[Examination of granuloma of revised cemented or cementless total hip arthroplasties using inductively coupled plasma atomic emission spectrometry (ICP-OES)].
BACKGROUND
Aseptic loosening is the most common problem in total hip arthroplasty (THA). One main aspect is inflammatory reaction against wear particles of the prosthesis materials. Analysing failure mechanisms in THA analysis of the particles and their element distribution of revised granulomatous tissue is essential to improve materials used in THA.


METHODS
23 granulomas of revised THA due to aseptic loosening, 13 of which with metal on metal bearing (M/M), were analysed using inductively coupled plasma atomic emission spectrometry (ICP-OES).


RESULTS
Elements Cr, Mn, Ni, Al, Cu, Zn, Cd, Ti, V, Zr, Nb and Fe could be detected. The maximum value of Cr was 23.88 ppb (parts per billion), Al 191.02 ppb, Ni 64.95 ppb and Zr 9.96 ppb. The highest value of Al could be found in cementless implants. The maximum value of the elements Cr and Ni could be detected in M/M. In cemented implants the highest value of Zr was found.


CONCLUSIONS
The origin of Zr was the used bone cement in cemented THA. The elements Cr and Ni were significantly higher in M/M bearings. The highest value of Al was detected in granulomas of revised corund rough blasted cementless implants. The histopathologic findings of the revised M/M bearings have been published recently. Inductively Coupled Plasma Atomic Emission Spectrometry (ICP-OES) could not show any differences of the alloying constituents in cases with or without allergic reactions. ICP-OES analysis seems to be not useful examination of histologic sections using SEM with cryotransfer unit.
Riedel
Frank
F
Orthopädische Klinik Rummelsberg, Schwarzenbruck, Deutschland. hf-riedel@arcor.de
Hönle
Wolfgang
W
Göske
Jürgen
J
Kachler
Werner
W
Holzwarth
Ulrich
U
Schuh
Alexander
A
D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects* / Q000379:methods; D002478:Cells, Cultured; D002484:Cementation; D019544:Equipment Failure Analysis / Q000379:methods; D005547:Foreign Bodies / Q000145:classification*; D006099:Granuloma / Q000145:classification*; D006621:Hip Joint / Q000737:chemistry* / Q000473:pathology* / Q000601:surgery; D006801:Humans; D008670:Metals / Q000032:analysis*; D011475:Prosthesis Failure; D016459:Prosthesis-Related Infections / Q000145:classification* / Q000209:etiology; D012086:Reoperation; D013054:Spectrophotometry, Atomic / Q000379:methods
D008670:Metals