title: Standardized analysis of UHMWPE wear particles from failed total joint arthroplasties.
abstract: Periprosthetic tissue obtained at revision surgery from eight total hip replacement cases was hydrolyzed, and polyethylene debris particles were isolated from each case. Individual particles were analyzed by scanning electron microscopy (SEM) and computerized image analysis in accordance with ASTM F1877-98, a standard for quantitative description of wear debris. For comparison, periprosthetic tissues from eight total knee revision and four total shoulder revision cases were processed and analyzed with identical methods. A total of 2599 hip, 4345 knee, and 1200 shoulder particles were analyzed. The morphologies of the isolated polyethylene particles from the total hip specimens were distinctly different from the total knee and total shoulder particles. The mean equivalent circle diameter (ECD) for hip particles was 0.694 microm +/- 0.005; knee particles measured 1.190 microm +/-0.009; and shoulder particles 1.183 microm +/- 0.017. The ECD was significantly different between hip particles and those from the shoulder and knee. The mean aspect ratio (AR) for the hip particles was 1.626 +/- 0.015, compared to the knee particles at 1.935 +/- 0.015 and shoulder particles at 2.082 +/- 0.033. The AR was statistically different among all three groups. Other descriptors from the ASTM standard, elongation (E), form factor (FF), and roundness (R) were all significantly different among the three groups of joints. This study demonstrates the utility of ASTM F1877-98 in differentiating wear debris particles from different sources.
authors.affiliation: Department of Orthopedics, UTHSCSA Mail Code 7774, 7703 Floyd Curl Drive, San Antonio, Texas 78229, USA.
authors.forename: Jay D
authors.initials: JD
authors.lastname: Mabrey
authors.forename: Armin
authors.initials: A
authors.lastname: Afsar-Keshmiri
authors.forename: Gerard A
authors.initials: GA
authors.lastname: Engh
authors.forename: Christi J
authors.initials: CJ
authors.lastname: Sychterz
authors.forename: Michael A
authors.initials: MA
authors.lastname: Wirth
authors.forename: Charles A
authors.initials: CA
authors.lastname: Rockwood
authors.forename: C Mauli
authors.initials: CM
authors.lastname: Agrawal
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019643:Arthroplasty, Replacement; D019644:Arthroplasty, Replacement, Hip; D019645:Arthroplasty, Replacement, Knee; D019544:Equipment Failure Analysis; D005260:Female; D006622:Hip Prosthesis; D006801:Humans; D007595:Joint Prosthesis; D007720:Knee Prosthesis; D008297:Male; D008855:Microscopy, Electron, Scanning; D008875:Middle Aged; D010014:Osteolysis / Q000209:etiology; D010316:Particle Size; D011095:Polyethylenes; D011475:Prosthesis Failure; D012785:Shoulder Joint / Q000473:pathology / Q000601:surgery
chemical_list: D011095:Polyethylenes; C111601:ultra-high molecular weight polyethylene