Migration of polyethylene particles around nonloosened cemented femoral components from a total hip arthroplasty-an autopsy study.
Three cemented femoral components from total hip arthroplasties retrieved at autopsy were examined in regard to the migration of birefringent polyethylene particles across the fixation interfaces. They were obtained from two patients who died from unrelated causes. They had been in place, respectively, for 8 and 9 years (first patient) and for 9 years (second patient). Osteolysis was present in the acetabular side only. The femoral components were not loosened. Histologic sections were performed at four levels of the femoral components, and polyethylene particles were counted with the use of a semiautomatic image analyzer. Sections below the tip of the stem were treated by deorganification and the lysate was centrifuged in the attempt to isolate wear debris. Particles were found at both interfaces (bone-cement and metal-cement) and in the cancellous bone between the trabeculae. They were also present in the Haversian canals of the cortical bone. Particles of various sizes were found in the medullary canal beneath the tip of the stem. In scanning electron microscopy, they appeared to have irregular shapes. Wear debris can migrate across the cement-bone interface of nonloosened implants. They appear to progress through the porosity of the cancellous bone.
Massin
Philippe
P
Department of Orthopaedic Surgery, Angers University Hospital, 4 rue Larrey, 49033 Angers CEDEX 01, France. PhMassin@chu-angers.fr
Chappard
Daniel
D
Flautre
Brigitte
B
Hardouin
Pierre
P
D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip; D001344:Autopsy; D001672:Biocompatible Materials / Q000378:metabolism*; D001843:Bone Cements; D001842:Bone and Bones / Q000166:cytology; D019544:Equipment Failure Analysis; D005260:Female; D006621:Hip Joint / Q000000981:diagnostic imaging; D006622:Hip Prosthesis; D006801:Humans; D008855:Microscopy, Electron, Scanning; D010014:Osteolysis; D010316:Particle Size; D020959:Polyethylene / Q000378:metabolism*; D011475:Prosthesis Failure; D011859:Radiography
D001672:Biocompatible Materials; D001843:Bone Cements; D020959:Polyethylene