Journal article
Characterization of wear debris in total elbow arthroplasty
Journal of shoulder and elbow surgery, v 22(7), pp 924-931
01 Jul 2013
PMID: 23582703
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Background: The purpose of this study was to evaluate wear debris in periprosthetic tissues at the time of revision total elbow arthroplasty. Polyethylene, metallic, and bone cement debris were characterized, and the tissue response was quantified.
Materials and methods: Capsular and medullary tissue samples were collected during revision surgery. Polyethylene debris was characterized by scanning electron microscopy after tissue digestion. The concentrations of metal and cement debris were quantified by inductively coupled plasma mass spectrometry. Tissue response was graded with a semiquantitative histologic method.
Results: Polyethylene particle size varied from the submicron range to over 100 mu m. The mean diameter ranged from 0.6 mu m to about 1 mu m. Particles in the synovial tissues were larger and less abundant than those in tissues from the medullary canal. Cement, titanium alloy, and low levels of cobalt-chrome debris were also present, with cement predominating over metal debris. Histiocyte response was associated with small polyethylene particles (0.5-2 mu m), and giant cells were associated with large polyethylene particles (> 2 mu m). Histiocyte scores positively correlated with the polyethylene particle number and the presence of metal.
Discussion: We have shown that periprosthetic tissues of total elbow patients who have undergone revision for loosening and osteolysis contain polyethylene, cement, and metal debris. Although the polyethylene particles were of a size and shape that have been previously shown to result in activation of phagocytic cells, osteolysis after total elbow arthroplasty is a multimodal process. Because of the presence of multiple wear particle sources, a cause-and-effect relationship between polyethylene debris and osteolysis cannot be established with certainty.
Level of evidence: Basic Science Study, Histology. (C) 2013 Journal of Shoulder and Elbow Surgery Board of Trustees.
Metrics
Details
- Title
- Characterization of wear debris in total elbow arthroplasty
- Creators
- Judd S. Day - ExponentRyan M. Baxter - Drexel UniversityMatthew L. Ramsey - Rothman InstituteBernard F. Morrey - Mayo CLinic, Rochester, MN, USA,Patrick M. Connor - OrthoCarolinaSteven M. Kurtz - Exponent (United States)Marla J. Steinbeck - Drexel University
- Publication Details
- Journal of shoulder and elbow surgery, v 22(7), pp 924-931
- Publisher
- Elsevier
- Number of pages
- 8
- Grant note
- Zimmer
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- College of Medicine; School of Biomedical Engineering, Science, and Health Systems
- Web of Science ID
- WOS:000320996100017
- Scopus ID
- 2-s2.0-84879256615
- Other Identifier
- 991019167594404721
UN Sustainable Development Goals (SDGs)
This publication has contributed to the advancement of the following goals:
InCites Highlights
Data related to this publication, from InCites Benchmarking & Analytics tool:
- Collaboration types
- Industry collaboration
- Domestic collaboration
- Web of Science research areas
- Orthopedics
- Sport Sciences
- Surgery