Submicron sized ultra-high molecular weight polyethylene wear particle analysis from revised SB Charité III total disc replacements

Abstract

Submicron sized particles are frequently observed in retrieved total hip and knee periprosthetic tissues and appear to be critical in the activation of the phagocytic inflammatory response. In this paper the concentration, size and shape of ultra-high molecular weight polyethylene (UHMWPE) wear particles between 0.05 and 2.00μm were determined after isolation from periprosthetic tissues from retrieved lumbar SB Charité III total disc replacements (TDR) using scanning electron microscopy (SEM). For comparison, UHMWPE wear particles were isolated from γ-radiation-air sterilized total hip arthroplasty (THA) revision tissues. The mean concentration of UHMWPE particles in TDR tissues was 1.6×10(9)g(-1)tissue (range 1.3-2.0), which was significantly lower than the concentration of 2.3×10(9)g(-1) THA revision tissue (range 1.8-3.2) (P=0.03). The mean particle size (equivalent circular diameter: TDR, 0.46μm; THA 0.53μm, P=0.60) and mean shape were comparable between TDR and THA (aspect ratio: TDR, 1.89; THA, 1.99, P=0.35; roundness: TDR, 0.58; THA, 0.56, P=0.35). However, the TDR particles tended to be smaller and more round. Although no correlations were found between visible damage to the UHMWPE core and the concentration or shape of the UHMWPE particles, a positive correlation was found between increasing particle size and increasing rim penetration of the TDR core (P=0.04). The presence of UHMWPE particles of similar size and shape in TDR tissue, albeit lower in concentration, might explain why, unlike THA, pain rather than osteolysis is the major reason for revision surgery.

Copyright © 2011 Acta Materialia Inc. Published by Elsevier Ltd. All rights reserved.

Figures

Figure 1

Histogram of the particle size from a validation sample as compared to the NIST reference standard (RM8385). The mean % difference (± sem) across all size ranges was 1.3 ± 0.4.

Figure 2

Representative ESEM images of UHMWPE wear debris from (A,B) TDR and (C,D) THA cohorts. (magnification 12,000×).

Figure 3

Histogram of the A) equivalent circular diameter, B) aspect ratio, and C) roundness of TDR and THA UHMWPE wear debris. Bars represent the mean percentage of particles within each size/shape range (± sem).