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NUMBER OF POLYETHYLENE PARTICLES AND OSTEOLYSIS IN TOTAL JOINT REPLACEMENTS

A QUANTITATIVE STUDY USING A TISSUE-DIGESTION METHOD

A. Kobayashi, MD, Assistant Professor1; M. A. R. Freeman, FRCS, Consultant Orthopaedic Surgeon2; W. Bonfield, FEng, Director3; Y. Kadoya, MD, Assistant Professor1; T. Yamac, BSc, Postgraduate Student4; N. Al-Saffar, PhD, Lecturer4; G. Scott, FRCS, Consultant Orthopaedic Surgeon2; and P. A. Revell, FRCPath, Professor4

1 Department of Orthopaedic Surgery, Osaka City University Medical School, 1-5-7, Asahi-machi, Abeno-ku, Osaka 545, Japan.
2 Bone and Joint Research Unit, The Royal London Hospital, 25–29 Ash-field Street, London E1 2AD, UK.
3 Interdisciplinary Research Centre (IRC) in Biomedical Materials, Queen Mary and Westfield College, Mile End Road, London E1 4NS, UK.
4 Osteoarticular Research Group and IRC in Biomedical Materials, Department of Histopathology, Royal Free Hospital School of Medicine, Pond Street, London NW3 2QG, UK.

Correspondence should be sent to Dr A. Kobayashi.

Our aim was to analyse the influence of the size, shape and number of particles on the pathogenesis of osteolysis. We obtained peri-implant tissues from 18 patients having revision surgery for aseptically loosened Freeman total knee replacements (10), Charnley total hip replacements (3) and Imperial College/London Hospital double-cup surface hip replacements (5). The size and shape of the polyethylene particles were characterised using SEM and their concentration was calculated. The results were analysed with reference to the presence of radiological osteolysis.

The concentration of polyethylene particles in 6 areas with osteolysis was significantly higher than that in 12 areas without osteolysis. There were no significant differences between the size and shape of the particles in these two groups.

We conclude that the most critical factor in the pathogenesis of osteolysis is the concentration of polyethylene particles accumulated in the tissue.




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[Abstract] [Full Text] [PDF]


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Hip, Knee, Trauma, Upper limb, Foot & Ankle, Paediatrics, Oncology, Spine, Arthroplasty, General