title: The biological response to orthopedic implants for joint replacement. II: Polyethylene, ceramics, PMMA, and the foreign body reaction.
abstract: Novel evidence-based prosthetic designs and biomaterials facilitate the performance of highly successful joint replacement (JR) procedures. To achieve this goal, constructs must be durable, biomechanically sound, and avoid adverse local tissue reactions. Different biomaterials such as metals and their alloys, polymers, ceramics, and composites are currently used for JR implants. This review focuses on (1) the biological response to the different biomaterials used for TJR and (2) the chronic inflammatory and foreign-body response induced by byproducts of these biomaterials. A homeostatic state of bone and surrounding soft tissue with current biomaterials for JR can be achieved with mechanically stable, infection free and intact (as opposed to the release of particulate or ionic byproducts) implants. Adverse local tissue reactions (an acute/chronic inflammatory reaction, periprosthetic osteolysis, loosening and subsequent mechanical failure) may evolve when the latter conditions are not met. This article (Part 2 of 2) summarizes the biological response to the non-metallic materials commonly used for joint replacement including polyethylene, ceramics, and polymethylmethacrylate (PMMA), as well as the foreign body reaction to byproducts of these materials. © 2016 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 105B: 1685-1691, 2017.
authors.affiliation: Department of Orthopedic Surgery, Stanford University, Stanford, California.|Laboratoire de Biomécanique et Biomatériaux Ostéo-Articulaires-UMR CNRS 7052, Faculté de Médecine-Université Paris 7, Paris, France.|Department of Orthopedic Surgery, Hopital Cochin, APHP, Paris, France.
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Gibon
authors.affiliation: Department of Orthopedic Surgery, Stanford University, Stanford, California.|Department of Oral and Maxillofacial Surgery, University of Chile-Conicyt, Santiago, Chile.
authors.forename: Luis A
authors.initials: LA
authors.lastname: Córdova
authors.affiliation: Department of Orthopedic Surgery, Stanford University, Stanford, California.
authors.forename: Laura
authors.initials: L
authors.lastname: Lu
authors.affiliation: Department of Orthopedic Surgery, Stanford University, Stanford, California.
authors.forename: Tzu-Hua
authors.initials: TH
authors.lastname: Lin
authors.affiliation: Department of Orthopedic Surgery, Stanford University, Stanford, California.
authors.forename: Zhenyu
authors.initials: Z
authors.lastname: Yao
authors.affiliation: Laboratoire de Biomécanique et Biomatériaux Ostéo-Articulaires-UMR CNRS 7052, Faculté de Médecine-Université Paris 7, Paris, France.|Department of Orthopedic Surgery, Hopital Cochin, APHP, Paris, France.
authors.forename: Moussa
authors.initials: M
authors.lastname: Hamadouche
authors.affiliation: Department of Orthopedic Surgery, Stanford University, Stanford, California.|Department of Bioengineering, Stanford University, Stanford, California.
authors.forename: Stuart B
authors.initials: SB
authors.lastname: Goodman
mesh_terms: D000818:Animals; D000069343:Bone-Implant Interface; D002516:Ceramics / Q000009:adverse effects / Q000737:chemistry; D005549:Foreign-Body Reaction / Q000209:etiology / Q000378:metabolism* / Q000473:pathology; D006622:Hip Prosthesis / Q000009:adverse effects*; D006801:Humans; D019904:Polymethyl Methacrylate / Q000009:adverse effects; D011140:Polyurethanes / Q000009:adverse effects / Q000737:chemistry
chemical_list: D011140:Polyurethanes; D019904:Polymethyl Methacrylate
keywords: biological response; biomaterials; foreign body response; inflammation; orthopedic implants