may include foreign body reaction, hypersensitivity, and wear debris. Clinical Relevance This case report shows that particle debris-induced pseudotumors should be considered when a patient with a wrist prosthesis presents with a mass suspicious for a neoplasm. In addition, treatment options of pseudotumors after wrist arthroplasty in literature is discussed.
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Affiliation(s)
- Sophie C. Ghijsen
- Department of Plastic, Reconstructive, and Hand Surgery, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Frank J. Nap
- Department of Radiology, Central Military Hospital (CMH) Utrecht and University Medical Center Utrecht, Utrecht, The Netherlands
| | - Arnold H. Schuurman
- Department of Plastic, Reconstructive, and Hand Surgery, University Medical Center Utrecht, Utrecht, The Netherlands
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11
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Quarto E, Zanirato A, Santolini F, Formica M. Bone impaction grafting and anti-protrusio cages in high-grade acetabular defects: a 22-year single centre experience. Arch Orthop Trauma Surg 2022; 142:2083-2091. [PMID: 34297189 DOI: 10.1007/s00402-021-04081-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Accepted: 07/19/2021] [Indexed: 11/28/2022]
Abstract
PURPOSE Report clinical and radiological long-term follow-up (FU) outcome of bone impaction grafting (BIG) and anti-protrusio cage (APC) technique in hip revision surgery. MATERIALS AND METHODS We analysed data on complications, as well as the clinical and radiological outcome of patients treated using this technique at our institution. We evaluated the acetabular bone stock renovation, acetabular component stability and its radiological migration. The clinical parameters considered were the Visual Analogue Scale (VAS) and the modified Harris Hip Score (mHHS). RESULTS Forty hips, with a mean 14.3-year FU, were included. This technique showed good clinical long-term results in an elderly and low-demanding population (mean age at surgery 71.4 ± 12.1 years). The radiological results were not as good as clinical results: 67.5% of cases had a radiographic evidence of resorption of less than 1/3 of the bone graft; 27.5% had a resorption ranging from 1/3 and ½ of the graft, and 5% had more than ½ of the graft. Paprosky type III B reported worse results in terms of graft resorption and a greater migration of the APC (p < 0.001). The survival rate was 95% and a 2.5% rate of septic failure was recorded. CONCLUSION Impaction grafting with femoral head and APC is an effective technique for treating high-grade acetabular defects. APC reconstructs the hip centre of rotation, avoiding loading forces on the underlying bone graft that can be correctly integrated. At long-term FU, satisfactory clinical results, not strictly correlated to radiological signs of integration, were observed; Paprosky type III B reported worse results in terms of graft resorption and a greater migration of the APC.
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Affiliation(s)
- E Quarto
- Genova, Clinica Ortopedica, IRCCS Policlinico San Martino, Largo Rosanna Benzi 10, 16132, Genoa, GE, Italy.
| | - A Zanirato
- Genova, Clinica Ortopedica, IRCCS Policlinico San Martino, Largo Rosanna Benzi 10, 16132, Genoa, GE, Italy
| | - F Santolini
- Genova, Ortopedia e Traumatologia d'Urgenza, IRCCS Policlinico San Martino, Genoa, Italy
| | - M Formica
- Genova, Clinica Ortopedica, IRCCS Policlinico San Martino, Largo Rosanna Benzi 10, 16132, Genoa, GE, Italy
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12
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Mjöberg B. Hip prosthetic loosening and periprosthetic osteolysis: A commentary. World J Orthop 2022; 13:574-577. [PMID: 35949708 PMCID: PMC9244959 DOI: 10.5312/wjo.v13.i6.574] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Revised: 06/02/2022] [Accepted: 06/14/2022] [Indexed: 02/06/2023] Open
Abstract
Prosthetic loosening and periprosthetic osteolysis have been debated for decades, both in terms of the timing and nature of the triggering events. The hypothesis of wear-particle-induced loosening states that wear particles cause a foreign-body response leading to periprosthetic osteolysis and ultimately to late prosthetic loosening, i.e., that the osteolysis precedes the loosening. The theory of early loosening, on the other hand, postulates that the loosening is already initiated during or shortly after surgery, i.e., that the osteolysis is secondary to the loosening. This commentary focuses on the causal relationship between prosthetic loosening and periprosthetic osteolysis.
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Affiliation(s)
- Bengt Mjöberg
- Department of Orthopedics, Lund University, Lund SE-221 00, Sweden
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13
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Jin J, Sawyer M, Bansal V, Pham J, Mohajir W, Wang D. Images in Vascular Medicine: Manifestation of vascular collaterals in particle disease. Vasc Med 2022; 27:403-404. [PMID: 35073808 DOI: 10.1177/1358863x211067567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Jeff Jin
- Department of Internal Medicine, University of Texas Health Science Center at Houston - McGovern Medical School, Houston, TX, USA
| | - Matthew Sawyer
- Department of Internal Medicine, University of Texas Health Science Center at Houston - McGovern Medical School, Houston, TX, USA
| | - Vishal Bansal
- Department of Internal Medicine, University of Texas Health Science Center at Houston - McGovern Medical School, Houston, TX, USA
| | - Jimmy Pham
- Department of Internal Medicine, University of Texas Health Science Center at Houston - McGovern Medical School, Houston, TX, USA
| | - Wasay Mohajir
- Department of Internal Medicine, University of Texas Health Science Center at Houston - McGovern Medical School, Houston, TX, USA
| | - Daniel Wang
- Department of Internal Medicine, University of Texas Health Science Center at Houston - McGovern Medical School, Houston, TX, USA
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14
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Shim BJ, Park SJ, Park CH. The Wear Rate and Survivorship in Total Hip Arthroplasty Using a Third-generation Ceramic Head on a Conventional Polyethylene Liner: A Minimum of 15-year Follow-up. Hip Pelvis 2022; 34:115-121. [PMID: 35800129 PMCID: PMC9204242 DOI: 10.5371/hp.2022.34.2.115] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Revised: 01/14/2022] [Accepted: 01/29/2022] [Indexed: 11/24/2022] Open
Abstract
Purpose Materials and Methods Results Conclusion
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Affiliation(s)
- Bum-Jin Shim
- Department of Orthopedic Surgery, Hallym University Chuncheon Sacred Heart Hospital, Chuncheon, Korea
| | - Sung-Jin Park
- Department of Orthopedic Surgery, Yeungnam University Medical Center, Daegu, Korea
| | - Chan Ho Park
- Department of Orthopedic Surgery, Yeungnam University Medical Center, Daegu, Korea
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15
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Hu X, Song J, Liao Z, Liu Y, Gao J, Menze B, Liu W. Morphological residual convolutional neural network (M-RCNN) for intelligent recognition of wear particles from artificial joints. FRICTION 2022; 10:560-572. [PMCID: PMC8372229 DOI: 10.1007/s40544-021-0516-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 03/18/2021] [Accepted: 03/30/2021] [Indexed: 06/28/2023]
Abstract
Finding the correct category of wear particles is important to understand the tribological behavior. However, manual identification is tedious and time-consuming. We here propose an automatic morphological residual convolutional neural network (M-RCNN), exploiting the residual knowledge and morphological priors between various particle types. We also employ data augmentation to prevent performance deterioration caused by the extremely imbalanced problem of class distribution. Experimental results indicate that our morphological priors are distinguishable and beneficial to largely boosting overall performance. M-RCNN demonstrates a much higher accuracy (0.940) than the deep residual network (0.845) and support vector machine (0.821). This work provides an effective solution for automatically identifying wear particles and can be a powerful tool to further analyze the failure mechanisms of artificial joints.
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Affiliation(s)
- Xiaobin Hu
- Department of Computer Science, Technical University of Munich, Garching, 85748 Germany
| | - Jian Song
- School of Biomedical Engineering, Sun Yat-sen University, Guangzhou, 510006 China
| | - Zhenhua Liao
- Key Laboratory of Biomedical Materials and Implant Devices, Research Institute of Tsinghua University in Shenzhen, Shenzhen, 518057 China
| | - Yuhong Liu
- State Key Laboratory of Tribology, Tsinghua University, Beijing, 100084 China
| | - Jian Gao
- Mckelvey School of Engineering, Washington University in Saint Louis, St. Louis, MO 63130 USA
| | - Bjoern Menze
- Department of Computer Science, Technical University of Munich, Garching, 85748 Germany
| | - Weiqiang Liu
- Key Laboratory of Biomedical Materials and Implant Devices, Research Institute of Tsinghua University in Shenzhen, Shenzhen, 518057 China
- State Key Laboratory of Tribology, Tsinghua University, Beijing, 100084 China
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16
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Alhamad M, Barão VAR, Sukotjo C, Cooper LF, Mathew MT. Ti-Ions and/or Particles in Saliva Potentially Aggravate Dental Implant Corrosion. MATERIALS 2021; 14:ma14195733. [PMID: 34640130 PMCID: PMC8510105 DOI: 10.3390/ma14195733] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Revised: 09/17/2021] [Accepted: 09/27/2021] [Indexed: 11/16/2022]
Abstract
The corrosive titanium products in peri-implant tissues are a potential risk factor for peri-implantitis. There is very limited information available on the effect of the corrosion and wear products on the dental implant corrosion. Therefore, we determined the influence of Ti-ions and Ti-particles on Ti corrosion. Eighteen commercially pure-Ti-grade-2 discs were polished to mirror-shine. Samples were divided into six groups (n = 3) as a function of electrolytes; (A) Artificial saliva (AS), (B) AS with Ti-ions (the electrolyte from group A, after corrosion), (C) AS with Ti-particles 10 ppm (D) AS with Ti-particles 20 ppm, (E) AS with Ti-ions 10 ppm, and (F) AS with Ti-ions 20 ppm. Using Tafel’s method, corrosion potential (Ecorr) and current density (Icorr) were estimated from potentiodynamic curves. Electrochemical Impedance Spectroscopy (EIS) data were used to construct Nyquist and Bode plots, and an equivalent electrical circuit was used to assess the corrosion kinetics. The corroded surfaces were examined through a 3D-white-light microscope and scanning electronic microscopy. The data demonstrated that the concentration of Ti-ions and corrosion rate (Icorr) are strongly correlated (r = 0.997, p = 0.046). This study indicated that high Ti-ion concentration potentially aggravates corrosion. Under such a severe corrosion environment, there is a potential risk of increased implant associated adverse tissue reactions.
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Affiliation(s)
- Mostafa Alhamad
- Department of Restorative Dentistry, College of Dentistry, University of Illinois at Chicago, Chicago, IL 60612, USA;
- Department of Restorative Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam 34212, Saudi Arabia
| | - Valentim A. R. Barão
- Department of Prosthodontics and Periodontology, Piracicaba Dental School, University of Campinas, Piracicaba, São Paulo 13414-903, Brazil;
| | - Cortino Sukotjo
- Department of Restorative Dentistry, College of Dentistry, University of Illinois at Chicago, Chicago, IL 60612, USA;
- Department of Prosthodontics, School of Dental Medicine, Bahçeşehir University, Istanbul 34353, Turkey
- Correspondence: (C.S.); (M.T.M.)
| | - Lyndon F. Cooper
- Department of Oral Biology, College of Dentistry, University of Illinois at Chicago, Chicago, IL 60612, USA;
| | - Mathew T. Mathew
- Department of Restorative Dentistry, College of Dentistry, University of Illinois at Chicago, Chicago, IL 60612, USA;
- Correspondence: (C.S.); (M.T.M.)
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17
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Multifunctional natural polymer-based metallic implant surface modifications. Biointerphases 2021; 16:020803. [PMID: 33906356 DOI: 10.1116/6.0000876] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
High energy traumas could cause critical damage to bone, which will require permanent implants to recover while functionally integrating with the host bone. Critical sized bone defects necessitate the use of bioactive metallic implants. Because of bioinertness, various methods involving surface modifications such as surface treatments, the development of novel alloys, bioceramic/bioglass coatings, and biofunctional molecule grafting have been utilized to effectively integrate metallic implants with a living bone. However, the applications of these methods demonstrated a need for an interphase layer improving bone-making to overcome two major risk factors: aseptic loosening and peri-implantitis. To accomplish a biologically functional bridge with the host to prevent loosening, regenerative cues, osteoimmunomodulatory modifications, and electrochemically resistant layers against corrosion appeared as imperative reinforcements. In addition, interphases carrying antibacterial cargo were proven to be successful against peri-implantitis. In the literature, metallic implant coatings employing natural polymers as the main matrix were presented as bioactive interphases, enabling rapid, robust, and functional osseointegration with the host bone. However, a comprehensive review of natural polymer coatings, bridging and grafting on metallic implants, and their activities has not been reported. In this review, state-of-the-art studies on multifunctional natural polymer-based implant coatings effectively utilized as a bone tissue engineering (BTE) modality are depicted. Protein-based, polysaccharide-based coatings and their combinations to achieve better osseointegration via the formation of an extracellular matrix-like (ECM-like) interphase with gap filling and corrosion resistance abilities are discussed in detail. The hypotheses and results of these studies are examined and criticized, and the potential future prospects of multifunctional coatings are also proposed as final remarks.
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18
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Bota NC, Nistor DV, Caterev S, Todor A. Historical overview of hip arthroplasty: From humble beginnings to a high-tech future. Orthop Rev (Pavia) 2021; 13:8773. [PMID: 33897987 PMCID: PMC8054655 DOI: 10.4081/or.2021.8773] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Accepted: 02/25/2021] [Indexed: 11/23/2022] Open
Abstract
Surgery of the arthritic hip was not an easy task in the previous centuries, lots of operations being followed very closely by complications and failures. Nowadays, hip arthroplasty is considered "the operation of the century". This review follows the evolution of surgery on the arthritic hip, with emphasis on arthroplasty. Acknowledging the history of this operation, one can better prepare its evolution and future directions of research. The final chapter briefly describes the current trends and future perspectives.
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Affiliation(s)
| | - Dan-Viorel Nistor
- Department of Orthopedics, Traumatology and Pediatric Orthopedics, “Iuliu Haţieganu” University of Medicine and Pharmacy, Cluj-Napoca, Romania
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19
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Effect of deep rolling on subsurface conditions of CoCr28Mo6 wrought alloy to improve the wear resistance of endoprostheses. J Mech Behav Biomed Mater 2021; 118:104398. [PMID: 33667927 DOI: 10.1016/j.jmbbm.2021.104398] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Revised: 02/06/2021] [Accepted: 02/11/2021] [Indexed: 12/28/2022]
Abstract
Wear of orthopaedic endoprostheses is associated with adverse local and systemic reactions and can lead to early implant failure. Manufacturing determines the initial subsurface microstructure of an alloy that influences the implant's wear behaviour. Therefore, this study aims at generating enhanced wear resistances by a modification of the surface and subsurface microstructure of a CoCr28Mo6 wrought alloy by applying deep rolling. The state of the art was investigated by means of eleven retrieved CoCr28Mo6 hip implant components from different manufacturers with respect to their subsurface microstructure and micro hardness profiles. CoCr28Mo6 wrought alloy samples (DIN EN ISO 5832-12) were aged at 750 °C for 24 h and/or plastically deformed by deep rolling with varying axial forces (170 N, 230 N and 250 N). The samples were metallographically prepared and investigated using optical and scanning electron microscopy with EDS and EBSD, micro hardness testing, XRD and tribological testing. The retrieved implant components revealed that, independent of the manufacturer, neither the head nor the stem trunnion exhibited a defined subsurface condition. The dominant phase within the implants was face-centered cubic (fcc). Some implants exhibited single hexagonal close-packed (hcp) grains due to a stress-induced phase transformation. The initial CoCr28Mo6 wrought alloy had a fcc crystal structure. After isothermal aging, the matrix entirely transformed to a hcp structure. In the initial fcc-condition, deep rolling generated a plastically deformed surface layer within the first 100 μm and stress-induced phase transformation to hcp was observed. Micro hardness gradients were present in the subsurface of up to 600 μm depth and exhibited a maximum increase of 34% by deep rolling in comparison to the initial fcc-matrix. This trend was confirmed by a correlated increase in residual compressive stresses. In tribological tests under serum lubrication, the modified samples generated lower wear in comparison to the contemporarily used fcc-matrix samples. This study demonstrates that deep rolling is an effective processing to modify the subsurface of a biomedical CoCr28Mo6 wrought alloy in order to increase the wear resistance. The intentional transformation from the fcc to the hcp phase induced by deformation offers great potential for implant application.
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20
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Wear of hip prostheses increases serum IGFBP-1 levels in patients with aseptic loosening. Sci Rep 2021; 11:576. [PMID: 33436773 PMCID: PMC7804331 DOI: 10.1038/s41598-020-79813-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Accepted: 12/01/2020] [Indexed: 11/19/2022] Open
Abstract
The biological mechanisms involved in aseptic loosening include inflammation-associated and bone resorption-associated processes. Coordinated cellular actions result in biochemical imbalances with devastating consequences for the joint. Given that this condition is not known for showing systemic signs, we investigated whether circulating levels of inflammation-related proteins are altered in patients with aseptic loosening. Our study included 37 patients who underwent revision surgery due to hip osteolysis and aseptic loosening and 31 patients who underwent primary total hip arthroplasty. Using antibody arrays, we evaluated the serum levels of 320 proteins in four patients from each group. The results showed differences in insulin-like growth factor-binding protein 1 (IGFBP-1) concentrations, which we then quantified using enzyme-linked immunosorbent assay tests in all study patients. The results confirmed that serum IGFBP-1 concentrations were higher in the revision surgery patients than in the hip arthroplasty patients. In vitro studies showed that exposure of human osteoblasts to titanium particles induced an IGFBP-1 release that further increased when exposure to particles was performed in media conditioned by human M1 macrophages. These findings suggest that elevated serum IGFBP-1 levels in patients with aseptic loosening can arise from increased local IGFBP-1 production in the inflammatory environment of the periprosthetic bed.
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21
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Liao C, Li Y, Tjong SC. Polyetheretherketone and Its Composites for Bone Replacement and Regeneration. Polymers (Basel) 2020; 12:E2858. [PMID: 33260490 PMCID: PMC7760052 DOI: 10.3390/polym12122858] [Citation(s) in RCA: 42] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Revised: 07/23/2020] [Accepted: 07/25/2020] [Indexed: 12/18/2022] Open
Abstract
In this article, recent advances in the development, preparation, biocompatibility and mechanical properties of polyetheretherketone (PEEK) and its composites for hard and soft tissue engineering are reviewed. PEEK has been widely employed for fabricating spinal fusions due to its radiolucency, chemical stability and superior sterilization resistance at high temperatures. PEEK can also be tailored into patient-specific implants for treating orbital and craniofacial defects in combination with additive manufacturing process. However, PEEK is bioinert, lacking osseointegration after implantation. Accordingly, several approaches including surface roughening, thin film coating technology, and addition of bioactive hydroxyapatite (HA) micro-/nanofillers have been adopted to improve osseointegration performance. The elastic modulus of PEEK is 3.7-4.0 GPa, being considerably lower than that of human cortical bone ranging from 7-30 GPa. Thus, PEEK is not stiff enough to sustain applied stress in load-bearing orthopedic implants. Therefore, HA micro-/nanofillers, continuous and discontinuous carbon fibers are incorporated into PEEK for enhancing its stiffness for load-bearing applications. Among these, carbon fibers are more effective than HA micro-/nanofillers in providing additional stiffness and load-bearing capabilities. In particular, the tensile properties of PEEK composite with 30wt% short carbon fibers resemble those of cortical bone. Hydrophobic PEEK shows no degradation behavior, thus hampering its use for making porous bone scaffolds. PEEK can be blended with hydrophilic polymers such as polyglycolic acid and polyvinyl alcohol to produce biodegradable scaffolds for bone tissue engineering applications.
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Affiliation(s)
- Chengzhu Liao
- Department of Materials Science and Engineering, Southern University of Science and Technology, Shenzhen 518055, China;
| | - Yuchao Li
- Department of Materials Science and Engineering, Liaocheng University, Liaocheng 252000, China
| | - Sie Chin Tjong
- Department of Physics, City University of Hong Kong, Tat Chee Avenue, Kowloon, Hong Kong, China
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22
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Quinn J, McFadden R, Chan CW, Carson L. Titanium for Orthopedic Applications: An Overview of Surface Modification to Improve Biocompatibility and Prevent Bacterial Biofilm Formation. iScience 2020; 23:101745. [PMID: 33235984 PMCID: PMC7670191 DOI: 10.1016/j.isci.2020.101745] [Citation(s) in RCA: 58] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Titanium and its alloys have emerged as excellent candidates for use as orthopedic biomaterials. Nevertheless, there are often complications arising after implantation of orthopedic devices, most notably prosthetic joint infection and aseptic loosening. To ensure that implanted devices remain functional in situ, innovation in surface modification has attracted much attention in the effort to develop orthopedic materials with optimal characteristics at the biomaterial-tissue interface. This review will draw together metallurgy, surface engineering, biofilm microbiology, and biomaterial science. It will serve to appreciate why titanium and its alloys are frequently used orthopedic biomaterials and address some of the challenges facing these biomaterials currently, including the significant problem of device-associated infection. Finally, the authors shall consolidate and evaluate surface modification techniques employed to overcome some of these issues by offering a unique perspective as to the direction in which research is headed from a broad, interdisciplinary point of view.
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Affiliation(s)
- James Quinn
- School of Pharmacy, Queen's University Belfast, Medical Biology Centre, 97 Lisburn Road, Belfast BT9 7BL, UK
| | - Ryan McFadden
- School of Mechanical and Aerospace Engineering, Queen's University Belfast, Ashby Building, Stranmillis Road, Belfast BT9 5AH, UK
| | - Chi-Wai Chan
- School of Mechanical and Aerospace Engineering, Queen's University Belfast, Ashby Building, Stranmillis Road, Belfast BT9 5AH, UK
| | - Louise Carson
- School of Pharmacy, Queen's University Belfast, Medical Biology Centre, 97 Lisburn Road, Belfast BT9 7BL, UK
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23
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Xu J, Li D, Cai Z, Sun H, Su B, Qiu M, Ma R. Exosomal lncRNAs NONMMUT000375.2 and NONMMUT071578.2 derived from titanium particle treated RAW264.7 cells regulate osteogenic differentiation of MC3T3-E1 cells. J Biomed Mater Res A 2020; 108:2251-2262. [PMID: 32363719 DOI: 10.1002/jbm.a.36983] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2019] [Revised: 03/25/2020] [Accepted: 04/19/2020] [Indexed: 12/19/2022]
Abstract
Periprosthetic osteolysis and the subsequent aseptic loosening can lead to the failure of joint replacement. Wear particles are well known to be the initiative cause inducing osteolysis through enhancing osteoclast-mediated bone resorption and reducing osteogenic differentiation. The purpose of this study was to investigate the effects of osteoclast-secreted exosomal long noncoding RNAs (lncRNAs) on osteogenesis in the process of particle-induced osteolysis. RAW264.7 cells were treated by titanium particles (TI). The inflammatory cytokines were increased, and expression of Receptor Activator of Nuclear Factor-κB and Nuclear factor of activated T cells c1 were also increased, indicating osteoclast differentiation occurred. The purified exosomes from RAW264.7 cells induced with TI inhibited osteogenic differentiation of MC3T3-E1 cells. RNA sequencing generated lncRNAs expression profiles (458 up-regulated and 1641 down-regulated) of the exosomes derived from RAW264.7 cells treated with TI. Based on the results of gene ontology/Kyoto Encyclopedia of Genes and Genomes analysis and quantitative real time polymerase chain reaction validation, we confirmed two candidate lncRNAs, NONMMUT000375.2 and NONMMUT071578.2. The regulation network presented that some vital genes involved in osteoclast differentiation, such as Bcl2, Wnt11, TGF-β, and Pdk1, were under the regulation of NONMMUT000375.2 and NONMMUT071578.2. Taken together, exosomes derived from TI treated RAW264.7 cells inhibit the osteogenic activity of MC3T3-E1 cells. Exosomal lncRNAs, NONMMUT000375.2 and NONMMUT071578.2 may potentially play their roles in promoting osteoclast differentiation and suppressing osteogenesis, which aggravates the osteoclastogenesis/osteogenesis imbalance.
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Affiliation(s)
- Jie Xu
- Department of Joint Surgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Deng Li
- Department of Joint Surgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Zhiqing Cai
- Department of Joint Surgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Hao Sun
- Department of Joint Surgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Baohua Su
- Department of Joint Surgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Meiling Qiu
- Department of Joint Surgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Ruofan Ma
- Department of Joint Surgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
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24
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Wilson BM, Moran MM, Meagher MJ, Ross RD, Mashiatulla M, Virdi AS, Sumner DR. Early changes in serum osteocalcin and body weight are predictive of implant fixation in a rat model of implant loosening. J Orthop Res 2020; 38:1216-1227. [PMID: 31825107 PMCID: PMC7225033 DOI: 10.1002/jor.24563] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Accepted: 11/30/2019] [Indexed: 02/04/2023]
Abstract
Biomarkers are of interest to identify patients at risk for peri-implant osteolysis and aseptic loosening. We used a rat model of particle-induced peri-implant osteolysis to investigate if early changes in biomarkers were associated with subsequent implant fixation strength. Implants were placed in rat femora, which were then challenged with intra-articular knee injections of either clean polyethylene, lipopolysaccharide-doped polyethylene, or cobalt-chromium alloy particles, with particle-free vehicle serving as control (n ≥ 8 per group). Rats were weighed weekly, blood was collected at weeks 0, 3, 5, and 6, and locomotor behavior was assessed 4 days before study conclusion. Rats were euthanized 6 weeks post surgery. Week 6 serum was analyzed for five bone remodeling markers, while longitudinal serum was assessed for osteocalcin. Bone-implant contact, peri-implant trabecular architecture, and implant fixation strength were measured. Rats challenged with cobalt-chromium particles had a significant reduction in implant fixation strength compared with the vehicle-control group (P = .034). This group also had elevated serum osteocalcin (P = .005), depressed weight gain (P = .001) and less frequent rearing behavior (P = .029). Regardless of group, change in serum osteocalcin at week 3 (r = -.368; P = .046), change in weight at week 2 (r = .586; P < .001), as well as weight change at all other time intervals were associated with fixation strength. The finding that early alterations in serum osteocalcin and body weight were predictive of subsequent implant fixation strength supports continued investigation of biomarkers for early detection of peri-implant osteolysis and implant loosening. Further, change in biomarker levels was found to be more indicative of implant fixation status than any single measurement.
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Affiliation(s)
- Brittany M. Wilson
- Department of Cell & Molecular Medicine, Rush University Medical Center, Chicago, IL
| | - Meghan M. Moran
- Department of Cell & Molecular Medicine, Rush University Medical Center, Chicago, IL.,Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL
| | - Matthew J. Meagher
- Department of Cell & Molecular Medicine, Rush University Medical Center, Chicago, IL
| | - Ryan D. Ross
- Department of Cell & Molecular Medicine, Rush University Medical Center, Chicago, IL.,Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL
| | - Maleeha Mashiatulla
- Department of Cell & Molecular Medicine, Rush University Medical Center, Chicago, IL
| | - Amarjit S. Virdi
- Department of Cell & Molecular Medicine, Rush University Medical Center, Chicago, IL.,Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL
| | - D. Rick Sumner
- Department of Cell & Molecular Medicine, Rush University Medical Center, Chicago, IL.,Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL
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25
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Sharma V, Bose S, Kundu B, Bodhak S, Mitun D, Balla VK, Basu B. Probing the Influence of γ-Sterilization on the Oxidation, Crystallization, Sliding Wear Resistance, and Cytocompatibility of Chemically Modified Graphene-Oxide-Reinforced HDPE/UHMWPE Nanocomposites and Wear Debris. ACS Biomater Sci Eng 2020; 6:1462-1475. [PMID: 33455381 DOI: 10.1021/acsbiomaterials.9b01327] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Osteolysis and aseptic loosening due to wear at the articulating interfaces of prosthetic joints are considered to be the key concerns for implant failure in load-bearing orthopedic applications. In an effort to reduce the wear and processing difficulties of ultrahigh-molecular-weight polyethylene (UHMWPE), our research group recently developed high-density polyethylene (HDPE)/UHMWPE nanocomposites with chemically modified graphene oxide (mGO). Considering the importance of sterilization, this work explores the influence of γ-ray dosage of 25 kGy on the clinically relevant performance-limiting properties of these newly developed hybrid nanocomposites in vitro. Importantly, this work also probes into the cytotoxic effects of the wear debris of different compositions and sizes on MC3T3 murine osteoblasts and human mesenchymal stem cells (hMSCs). In particular, γ-ray-sterilized 1 wt % mGO-reinforced HDPE/UHMWPE nanocomposites exhibit an improvement in the oxidation index (16%), free energy of immersion (-12.1 mN/m), surface polarity (5.0%), and hardness (42%). Consequently, such enhancements result in better tribological properties, especially coefficient of friction (+13%) and wear resistance, when compared with UHMWPE. A spectrum of analyses using transmission electron microscopy (TEM) and in vitro cytocompatibility assessment demonstrate that phagocytosable (0.5-4.5 μm) sterilized 1 mGO wear particles, when present in culture media at 5 mg/mL concentration, induce neither significant reduction in MC3T3 murine osteoblast and hMSC growth nor cell morphology phenotype, during 24, 48, and 72 h of incubation. Taken together, this study suggests that γ-ray-sterilized HDPE/UHMWPE/mGO nanocomposites can be utilized as promising articulating surfaces for total joint replacements.
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Affiliation(s)
- Vidushi Sharma
- Laboratory for Biomaterials, Materials Research Center, Indian Institute of Science, Bangalore 560012, India
| | - Suryasarathi Bose
- Department of Materials Engineering, Indian Institute of Science, Bangalore 560012, India
| | - Biswanath Kundu
- Bioceramics & Coating Division, CSIR-Central Glass & Ceramic Research Institute, 196 Raja S. C. Mullick Road, Kolkata 700032, India
| | - Subhadip Bodhak
- Bioceramics & Coating Division, CSIR-Central Glass & Ceramic Research Institute, 196 Raja S. C. Mullick Road, Kolkata 700032, India
| | - Das Mitun
- Bioceramics & Coating Division, CSIR-Central Glass & Ceramic Research Institute, 196 Raja S. C. Mullick Road, Kolkata 700032, India.,Biomaterials and Corrosion Laboratory, Department of Materials Science and Engineering, Tel-Aviv University, Ramat Aviv, Tel Aviv 6997801, Israel
| | - Vamsi Krishna Balla
- Bioceramics & Coating Division, CSIR-Central Glass & Ceramic Research Institute, 196 Raja S. C. Mullick Road, Kolkata 700032, India.,Materials Innovation Guild, Department of Mechanical Engineering, University of Louisville, Louisville, Kentucky 40208, United States
| | - Bikramjit Basu
- Laboratory for Biomaterials, Materials Research Center, Indian Institute of Science, Bangalore 560012, India.,Centre for Biosystems Science and Engineering, Indian Institute of Science, Bangalore 560012, India
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26
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Abstract
Prosthetic loosening has been debated for decades, both in terms of the timing and nature of the triggering events. Multiple radiostereometric studies of hip prostheses have now shown that early migration poses a risk of future clinical failure, but is this enough to explain late clinical loosening?To answer this question, the progression of loosening from initiation to radiographic detection is described; and the need for explanations other than early prosthetic loosening is analysed, such as stress-shielding, particle disease, and metal sensitivity.Much evidence indicates that prosthetic loosening has already been initiated during or shortly after the surgery, and that the subsequent progression of loosening is affected by biomechanical factors, fluid pressure fluctuations and inflammatory responses to necrotic cells and cell fragments, i.e. the concept of late loosening appears to be a misinterpretation of late-detected loosening.Clinical implications: atraumatic surgery and initial prosthetic stability are crucial in ensuring low risk of prosthetic loosening. Cite this article: EFORT Open Rev 2020;5:113-117. DOI: 10.1302/2058-5241.5.190014.
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Affiliation(s)
- Bengt Mjöberg
- Department of Orthopaedics, Lund University, Lund, Sweden
- Bengt Mjöberg, Västra Vallgatan 29, SE-27135 Ystad, Sweden.
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27
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Ryu DJ, Sonn CH, Hong DH, Kwon KB, Park SJ, Ban HY, Kwak TY, Lim D, Wang JH. Titanium Porous Coating Using 3D Direct Energy Deposition (DED) Printing for Cementless TKA Implants: Does It Induce Chronic Inflammation? MATERIALS 2020; 13:ma13020472. [PMID: 31963803 PMCID: PMC7014007 DOI: 10.3390/ma13020472] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/14/2019] [Revised: 01/11/2020] [Accepted: 01/14/2020] [Indexed: 12/13/2022]
Abstract
Because of the recent technological advances, the cementless total knee arthroplasty (TKA) implant showed satisfactory implant survival rate. Newly developed 3D printing direct energy deposition (DED) has superior resistance to abrasion as compared to traditional methods. However, there is still concern about the mechanical stability and the risk of osteolysis by the titanium (Ti) nanoparticles. Therefore, in this work, we investigated whether DED Ti-coated cobalt-chrome (CoCr) alloys induce chronic inflammation reactions through in vitro and in vivo models. We studied three types of implant surfaces (smooth, sand-blasted, and DED Ti-coated) to compare their inflammatory reaction. We conducted the in vitro effect of specimens using the cell counting kit-8 (CCK-8) assay and an inflammatory cytokine assay. Subsequently, in vivo analysis of the immune profiling, cytokine assay, and histomorphometric evaluation using C57BL/6 mice were performed. There were no significant differences in the CCK-8 assay, the cytokine assay, and the immune profiling assay. Moreover, there were no difference for semi-quantitative histomorphometry analysis at 4 and 8 weeks among the sham, smooth, and DED Ti-coated samples. These results suggest that DED Ti-coated printing technique do not induce chronic inflammation both in vitro and in vivo. It has biocompatibility for being used as a surface coating of TKA implant.
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Affiliation(s)
- Dong Jin Ryu
- Department of Orthopedic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Korea; (D.J.R.); (K.B.K.); (S.J.P.)
| | - Chung-Hee Sonn
- Samsung Biomedical Research Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Korea; (C.-H.S.); (D.H.H.)
| | - Da Hee Hong
- Samsung Biomedical Research Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Korea; (C.-H.S.); (D.H.H.)
| | - Kyeu Back Kwon
- Department of Orthopedic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Korea; (D.J.R.); (K.B.K.); (S.J.P.)
| | - Sang Jun Park
- Department of Orthopedic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Korea; (D.J.R.); (K.B.K.); (S.J.P.)
| | - Hun Yeong Ban
- Department of Mechanical Engineering, Sejong University, Seoul 05006, Korea; (H.Y.B.); (T.Y.K.)
| | - Tae Yang Kwak
- Department of Mechanical Engineering, Sejong University, Seoul 05006, Korea; (H.Y.B.); (T.Y.K.)
| | - Dohyung Lim
- Department of Mechanical Engineering, Sejong University, Seoul 05006, Korea; (H.Y.B.); (T.Y.K.)
- Correspondence: (D.L.); (J.H.W.); Tel.: +82-2-3408-3672 (D.L.); +82-2-3410-3507 (J.H.W.); Fax: +82-2-3408-4333 (D.L.); +82-2-3410-0061 (J.H.W.)
| | - Joon Ho Wang
- Department of Orthopedic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Korea; (D.J.R.); (K.B.K.); (S.J.P.)
- Department of Health Sciences and Technology, SAIHST, Sungkyunkwan University, Seoul 06351, Korea
- Department of Medical Device Management and Research, SAIHST, Sungkyunkwan University, Seoul 06351, Korea
- Correspondence: (D.L.); (J.H.W.); Tel.: +82-2-3408-3672 (D.L.); +82-2-3410-3507 (J.H.W.); Fax: +82-2-3408-4333 (D.L.); +82-2-3410-0061 (J.H.W.)
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Niarakis A, Giannopoulou E, Syggelos SA, Panagiotopoulos E. Effects of proteasome inhibitors on cytokines, metalloproteinases and their inhibitors and collagen type-I expression in periprosthetic tissues and fibroblasts from loose arthroplasty endoprostheses. Connect Tissue Res 2019; 60:555-570. [PMID: 30931650 DOI: 10.1080/03008207.2019.1601186] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Objective: Aseptic loosening is a major problem in total joint replacement. Implant wear debris provokes a foreign body host response and activates cells to produce a variety of mediators and ROS, leading to periprosthetic osteolysis. Elevated ROS levels can harm proteasome function. Proteasome inhibitors have been reported to alter the secretory profile of cells involved in inflammation and also to induce ROS production. In this work, we aimed to document the effects of proteasome inhibitors MG-132 and Epoxomicin, on the production of factors involved in aseptic loosening, in periprosthetic tissues and fibroblasts, and investigate the role of proteasome impairment in periprosthetic osteolysis. Materials and methods: IL-6 levels in tissue cultures were determined by sandwich ELISA. MMP-1, -3, -13, -14 and TIMP-1 levels in tissue or cell cultures were determined by indirect ELISA. Results for MMP-1 and TIMP-1 in tissue cultures were confirmed by Western blotting. MMP-2 and MMP-9 levels were determined by gelatin zymography. Gene expression of IL-6, MMP-1,-3,-14, TIMP-1 and collagen type-I was determined by RT-PCR. Results: Results show that proteasome inhibition induces the expression of ΜΜΡ-1, -2, -3, -9 and suppresses that of IL-6, MMP-14, -13, TIMP-1 and collagen type I, enhancing the collagenolytic and gelatinolytic activity already present in periprosthetic tissues, as documented in various studies. Conclusions: These findings suggest that proteasome impairment could be a contributing factor to aseptic loosening. Protection and enhancement of proteasome efficacy could thus be considered as an alternative strategy toward disease treatment.
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Affiliation(s)
- Anna Niarakis
- Laboratory of Biochemistry, Department of Chemistry, University of Patras , Patras , Greece.,GenHotel EA3886, Univ Evry, Université Paris-Saclay , Evry , France
| | | | - Spyros A Syggelos
- Department of Anatomy-Histology-Embryology, School of Medicine, University of Patras , Patras , Greece
| | - Elias Panagiotopoulos
- Department of Orthopaedics, School of Medicine, University of Patras , Patras , Greece
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Xiong L, Liu Y, Zhu F, Lin J, Wen D, Wang Z, Bai J, Ge G, Xu C, Gu Y, Xu Y, Zhou J, Geng D. Acetyl-11-keto-β-boswellic acid attenuates titanium particle-induced osteogenic inhibition via activation of the GSK-3β/β-catenin signaling pathway. Theranostics 2019; 9:7140-7155. [PMID: 31695758 PMCID: PMC6831297 DOI: 10.7150/thno.35988] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2019] [Accepted: 09/01/2019] [Indexed: 12/14/2022] Open
Abstract
Rationale: Peri-prosthetic osteolysis (PPO) is mainly induced by wear particles and represents the leading cause of implant failure and revision surgery. Previous studies have identified mitigation of wear particle-induced inflammation and bone resorption as the main approaches to treat PPO. Recently, wear particle-induced reduction of bone formation around the prosthesis was identified as a major factor in the development of PPO. Acetyl-11-keto-β-boswellic acid (AKBA), a derivative of frankincense, has been shown to play a potential role in bone metabolism. However, whether AKBA enhances bone formation in wear particle-induced osteolysis remains unknown. In this study, we examined whether AKBA attenuates titanium particle-induced osteogenic reduction. Methods: Titanium particles were used to induce osteolysis in murine calvaria, and micro-CT and histological analyses were used to evaluate the results. Mouse osteoblast cells, MC3T3-E1 were co-cultured with titanium particles to determine their effect on osteoblast formation in vitro. Results: We demonstrated that AKBA treatment significantly inhibited titanium particle-induced osteogenic inhibition by enhancing osteogenesis both in vivo and in vitro. AKBA treatment also enhanced the phosphorylation of GSK-3β, decreased the degradation of β-catenin, and increased the translocation of β-catenin from the cytoplasm to the nucleus. Taken together, these results showed that AKBA treatment attenuated titanium-induced osteogenic inhibition by activating the GSK-3β/β-catenin signaling pathway. Conclusion: These findings suggest that AKBA is a promising new target in the prevention and treatment of PPO.
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Costa BC, Alves AC, Toptan F, Pinto AM, Grenho L, Fernandes MH, Petrovykh DY, Rocha LA, Lisboa-Filho PN. Exposure effects of endotoxin-free titanium-based wear particles to human osteoblasts. J Mech Behav Biomed Mater 2019; 95:143-152. [DOI: 10.1016/j.jmbbm.2019.04.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Revised: 04/04/2019] [Accepted: 04/05/2019] [Indexed: 02/01/2023]
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Döring J, Crackau M, Nestler C, Welzel F, Bertrand J, Lohmann CH. Characteristics of different cathodic arc deposition coatings on CoCrMo for biomedical applications. J Mech Behav Biomed Mater 2019; 97:212-221. [PMID: 31129165 DOI: 10.1016/j.jmbbm.2019.04.026] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2018] [Revised: 03/11/2019] [Accepted: 04/13/2019] [Indexed: 01/19/2023]
Abstract
Coatings of endoprostheses are used to improve the tribological performance of arthroplasties. A major challenge for the successful use of these coatings, however, is a stable layer adhesion, a smooth surface, as well as a reduction in droplet formation during the coating process. Explants with commercially available coatings were investigated to assess surface/layer defects and adhesion properties. For the investigation of new coatings, we used cathodic arc deposition (Arc-PVD) to generate TiN, ZrN similar to the currently commercially available coatings and three different diamond like carbon (DLC) coatings on CoCrMo substrate. All surface coatings were mechanically specified by measuring roughness, coating thickness, abrasive wear and critical loads. A friction wear test was modified using an UHMWPE counterpart with a contact pressure of 10 MPa to compare different coatings in one tribological test setup. Calf serum was used as lubricant. The commercially used coatings on the retrieved explants show several defects and the critical load for coating failure varied widely. All produced surface coatings showed an increased surface roughness after coating compared to uncoated samples, which was due to droplet formation, especially in the DLC coatings. A diamond post-polishing process was performed to reduce the surface roughness and reach the ISO standard of Ra < 50 nm. The ZrN and TiN coatings exhibited a decreased friction after removing of the droplets in comparison to uncoated CoCrMo samples, indicating that the post-polishing process might be a useful tool to ameliorate the tribological performance. The friction coefficient for all tested DLC layers was more than two times increased compared to the CoCrMo samples. The use of hard/soft bearings with DLC coated endoprostheses seems to be not advantageous.
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Affiliation(s)
- Joachim Döring
- Department of Orthopaedic Surgery, Medical Faculty, Otto-von-Guericke-University Magdeburg, Leipziger Straße 44, 39120, Magdeburg, Germany.
| | - Maria Crackau
- Department of Orthopaedic Surgery, Medical Faculty, Otto-von-Guericke-University Magdeburg, Leipziger Straße 44, 39120, Magdeburg, Germany
| | - Christian Nestler
- Department of Orthopaedic Surgery, Medical Faculty, Otto-von-Guericke-University Magdeburg, Leipziger Straße 44, 39120, Magdeburg, Germany; Institute of Manufacturing Technology and Quality Management, Otto-von-Guericke-University Magdeburg, Universitätsplatz 2, 39106, Magdeburg, Germany
| | - Florian Welzel
- Institute of Manufacturing Technology and Quality Management, Otto-von-Guericke-University Magdeburg, Universitätsplatz 2, 39106, Magdeburg, Germany
| | - Jessica Bertrand
- Department of Orthopaedic Surgery, Medical Faculty, Otto-von-Guericke-University Magdeburg, Leipziger Straße 44, 39120, Magdeburg, Germany
| | - Christoph H Lohmann
- Department of Orthopaedic Surgery, Medical Faculty, Otto-von-Guericke-University Magdeburg, Leipziger Straße 44, 39120, Magdeburg, Germany
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Destruel A, Fuentes M, Weber E, O'Brien K, Jin J, Liu F, Barth M, Crozier S. A numerical and experimental study of RF shimming in the presence of hip prostheses using adaptive SAR at 3 T. Magn Reson Med 2019; 81:3826-3839. [PMID: 30803001 DOI: 10.1002/mrm.27688] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2018] [Revised: 01/17/2019] [Accepted: 01/20/2019] [Indexed: 12/25/2022]
Abstract
PURPOSE Parallel transmission techniques in MRI have the potential to improve the image quality near metal implants at 3 T. However, current testing of implants only evaluates the risk of radiofrequency (RF) heating in phantoms in circularly polarized mode. We investigate the influence of changing the transmission settings in a 2-channel body coil on the peak temperature near 2 CoCrMo hip prostheses, using adaptive specific absorption rate (SAR) as an estimate of RF heating. METHODS Adaptive SAR is a SAR averaging method that is optimized to correlate with thermal simulations and limit the temperature to 39°C near hip implants. The simulated peak temperature was compared when using whole-body SAR, SAR10g , and adaptive SAR as a constraint for the maximum allowed input power. Adaptive SAR was used as a fast estimate of temperature to evaluate the trade-off between good image quality and low heating near the hip implants. Electromagnetic simulations were validated by simulating and measuring B1 maps and electric fields in a phantom at 3 T. RESULTS Simulations and measurements showed excellent agreement. Limiting whole-body SAR to 2 W/kg and SAR10g to 10 W/kg resulted in temperatures up to 49.3°C and 40.7°C near the hip implants after 30 minutes of RF exposure, respectively. Predictions based on adaptive SAR limited the temperature to 39°C, and allowed to improve the B1 field distribution while preventing peak temperatures near the hip implants. CONCLUSION Significant RF heating can occur at 3 T near hip implants when parallel transmission is used. Adaptive SAR can be integrated in RF shimming algorithms to improve the uniformity and reduce heating.
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Affiliation(s)
- Aurelien Destruel
- School of Information Technology and Electrical Engineering, University of Queensland, St. Lucia, Australia.,Centre for Advanced Imaging, University of Queensland, St. Lucia, Australia
| | - Miguel Fuentes
- School of Information Technology and Electrical Engineering, University of Queensland, St. Lucia, Australia.,Population Health Research on Electromagnetic Energy, School of Public Health and Preventive Medicine, Monash University, Clayton, Australia
| | - Ewald Weber
- School of Information Technology and Electrical Engineering, University of Queensland, St. Lucia, Australia
| | - Kieran O'Brien
- Centre for Advanced Imaging, University of Queensland, St. Lucia, Australia.,Siemens Healthcare, Brisbane, Australia
| | - Jin Jin
- Siemens Healthineers USA, Los Angeles, California
| | - Feng Liu
- School of Information Technology and Electrical Engineering, University of Queensland, St. Lucia, Australia
| | - Markus Barth
- Centre for Advanced Imaging, University of Queensland, St. Lucia, Australia
| | - Stuart Crozier
- School of Information Technology and Electrical Engineering, University of Queensland, St. Lucia, Australia
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Fu G, Li S, Ouyang N, Wu J, Li C, Liu W, Qiu J, Peng P, Qin L, Ding Y. Antiresorptive Agents are More Effective in Preventing Titanium Particle-Induced Calvarial Osteolysis in Ovariectomized Mice Than Anabolic Agents in Short-Term Administration. Artif Organs 2019; 42:E259-E271. [PMID: 30328628 PMCID: PMC6585759 DOI: 10.1111/aor.13271] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2018] [Revised: 03/28/2018] [Accepted: 04/02/2018] [Indexed: 12/22/2022]
Abstract
Aseptic loosening due to wear particle‐induced osteolysis is the main cause of arthroplasty failure and the influence of postmenopausal osteoporosis and anti‐osteoporosis treatment on Titanium (Ti) particle‐induced osteolysis remains unclear. 66 C57BL/6J female mice were used in this study. Ovariectomy (OVX) was performed to induce osteopenia mice and confirmed by micro‐CT. The Ti particle‐induced mouse calvaria osteolysis model was established subsequently and both OVX and Sham‐OVX mice were divided into four groups, respectively: Ti (‐) group, Ti group, Ti + zoledronic acid (ZOL) group (50ug/kg, local administration, single dose) and Ti + teriparatide (TPTD) group (40ug/kg/d, subcutaneous injection*14d). Mice calvarias were collected for micro‐CT and histomorphometric analysis 2 weeks after particle induction. 8 weeks after bilateral OVX, significantly reduced BMD and microstructure parameters in both proximal tibia and calvaria were observed in OVX mice when comparing with Sham‐OVX mice. OVX mice in Ti group had not only markly decreased BMD and BV/TV, but also significantly increased total porosity, eroded surface area and osteoclast numbers when comparing with Sham‐OVX mice. Shown by Two‐way ANOVA analysis, the interaction terms between OVX and Ti implantation on micro‐CT and histomorphometry parameters didn’t reach significant difference. As illustrated by micro‐CT and histological analysis, ZOL treatment markedly inhibited Ti particle‐induced osteolysis in OVX mice and Sham‐OVX mice, and there were significant differences when comparing to both Ti and Ti+TPTD group. The combination of osteoporosis and Ti particle implantation result in aggravated bone resorption, accompanied with increased osteoclasts and excessive inflammation response. ZOL was more effective in preventing Ti particle‐induced osteolysis in both OVX mice and Sham‐OVX mice than TPTD in short‐term administration. ZOL exert the protective effects on Ti particle‐induced bone loss via the suppression of osteoclasts.
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Affiliation(s)
- Guangtao Fu
- Department of Orthopedics, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Yuexiu District, Guangzhou, Guangdong Province, People's Republic of China
| | - Shixun Li
- Department of Orthopedics, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Yuexiu District, Guangzhou, Guangdong Province, People's Republic of China
| | - Nengtai Ouyang
- Cellular & Molecular Diagnostics Center, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Yuexiu District, Guangzhou, Guangdong Province, People's Republic of China
| | - Junyan Wu
- Department of Pharmaceuticals, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Yuexiu District, Guangzhou, Guangdong Province, People's Republic of China
| | - Changchuan Li
- Department of Orthopedics, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Yuexiu District, Guangzhou, Guangdong Province, People's Republic of China
| | - Wei Liu
- Department of Orthopedics, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Yuexiu District, Guangzhou, Guangdong Province, People's Republic of China
| | - Junxiong Qiu
- Department of Orthopedics, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Yuexiu District, Guangzhou, Guangdong Province, People's Republic of China
| | - Peng Peng
- Department of Orthopedics, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Yuexiu District, Guangzhou, Guangdong Province, People's Republic of China
| | - Ling Qin
- Musculoskeletal Research Laboratory, Department of Orthopaedics & Traumatology, The Chinese University of Hong Kong, Hong Kong SAR
| | - Yue Ding
- Department of Orthopedics, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Yuexiu District, Guangzhou, Guangdong Province, People's Republic of China.,Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Yuexiu District, Guangzhou, Guangdong Province, People's Republic of China
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Bu Y, Zheng D, Wang L, Liu J. LncRNA TSIX promotes osteoblast apoptosis in particle-induced osteolysis by down-regulating miR-30a-5p. Connect Tissue Res 2018; 59:534-541. [PMID: 29260905 DOI: 10.1080/03008207.2017.1413362] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE This study aims to investigate the role of TSIX/miR-30a-5p axis in particle-induced osteolysis (PIO). METHOD PIO mouse model was established by the implantation of Co-Cr-Mo metal particles (CoPs). MC3T3-E1 cells received CoPs stimulation. Bone mineral density (BMD) in the skull was detected to evaluate PIO development. The expression of TSIX and miR-30a-5p was detected by using qRT-PCR. Osteoblast apoptosis was measured using flow cytometry. RNA pull-down was used to verify the regulatory relationship between TSIX and miR-30a-5p. RESULT The results showed that BMD of the skull in PIO mice was significantly decreased compared with control mice, which indicated that the PIO model was established successfully. Moreover, CoPs could up-regulate TSIX level, down-regulate miR-30a-5p expression, and promote osteoblast apoptosis in vivo and in vitro. The results also found that TSIX negatively regulated miR-30a-5p expression, and knockdown of TSIX inhibited Runx2 expression. As expected, miR-30a-5p inhibitor could reverse the inhibition of si-TSIX on osteoblast apoptosis. CONCLUSION TSIX played a pivotal role in PIO development by negatively regulating miR-30a-5p.
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Affiliation(s)
- Yanmin Bu
- a Department of Orthopedics , Tianjin Hospital , Tianjin , People's Republic of China
| | - Dezhi Zheng
- a Department of Orthopedics , Tianjin Hospital , Tianjin , People's Republic of China
| | - Lei Wang
- a Department of Orthopedics , Tianjin Hospital , Tianjin , People's Republic of China
| | - Jun Liu
- a Department of Orthopedics , Tianjin Hospital , Tianjin , People's Republic of China
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35
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Benitez C, Pérez-Jara J, Garcia-Paino L, Montenegro T, Martin E, Vilches-Moraga A. Particulate wear debris osteolysis, acute urinary retention and delirium as late complications of hip arthroplasty. Age Ageing 2018; 47:756-757. [PMID: 29893777 DOI: 10.1093/ageing/afy083] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2017] [Accepted: 05/10/2018] [Indexed: 11/13/2022] Open
Abstract
Intrapelvic mass formation as a result of particulate wear debris induced osteolysis is a recognised late complication of cementless total hip arthroplasty. Clinical presentation typically involves hip and/or leg pain resulting in functional impairment, and obstructive urinary symptoms developing 3-20 years after surgery. An acute confusional state has never been described in this scenario. We report the case of an 86-year-old gentleman with a diagnosis of dementia brought to our emergency department with an acute confusional state. Abdominal imaging revealed a distended bladder, a large pelvic mass and a lytic lesion within his right acetabulum. Cytological and microbiological examination of fluid obtained with radiologically guided aspiration of the mass was negative for neoplasia and infection.
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Affiliation(s)
- Carmen Benitez
- Unidad de Geriatría, Hospital El Bierzo, Ponferrada, León. Spain
| | | | - Luis Garcia-Paino
- Servicio de Traumatología, Hospital El Bierzo, Ponferrada, León, Spain
| | | | | | - Arturo Vilches-Moraga
- Ageing and Complex Medicine Directorate, Salford Royal NHS Foundation Trust, Salford Hospital, Manchester, UK
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Mahon OR, Dunne A. Disease-Associated Particulates and Joint Inflammation; Mechanistic Insights and Potential Therapeutic Targets. Front Immunol 2018; 9:1145. [PMID: 29892292 PMCID: PMC5985611 DOI: 10.3389/fimmu.2018.01145] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2018] [Accepted: 05/07/2018] [Indexed: 12/27/2022] Open
Abstract
It is now well established that intra-articular deposition of endogenous particulates, such as osteoarthritis-associated basic calcium phosphate crystals, gout-associated monosodium urate crystals, and calcium deposition disease-associated calcium pyrophosphate crystals, contributes to joint destruction through the production of cartilage-degrading enzymes and pro-inflammatory cytokines. Furthermore, exogenous wear-debris particles, generated from prosthetic implants, drive periprosthetic osteolysis which impacts on the longevity of total joint replacements. Over the last few years, significant insight has been gained into the mechanisms through which these particulates exert their effects. Not only has this increased our understanding of the pathological processes associated with crystal deposition but it has also led to the identification of a number of therapeutic targets to treat particulate-associated disease. In this review, we discuss recent developments regarding the cellular events triggered by joint-associated particulates, as well as future directions in therapy for particulate-related arthropathies.
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Affiliation(s)
- Olwyn R Mahon
- School of Biochemistry and Immunology, School of Medicine, Trinity College Dublin, Trinity Biomedical Sciences Institute, The University of Dublin, Dublin, Ireland
| | - Aisling Dunne
- School of Biochemistry and Immunology, School of Medicine, Trinity College Dublin, Trinity Biomedical Sciences Institute, The University of Dublin, Dublin, Ireland
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37
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38
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Li J, Li Y, Peng X, Li B, Qin H, Chen Y. In vivo analysis of the effects of CoCrMo and Ti particles on inflammatory responses and osteolysis. RSC Adv 2018; 8:5151-5157. [PMID: 35542395 PMCID: PMC9082049 DOI: 10.1039/c7ra12325f] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2017] [Accepted: 01/23/2018] [Indexed: 11/25/2022] Open
Abstract
Metal wear particles play a major role in periprosthetic osteolysis and aseptic loosening in patients with total joint arthroplasty. The ability to induce osteolysis depends on the size, shape, dose, and type of the particles. However, much remains unknown regarding which type of metal particles are most reactive. We compared the inflammatory response and bone loss induced by two metal wear particles, cobalt-chromium-molybdenum (CoCrMo) and titanium (Ti), in a mouse calvaria model of osteolysis. We found that CoCrMo particles caused markedly greater bone resorption than Ti particles, according to three-dimensional images of the calvariae. CoCrMo particles activated more functional osteoclasts by significantly increasing the expression of the osteoclast-specific gene tartrate-specific acid phosphatase (Trap), calcitonin receptor (Ctr), and nuclear factor of activated T cells c1 (Nfatc1), and induced a greater increase in the ratio of receptor activator of nuclear factor kappa B ligand (RANKL)/osteoprotegerin (OPG) than Ti particles. CoCrMo particles also induced a stronger local inflammatory response, markedly increasing the expression and secretion of tumor necrosis factor-α and interleukin-1β compared with Ti particles. Therefore, CoCrMo particles induced a more severe inflammatory response and greater osteolysis than Ti particles in vivo.
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Affiliation(s)
- Juehong Li
- Department of Orthopaedic Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital Shanghai China +86-21-24058102
| | - Yamin Li
- Department of Orthopaedic Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital Shanghai China +86-21-24058102
| | - Xiaochun Peng
- Department of Orthopaedic Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital Shanghai China +86-21-24058102
| | - Bin Li
- Department of Orthopaedic Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital Shanghai China +86-21-24058102
| | - Hui Qin
- Department of Orthopaedic Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital Shanghai China +86-21-24058102
| | - Yunsu Chen
- Department of Orthopaedic Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital Shanghai China +86-21-24058102
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39
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Gwam CU, Mistry JB, Mohamed NS, Thomas M, Bigart KC, Mont MA, Delanois RE. Current Epidemiology of Revision Total Hip Arthroplasty in the United States: National Inpatient Sample 2009 to 2013. J Arthroplasty 2017; 32:2088-2092. [PMID: 28336249 DOI: 10.1016/j.arth.2017.02.046] [Citation(s) in RCA: 309] [Impact Index Per Article: 44.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2016] [Revised: 02/07/2017] [Accepted: 02/18/2017] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Despite the excellent outcomes associated with primary total hip arthroplasty (THA), implant failure and revision continues to burden the healthcare system. THA failure has evolved and displays variability throughout the literature. In order to understand how THAs are failing and how to reduce this burden, it is essential to assess modes of implant failure on a large scale. Thus, we report: (1) etiologies for revision THA; (2) frequencies of revision THA procedures; (3) patient demographics, payor type, and US Census region of revision THA patients; and (4) the length of stay and total costs based on the type of revision THA procedure. METHODS We queried the National Inpatient Sample database for all revision THA procedures performed between January 1, 2009 and December 31, 2013. This yielded 258,461 revision THAs. Patients specific demographics were identified in order to determine the prevalence of revision procedure performed. RESULTS Dislocation was the main indication for revision THA (17.3%), followed by mechanical loosening (16.8%). All-component revision was the most common procedure performed (41.8%). Patients were most commonly white (77.4%), aged 75 years and older (31.6%), and resided in the South US Census region (37.0%). The average length of stay for all procedures was 5.29 days. The mean total charge for revision THA procedures was $77,851.24. CONCLUSION Dislocation and mechanical loosening is the predominant indication for revision THA in the United States. With the frequency of revision THAs projected to double in the next decade, orthopedists must take steps to mitigate this potentially devastating complication.
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Affiliation(s)
- Chukwuweike U Gwam
- Rubin Institute for Advanced Orthopedics, Center for Joint Preservation and Replacement, Sinai Hospital of Baltimore, Baltimore, Maryland
| | - Jaydev B Mistry
- Rubin Institute for Advanced Orthopedics, Center for Joint Preservation and Replacement, Sinai Hospital of Baltimore, Baltimore, Maryland
| | - Nequesha S Mohamed
- Rubin Institute for Advanced Orthopedics, Center for Joint Preservation and Replacement, Sinai Hospital of Baltimore, Baltimore, Maryland
| | - Melbin Thomas
- Rubin Institute for Advanced Orthopedics, Center for Joint Preservation and Replacement, Sinai Hospital of Baltimore, Baltimore, Maryland
| | - Kevin C Bigart
- Department of Orthopaedic Surgery, Cleveland Clinic, Cleveland, Ohio
| | - Michael A Mont
- Department of Orthopaedic Surgery, Cleveland Clinic, Cleveland, Ohio
| | - Ronald E Delanois
- Rubin Institute for Advanced Orthopedics, Center for Joint Preservation and Replacement, Sinai Hospital of Baltimore, Baltimore, Maryland
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40
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Abstract
Aseptic loosening of implants remains the most common reason for revision surgery for hip, knee, or ankle prostheses. Although a great scientific effort has been made to explain the underlying mechanisms it remains poorly understood, complex, and multifactorial. Many factors, including age, body weight, activity lesions, implant design, fixation methods, material proprieties, immunologic responses, and biomechanical adaptations to total ankle replacement all contribute to the development of periprosthetic osteolysis.
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Affiliation(s)
- Norman Espinosa
- Institute for Foot and Ankle Reconstruction Zurich, Kappelistrasse 7, Zurich 8002, Switzerland.
| | - Georg Klammer
- Institute for Foot and Ankle Reconstruction Zurich, Kappelistrasse 7, Zurich 8002, Switzerland
| | - Stephan H Wirth
- Department of Orthopaedics, University of Zurich, Forchstrasse 340, Zurich 8008, Switzerland
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41
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Koivu H, Kohonen I, Mattila K, Loyttyniemi E, Tiusanen H. Medium to long-term results of 130 Ankle Evolutive System total ankle replacements-Inferior survival due to peri-implant osteolysis. Foot Ankle Surg 2017; 23:108-115. [PMID: 28578793 DOI: 10.1016/j.fas.2017.03.016] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2016] [Revised: 03/16/2017] [Accepted: 03/30/2017] [Indexed: 02/04/2023]
Abstract
BACKGROUND The study reports the medium to long-term results of 130 Ankle Evolutive System total ankle replacements operated at a single-centre. Previously high amount of peri-implant osteolysis was reported from the same material. METHODS Between 2002 and 2008 one hundred and thirty consecutive ankles replaced with AES ankle prosthesis were followed both radiologically and clinically. RESULTS The five-year survival was 87.3% (95% confidence interval (CI) 80.0-92.0%), and ten-year survival 74.9% (95% confidence interval (CI) 65.4-82.2%) at a median follow-up time of 96 months (range 2-161; 8 years). Peri-implant osteolysis was found in 91 (70%) ankles, marked in 78 (60%). 44 ankles (34%) have been revised by filling of the cavities, 24 (18%) by fusion, and 6 by further replacement, resulting in the revision rate of 58%. Osteolysis was the main reason for all revisions. The improvement of the Kofoed Score and pain points was significant (all p<0.0001), and the subjective patient satisfaction was good. CONCLUSIONS Outcome of the current study was seriously affected by osteolysis and is inferior compared to previous reports.
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Affiliation(s)
- Helka Koivu
- Hospital Terveystalo Pulssi and University of Turku, Turku University Hospital, University of Turku, Turku, Finland.
| | - Ia Kohonen
- The Medical Imaging Centre of Southwest Finland, Turku University Hospital, University of Turku, Turku, Finland
| | - Kimmo Mattila
- The Medical Imaging Centre of Southwest Finland, Turku University Hospital, University of Turku, Turku, Finland
| | | | - Hannu Tiusanen
- Department of Orthopaedics, Turku University Hospital,University of Turku, Turku, Finland
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