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Dissertation
The osteolytic potential of polyethylene wear debris in periprosthetic tissues surrounding total joint replacements
Doctor of Philosophy (Ph.D.), Drexel University
Aug 2011
DOI:
https://doi.org/10.17918/etd-3773
Abstract
Despite the widespread implementation of highly crosslinked polyethylene (HXLPE) liners to reduce the clinical incidence of osteolysis, it is not known if the substantially improved wear resistance will outweigh the inflammatory potential of HXLPE wear debris generated in vivo. To address these unanswered questions with regard to wear debris in THA, a detailed analysis of the differences in size, shape, number and biological activity of polyethylene wear particles was performed. Pseudocapsular tissues were obtained from the primary revision surgery of four gamma inert--sterilized conventional polyethylene liners (CPE), five annealed HXLPE liners and five remelted HXLPE liners. Subsequently, tissues were digested using nitric acid and polyethylene wear particles (>0.05 [mu]m) were evaluated using scanning electron microscopy to determine particle size, shape, number and biological activity. Tissues from both remelted and annealed HXLPE cohorts contained significantly smaller and rounder particles compared to the CPE cohort. Despite the increased percentage of submicron particles, the total number of particles was also lower for both HXLPE cohorts. The volume fraction distribution and specific biological activity per unit volume (SBA) were not significantly different between any of the cohorts. However, the decreased size and number of HXLPE wear debris resulted in a significant decrease in the total particle volume (mm3) per gram of tissue. Accordingly, when the SBA was normalized by the total particle volume, functional biological activity of the HXLPE wear debris was significantly decreased compared to the CPE cohort. Overall, these data show that despite the increased percentage of submicron wear particles, the osteolytic potential of wear debris generated by HXLPE liners in vivo is significantly reduced by the improvements in polyethylene wear resistance.
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Details
- Title
- The osteolytic potential of polyethylene wear debris in periprosthetic tissues surrounding total joint replacements
- Creators
- Ryan Michael Baxter - DU
- Contributors
- Steven M. Kurtz (Advisor) - Drexel University (1970-)
- Awarding Institution
- Drexel University
- Degree Awarded
- Doctor of Philosophy (Ph.D.)
- Publisher
- Drexel University; Philadelphia, Pennsylvania
- Resource Type
- Dissertation
- Language
- English
- Academic Unit
- School of Biomedical Engineering, Science, and Health Systems (1997-2026); Drexel University
- Other Identifier
- 3773; 991014632265904721