Die Anwendung antiallergisch beschichteter Knieendoprothesen ist mittelfristig sicher

Postler, Anne; Beyer, Franziska; Lützner, Cornelia; Tille, Eric; Lützner, Jörg

doi:10.1007/s00132-021-04186-6

Cited by 3 publications

(1 citation statement)

References 38 publications

(36 reference statements)

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“…12,[21][22][23] In addition, arc PVD coatings are also beneficial as a barrier to metallic ions. 24 Despite the clinical reliability of arc PVD-coated endoprostheses directly compared to the uncoated versions, 25,26 certain coating damages are not preventable despite all technical efforts. As known from retrieval studies, arc PVD TiN coatings may exhibit wear signs like scratches and indentations.…”

Section: Introductionmentioning

confidence: 99%

Isolation of TiNbN wear particles from a coated metal‐on‐metal bearing: Morphological characterization and in vitro evaluation of cytotoxicity in human osteoblasts

Sellin,

Seyfarth‐Sehlke,

Aziz

et al. 2023

J Biomed Mater Res

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To improve the wear resistance of articulating metallic joint endoprostheses, the surfaces can be coated with titanium niobium nitride (TiNbN). Under poor tribological conditions or malalignment, wear can occur on these implant surfaces in situ. This study investigated the biological response of human osteoblasts to wear particles generated from TiNbN‐coated hip implants. Abrasive particles were generated in a hip simulator according to ISO 14242‐1/−2 and extracted with Proteinase K. Particle characteristics were evaluated by electron microscopy and energy dispersive x‐ray spectroscopy (EDS), inductively coupled plasma mass spectrometry (ICP‐MS) and dynamic light scattering (DLS) measurements. Human osteoblasts were exposed to different particle dilutions (1:20, 1:50, and 1:100), and cell viability and gene expression levels of osteogenic markers and inflammatory mediators were analyzed after 4 and 7 days. Using ICP‐MS, EDS, and DLS measurements, ~70% of the particles were identified as TiNbN, ranging from 39 to 94 nm. The particles exhibited a flat and subangular morphology. Exposure to particles did not influence cell viability and osteoblastic differentiation capacity. Protein levels of collagen type 1, osteoprotegerin, and receptor activator of nuclear factor κB ligand were almost unaffected. Moreover, the pro‐inflammatory response via interleukins 6 and 8 was minor induced after particle contact. A high number of TiNbN wear particles only slightly affected osteoblasts' differentiation ability and inflammatory response compared to metallic particles. Nevertheless, further studies should investigate the role of these particles in peri‐implant bone tissue, especially concerning other cell types.

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Section: Introductionmentioning

confidence: 99%

Isolation of TiNbN wear particles from a coated metal‐on‐metal bearing: Morphological characterization and in vitro evaluation of cytotoxicity in human osteoblasts

Sellin,

Seyfarth‐Sehlke,

Aziz

et al. 2023

J Biomed Mater Res

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Increased inflammatory response is associated with less favorable functional results 5 years after total knee arthroplasty

Lützner

Beyer

Lützner

et al. 2022

Knee Surg Sports Traumatol Arthrosc

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Purpose Allergy against implant materials is discussed controversially and still not fully understood. Despite these controversies, a relevant number of patients receive hypoallergenic knee implants. The aim of this study was to compare a new coating system with the standard implant in total knee arthroplasty (TKA). Additionally, the influence of proinflammatory cytokines on patient-reported outcome measures (PROMs) was investigated. Methods 120 patients without known metal allergy and without previous metal implants were included. The patients were randomized to receive a coated or standard TKA of the same knee system. 105 patients completed the 5 year follow-up. Patient-reported outcome measures (PROMs) including knee function (Oxford Knee Score, OKS), quality of life (SF36) and UCLA activity scale were assessed. Additionally, several cytokines with a possible role in implant allergy were measured in patient`s serum (IL-1beta, IL-5, IL-6, IL-8, IL-10, IP-10, IFN γ, TNF α). Group comparison was performed using Mann–Whitney U test for continuous values and chi-square test for categorical values. Results There were no differences in PROMs between both groups at any follow-up. The majority of patients demonstrated no elevation of the measured blood cytokines. The blood cytokine pattern after 5 years demonstrated no differences between study groups. There was a significant association between elevated IL-8 values and worse results in the overall OKS (p = 0.041), the OKS function component (p = 0.004), the UCLA activity scale (p = 0.007) and the physical component of SF36 (p = 0.001). Conclusion There were no problems with the new coating during mid-term follow-up and no differences in PROMs between coated and standard TKA. Patients with an increased inflammatory response demonstrated worse functional results, regardless of the implant. Level of evidence I. Clinical trial registration The study protocol was registered in the US National Institutes of Health’s database (http://www.clinicaltrials.gov) registry under NCT00862511.

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Modern Coatings in Knee Arthroplasty

Lützner¹,

Altermann²,

Reyna³

et al. 2023

Arthroplasty - Advanced Techniques and Future Perspectives

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All metal implants in human bodies corrode, which results in metal ion release. This is not necessarily a problem and represents for most patients no hazard. However, both local and systemic effects are possible, including hypersensitivity. To avoid this, coatings on standard implants (mono- or multi-layer) and surface modifications have been developed and are in use. This chapter explains the background of metal ion release, biological reactions, coating technologies, biotribological and biomechanical properties, as well as the clinical results of modern knee arthroplasty implant coatings. There is no general concern about metal ion release from CoCrMo standard implants for most patients. If patients present with a confirmed metal allergy, a multilayer-coated or oxidized zirconium implant is currently the best option for these patients.

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Die Anwendung antiallergisch beschichteter Knieendoprothesen ist mittelfristig sicher

Cited by 3 publications

References 38 publications

Isolation of TiNbN wear particles from a coated metal‐on‐metal bearing: Morphological characterization and in vitro evaluation of cytotoxicity in human osteoblasts

Isolation of TiNbN wear particles from a coated metal‐on‐metal bearing: Morphological characterization and in vitro evaluation of cytotoxicity in human osteoblasts

Increased inflammatory response is associated with less favorable functional results 5 years after total knee arthroplasty

Modern Coatings in Knee Arthroplasty

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