Polyethylene and metal wear particles: characteristics and biological effects

Abstract

This paper first presents a brief overview about the mechanism of wear particle formation as well as wear particle characteristics in metal-on-polyethylene and metal-on-metal artificial hip joints. The biological effects of such particles are then described, focusing on the inflammatory response induced by each type of particles as well as on how metal wear products may be the source of a T lymphocyte-mediated specific immune response, early adverse tissue responses, and genotoxicity. Finally, some of the current in vivo models used for the analysis of tissue response to various wear particles are presented.

The Divergence of Wear Propagation and Stress at Steep Acetabular Cup Positions Using Ceramic Heads and Sequentially Cross-Linked Polyethylene Liners

“…In all other cases (2)(3)(4), loads were applied to the femoral head in multiple directions, according to the transformations published in [28]. The maximum loads in cases 2-4 were adapted to the maximum load in ISO 14242-1 (3 kN), resulting in an assumed patient body mass of 131 kg.…”

“…Wear debris from the articulating partners of the total hip replacement (THR) is responsible for inflammatory reactions in the periprosthetic tissue, causing osteolysis and aseptic implant loosening [1,2]. Crosslinking the ultra-high molecular weight polyethylene (UHMWPE) clinically reduces the wear between the liner and femoral head [3,4] and could lead to longer implant durability.…”

Highly Crosslinked Polyethylene Does Not Reduce Aseptic Loosening in Cemented THA 10-year Findings of a Randomized Study

“…Extensive efforts have been made to reveal the etiology of aseptic loosening and the pathophysiologic mechanisms involved. Histology [1,3] and laboratory [25,27,37] studies have led to the conclusion that polyethylene (PE) wear particles play an important role in the loosening process [6,26], initiating an intensive search for articulations less prone to wear.…”

Clinical outcomes assessment of three similar hip arthroplasty bearing surfaces

“…The higher wear rates are associated with osteolysis, which would in turn increase the risk of need for surgical revision. 20 Thus, this surface is generally considered to be better suited for patients with lower activity levels that will not erode it as much.…”