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Accepted (AM)Open Access (License Unspecified), Open
Journal article
Distinct immunohistomorphologic changes in periprosthetic hip tissues from historical and highly crosslinked UHMWPE implant retrievals
Journal of biomedical materials research. Part A, v 95A(1)
01 Oct 2010
PMID: 20740602
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Assessment of immune response to implant wear debris in periprosthetic tissue following total hip arthroplasty suggests that multiple factors are involved in the loss implant function. The current study investigated wear debris and the associated immunohistomorphologic changes in tissues from nine patients with historical (gamma air-sterilized) and nine highly crosslinked UHMWPE implant components. Paraffin embedded tissue sections were evaluated for the presence of histiocytes, giant cells, fibrocartilage/bone, and necrosis. To determine the incidence, degree and co-localization of immunohistomorphologic changes and wear, overlapping full-field tissue arrays were collected in brightfield and polarized light. The historical cohort tissues predominantly showed histiocytes associated with significant accumulations of small wear (0.5-2 mu m), and giant cells associated with large wear (>= 2 mu m). Frequently, focal regions of necrosis were observed in association with wear debris. For the highly crosslinked cohort, inflammation and associated wear debris were limited, but in tissues from patients revised after implantation times of >2 years a response was observed. Whereas significant amounts of fibrocartilage/bone were observed in patients at earlier implantation times. In both cohorts, tissue responses were more extensive in the retroacetabular or proximal femoral regions. The current findings suggest that wear debris-induced inflammation may be a major contributor to the loss of implant function for both the historical and highly crosslinked cohorts, but it is not the primary cause of early implant loosening. This study highlights the importance of using a more quantitative and standardized assessment of immunohistomorphologic responses in periprosthetic tissues, and emphasizes differences in specific anatomical regions of individual patient tissues. (C) 2010 Wiley Periodicals, Inc. J Biomed Mater Res Part A: 95A: 68-78, 2010.
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Details
- Title
- Distinct immunohistomorphologic changes in periprosthetic hip tissues from historical and highly crosslinked UHMWPE implant retrievals
- Creators
- Ryan M. Baxter - Drexel UniversityAllyson Ianuzzi - ExponentTheresa A. Freeman - Thomas Jefferson UniversitySteven M. Kurtz - Exponent (United States)Marla J. Steinbeck - Drexel University
- Publication Details
- Journal of biomedical materials research. Part A, v 95A(1)
- Publisher
- Wiley
- Number of pages
- 11
- Grant note
- R01AR047904 / NATIONAL INSTITUTE OF ARTHRITIS AND MUSCULOSKELETAL AND SKIN DISEASES; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Institute of Arthritis & Musculoskeletal & Skin Diseases (NIAMS) R01 AR047904 / NIAMS NIH HHS; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Institute of Arthritis & Musculoskeletal & Skin Diseases (NIAMS)
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- School of Biomedical Engineering, Science, and Health Systems
- Web of Science ID
- WOS:000281448700008
- Scopus ID
- 2-s2.0-77956485589
- Other Identifier
- 991019167652304721
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- Collaboration types
- Industry collaboration
- Domestic collaboration
- Web of Science research areas
- Engineering, Biomedical
- Materials Science, Biomaterials