UHMWPE wear debris

Affatato, S., Fernandes, B. et al.. Isolation and Morphological Characterization of UHMWPE Wear Debris Generated in vitro. Biomaterials, 22, 2325-2331, 2001. 

Before implanting cups in patients, however, he implanted the UHMWPE in his own thigh, both in the bulk and finely divided (particulate) state. He also implanted PTFE in his thigh, to serve as a historical control. The results of this personal biocompatibility test, published in the Lancet in 1963 (Chamley 1963), convinced Chamley that UHMWPE-wear debris was biocompatible, whereas the particulate PTFE was not. Armed with this information, Chamley began implanting UHMWPE in patients during November 1962. 

Which of the following complications has not been associated with the production UHMWPE wear debris in hip replacements ... 

Further analysis of the type of wear in UHMWPE glenoid components has also been conducted by examining the wear debris generated in the shoulder. Isolation and characterization of the UHMWPE wear debris generated in failed shoulder, hip, and knee arthroplasties gives added... 

In Vitro and In Vivo Models Used to Study the Immune Response to UHMWPE Wear Debris... 

Since the seminal work by Hans-Georg Willert, which demonstrated macrophage activation by UHMWPE wear debris, interest in understanding the complete immune response in periprosthetic tissue has exploded [4]. For most nonimmunologists, this complex area is difficult to grasp, but hopefully the following information will provide a basis for a better understanding of the immune system. 

IMMUNOLOGIC RESPONSES TO JOINT REPLACEMENT UHMWPE WEAR DEBRIS... 

FIGURE 23.4 CD3 immunostained T cells (red arrows) and foreign body giant cell (green arrow) localized with UHMWPE wear debris (yellow arrows) from a historical, gamma-air sterilized UHMWPE hip replacement revised 14.2 years post-implantation. 200X magnification. Scale interval represents 10 pm. 

The involvement of NK cells in the removal of damaged cells or cells that have lost self recognizing surface receptors in periprosthetic tissues has not been investigated. Like the Th17 cells, NK cells secrete cytokines that regulate T and B cell responses, and they are involved in the development of autoimmune diseases. Finally, the disregu-lation of Treg cells may also affect the tissue response to wear debris by failure to suppress the activity of stimulated immune cells. The involvement of T cell subsets and NK cells in periprosthetic tissue inflammation associated with UHMWPE wear debris will require additional studies. 

FIGURE 23.5 Combination of metal (A, red arrow) and UHMWPE wear debris (B) in periprosthetic hip tissue revised 19 years postimplantation. Main image lOOX magnification. Scale interval represents 10 pm. 

IN VITRO AND IN VIVO MODELS USED TO STUDY THE IMMUNE RESPONSE TO UHMWPE WEAR DEBRIS... 

Shanbhag AS, Bailey HO, Hwang DS, Cha CW, Eror NG, Rubash HE. Quantitative analysis of ultrahigh molecular weight polyethylene (UHMWPE) wear debris associated with total knee replacements. J Biomed Mater Res 2000 53(1) 100-10. 

Elfick APD, Green SM, Krilder S, Unsworth A. The nature and dissemination of UHMWPE wear debris retrieved from periprosthetic tissue of THR. J Viomws Mater Res 2003 65A 95-108. 

Wang A, Essner A, Stark C, Dumbleton JH. Comparison of the size and morphology of UHMWPE wear debris produced by a hip joint... 

FIGURE 28.1 Periprosthetic osteolysis, caused by UHMWPE wear debris, can result in massive bone loss around the acetabular and femoral components, necessitating difficult revision arthroplasty. 

UHMWPE wear continues to be an important factor in the long-term survivability of orthopedic implants [1-3]. As established in Chapter 23, periprosthetic osteolysis occurs secondary to the generation of UHMWPE wear debris in total hip arthroplasty (THA) [1, 2, 4]. In the last decade, efforts have been made to increase the wear resistance of UHMWPE [1, 5, 6], Highly crosslinked UHMWPE (Chapters 13 and 14) was introduced in THA 10 years ago and more recently in total knee arthroplasty. UHMWPE wear volume and wear patterns must be fiiUy evaluated to understand historic UHMWPE wear processes to evaluate the efficacy of highly crosslinked UHMWPE and to analyze future UHMWPE formulations that attempt to improve the clinical performance of UHMWPE. 

Baudriller H, Chabrand P, Moukoko D. Modeling UHMWPE wear debris generation. J Biomed Mater Res B Appl Biomater 2007 Febuary 80B(2) 479-85. 

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