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The effects of the concentration of high-density polyethylene particles on the bone-implant interface

R. A. Brooks, PhD, Research Associate1; J. R. Sharpe, PhD, Research Associate1; J. A. Wimhurst, FRCS, Specialist Registrar in Orthopaedics1; B. J. Myer, HNC, Senior Laboratory Technician1; E. N. Dawes, PhD, Research Associate2; and N. Rushton, MD, FRCS, Director1

1 Orthopaedic Research Unit, University of Cambridge, Box 180, Adden-brooke’s Hospital, Hills Road, Cambridge CB2 2QQ, UK.
2 Department of Pathology, Molecular Biology Group, University of New-castle upon Tyne, Royal Victoria Infirmary, Newcastle upon Tyne NE1 4LP, UK.

Correspondence should be sent to Dr R. A. Brooks.

We used a rat model in vivo to study the effects of the concentration of polyethylene particles on the bone-implant interface around stable implants in the proximal tibia. Intra-articular injections of 104, 106 or 108 high-density polyethylene (HDPE) particles per joint were given 8, 10 and 12 weeks after surgery. The animals were killed after 14 and 26 weeks and the response at the interface determined.

Fibrous tissue was seen at the bone-implant interface when the head of the implant was flush with the top of the tibia but not when it was sunk below the tibial plateau. In the latter case the implant was completely surrounded by a shell of bone. The area of fibrous tissue and that of the gap between the implant and bone was related to the concentration of particles in the 14-week group (p < 0.05).

Foreign-body granulomas containing HDPE particles were seen at the bone-implant interface in animals given 108 particles. The pathology resembles that seen around prostheses with aseptic loosening and we suggest that this is a useful model by which to study this process.






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