Metal‐Specific Biomaterial Accumulation in Human Peri‐Implant Bone and Bone Marrow

Abstract

Metallic implants are frequently used in medicine to support and replace degenerated tissues. Implant loosening due to particle exposure remains a major cause for revision arthroplasty. The exact role of metal debris in sterile peri-implant inflammation is controversial, as it remains unclear whether and how metals chemically alter and potentially accumulate behind an insulating peri-implant membrane, in the adjacent bone and bone marrow (BM). An intensively focused and bright synchrotron X-ray beam allows for spatially resolving the multi-elemental composition of peri-implant tissues from patients undergoing revision surgery. In peri-implant BM, particulate cobalt (Co) is exclusively co-localized with chromium (Cr), non-particulate Cr accumulates in the BM matrix. Particles consisting of Co and Cr contain less Co than bulk alloy, which indicates a pronounced dissolution capacity. Particulate titanium (Ti) is abundant in the BM and analyzed Ti nanoparticles predominantly consist of titanium dioxide in the anatase crystal phase. Co and Cr but not Ti integrate into peri-implant bone trabeculae. The characteristic of Cr to accumulate in the intertrabecular matrix and trabecular bone is reproducible in a human 3D in vitro model. This study illustrates the importance of updating the view on long-term consequences of biomaterial usage and reveals toxicokinetics within highly sensitive organs.

Human microphysiological systems for drug development

“…A vascularized human bone marrow-on-a-chip that supports differentiation and maturation of multiple blood cell lineages also recapitulates myelo-erythroid toxicities after clinically relevant exposures to chemotherapeutic drugs and ionizing radiation, as well as bone marrow recovery after drug-induced myelosuppression (10). Moreover, an MPS model composed of bone tissue was exposed to hip implant-associated dissolved cobalt and chromium at clinically relevant concentrations, which led to the identification of direct cytotoxic effects and successfully verified the integration of chromium into cancellous bone and binding to intertrabecular matrix previously found in patients (11).…”

Biocompatibility Analyses of HF-Passivated Magnesium Screws for Guided Bone Regeneration (GBR)

“…Nonresorbable fixation systems made of titanium (Ti) are the most widely used applications for this purpose, due to their good mechanical properties and biocompatibility, but are also associated with typical disadvantages, similar to delayed osteointegration and microbial colonization [56,57]. An additional concern is the reported accumulation of material particles around Ti and ceramic implants [58,59] However, the main disadvantage for nonresorbable fixation screws is the requirement for their subsequent surgical removal and the resulting risks for the patient [9,49,56,57,60]. Bioresorbable screws, made from polymers such as polylactide and polyglycolide and their copolymers are also available [22,23,61,62].…”

Revealing Inflammatory Indications Induced by Titanium Alloy Wear Debris in Periprosthetic Tissue by Label-Free Correlative High-Resolution Ion, Electron and Optical Microspectroscopy

“…Al can be transported around the body via the bloodstream, bound to transferrin [ 64 ], leading to toxic effects including malignancies [ 65 ], or playing a role in central nervous system degenerative diseases [ 66 ]. Due to its intrinsic proximity to the bone tissue, Al could also accumulate in the bones as it was recently found that metal-specific biomaterials can be accumulated in the peri-implant bone tissue [ 67 ]. The accumulation of Al in bone has also been related to bone fractures accompanying specific diseases [ 68 ].…”