- MeSH
- Arthralgia diagnosis etiology therapy MeSH
- Diagnosis, Differential MeSH
- Humans MeSH
- Joint Diseases diagnosis pathology therapy MeSH
- Prognosis MeSH
- Range of Motion, Articular MeSH
- Hand * anatomy & histology diagnostic imaging pathology MeSH
- Wrist * anatomy & histology diagnostic imaging pathology MeSH
- Check Tag
- Humans MeSH
- Publication type
- Review MeSH
- MeSH
- Hand Deformities * physiopathology therapy MeSH
- Hand Joints physiopathology MeSH
- Humans MeSH
- Arthritis, Rheumatoid * pathology therapy MeSH
- Check Tag
- Humans MeSH
- Publication type
- Review MeSH
- Keywords
- chirurgie ruky, revmatochirurgie,
- MeSH
- Arthroplasty, Replacement, Finger * methods instrumentation MeSH
- Biocompatible Materials therapeutic use MeSH
- Adult MeSH
- Finger Joint surgery pathology MeSH
- Middle Aged MeSH
- Humans MeSH
- Pain Measurement MeSH
- Young Adult MeSH
- Postoperative Complications MeSH
- Prospective Studies MeSH
- Joint Prosthesis MeSH
- Arthritis, Rheumatoid * complications MeSH
- Range of Motion, Articular MeSH
- Aged MeSH
- Patient Satisfaction MeSH
- Carbon MeSH
- Treatment Outcome MeSH
- Check Tag
- Adult MeSH
- Middle Aged MeSH
- Humans MeSH
- Young Adult MeSH
- Male MeSH
- Aged MeSH
- Female MeSH
PURPOSE OF THE STUDY The aim of the study was to evaluate in vivo and compare, in terms of the quality and number of ultra high-molecular polyethylene (UHMWPE) wear particles, total knee replacements of identical construction differing only in the material used for femoral component production, i.e., CoCrMo alloy or ZrO2 ceramics. MATERIAL AND METHODS Samples of peri-prosthetic granuloma tissue were collected in two patients with total knee replacement suffering from implant migration, who were matched in relevant characteristics. The primary knee replacement in Patient 1 with a CoCrMo femoral component was done 7.2 years and in Patient 2 with a ZrO2 implant 6.8 years before this assessment. The polyethylene wear-induced granuloma was analysed by the MORF method enabling us to assess the shape and size of wear debris and the IRc method for assessment of particle concentration. RESULTS In the granuloma tissue samples of Patient 1, on the average, particles were 0.30 mm in size and their relative volume was 0.19. In the Patient 2 tissue samples, the average size of particles was 0.33 mm and their relative volume was 0.26. There was no significant difference in either particle morphology or their concentration in the granuloma tissue between the two patients. DISCUSSION One of the options of how to reduce the production of polyethylene wear particles is to improve the tribological properties of contacting surfaces in total knee replacement by substituting a cobalt-chrome femoral component with a zirconia ceramic femoral component. The previous in vitro testing carried out with a mechanical simulator under conditions approaching a real weight-bearing in the human body did show a nearly three-fold decrease in the number of UHMWPE wear particles in zirconia components. The evaluation of granuloma tissue induced by the activity of a real prosthetic joint for nearly seven years, however, did not reveal any great difference in either quality or quantity of polyethylene debris between the two replacements. The difference of surface roughness between CoCrMo (Ra = 0.05) and ZrO2 (Ra = 0.02) components did not play any role in in vivo conditions. CONCLUSIONS In accordance with a previous clinical study, this evaluation of the quality and quantity of UHMWPE wear particles produced by a ceramic femoral component in vivo failed to demonstrate any advantage of zirconia ceramic components over the cobalt-chrome femoral components so far used.
- MeSH
- Equipment Failure Analysis MeSH
- Ceramics MeSH
- Middle Aged MeSH
- Humans MeSH
- Polyethylenes MeSH
- Knee Prosthesis MeSH
- Foreign-Body Reaction etiology pathology MeSH
- Prosthesis Failure MeSH
- Aged MeSH
- Chromium Alloys MeSH
- Arthroplasty, Replacement, Knee MeSH
- Particle Size MeSH
- Zirconium MeSH
- Check Tag
- Middle Aged MeSH
- Humans MeSH
- Aged MeSH
- Female MeSH
- Publication type
- Comparative Study MeSH
Extensive osteolysis adjacent to orthopedic implants is often associated with wear particles of prosthetic material. The activation of the RANKL/RANK/OPG system is considered to be a likely cause of periprosthetic osteolysis leading to implant failure. The aim of this study was to examine the possible correlation between the clinical extent of osteolysis, the number of wear particles and expression of the osteoclastic mediator RANKL (receptor activator of nuclear factor kappa B ligand) in the tissues around aseptically loosened cemented and non-cemented total hip replacements. Periprosthetic tissues were harvested from 59 patients undergoing revision of hip replacement for aseptic loosening. We observed RANKL-positive cells in 23 of our 59 patients, their presence was noted predominantly in tissues with a loosened cemented endoprosthesis. We have found that RANKL is present only in tissues with a large amount of wear debris and predominantly in cases involving loosened cemented implants.
- MeSH
- Immunohistochemistry methods utilization MeSH
- Data Interpretation, Statistical MeSH
- Leptin isolation & purification adverse effects MeSH
- RANK Ligand isolation & purification adverse effects MeSH
- Arthroplasty, Replacement, Hip adverse effects MeSH
- Osteolysis etiology MeSH
- Joint Prosthesis adverse effects MeSH
- Prosthesis Failure MeSH
