title: Histopathological Analysis of PEEK Wear Particle Effects on the Synovial Tissue of Patients.
abstract: Introduction. Increasing interest developed in the use of carbon-fiber-reinforced-poly-ether-ether-ketones (CFR-PEEK) as an alternative bearing material in knee arthroplasty. The effects of CFR-PEEK wear inin vitroand animal studies are controversially discussed, as there are no data available concerning human tissue. The aim of this study was to analyze human tissue containing CFR-PEEK as well as UHMWPE wear debris. The authors hypothesized no difference between the used biomaterials.Methods and Materials. In 10 patients during knee revision surgery of a rotating-hinge-knee-implant-design, synovial tissue samples were achieved (tibial inserts: UHMWPE; bushings and flanges: CFR-PEEK). One additional patient received revision surgery without any PEEK components as a control. The tissue was paraffin-embedded, sliced into 2μm thick sections, and stained with hematoxylin and eosin in a standard process. A modified panoptical staining was also done.Results. A "wear-type" reaction was seen in the testing and the control group. In all samples, the UHMWPE particles were scattered in the tissue or incorporated in giant cells. CFR-PEEK particles were seen as conglomerates and only could be found next to vessels. CFR-PEEK particles showed no giant-cell reactions. In conclusion, the hypothesis has to be rejected. UHMWPE and PEEK showed a different scatter-behavior in human synovial tissue.
authors.affiliation: Department of Orthopaedic Surgery, University Hospital of Munich (LMU), Campus Großhadern, Marchioninistraße 15, 81377 Munich, Germany.
authors.forename: A C
authors.identifier: 0000-0002-9899-6736
authors.initials: AC
authors.lastname: Paulus
authors.affiliation: Department of Orthopaedic Surgery, University Hospital of Munich (LMU), Campus Großhadern, Marchioninistraße 15, 81377 Munich, Germany.
authors.forename: S
authors.identifier: 0000-0003-1581-5301
authors.initials: S
authors.lastname: Haßelt
authors.affiliation: Department of Orthopaedic Surgery, University Hospital of Munich (LMU), Campus Großhadern, Marchioninistraße 15, 81377 Munich, Germany.
authors.forename: V
authors.initials: V
authors.lastname: Jansson
authors.affiliation: Department of Orthopaedics, Vienna General Hospital, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria.
authors.forename: A
authors.initials: A
authors.lastname: Giurea
authors.affiliation: Department of Traumatology and Orthopaedics, St. Vincenz Hospital, Am Stein 24, 58706 Menden, Germany.
authors.forename: H
authors.identifier: 0000-0002-4083-7193
authors.initials: H
authors.lastname: Neuhaus
authors.affiliation: Department of Orthopaedic Surgery, University Hospital of Munich (LMU), Campus Großhadern, Marchioninistraße 15, 81377 Munich, Germany; Aesculap AG Research & Development, Aesculap-Platz 1, 78532 Tuttlingen, Germany.
authors.forename: T M
authors.identifier: 0000-0002-1068-7497
authors.initials: TM
authors.lastname: Grupp
authors.affiliation: Department of Orthopaedic Surgery, University Hospital of Munich (LMU), Campus Großhadern, Marchioninistraße 15, 81377 Munich, Germany.
authors.forename: S
authors.identifier: 0000-0003-2065-432X
authors.initials: S
authors.lastname: Utzschneider
mesh_terms: D000368:Aged; D019645:Arthroplasty, Replacement, Knee / Q000379:methods; D001577:Benzophenones; D001672:Biocompatible Materials / Q000737:chemistry; D002244:Carbon / Q000737:chemistry*; D000077482:Carbon Fiber; D016207:Cytokines / Q000378:metabolism; D005260:Female; D006801:Humans; D007659:Ketones / Q000737:chemistry*; D007720:Knee Prosthesis / Q000009:adverse effects*; D008297:Male; D008422:Materials Testing; D008875:Middle Aged; D010232:Paraffin / Q000737:chemistry; D011092:Polyethylene Glycols / Q000737:chemistry*; D011108:Polymers; D011474:Prosthesis Design; D011475:Prosthesis Failure; D012086:Reoperation; D013583:Synovial Membrane / Q000378:metabolism*; D013977:Tibia / Q000033:anatomy & histology
chemical_list: D001577:Benzophenones; D001672:Biocompatible Materials; D000077482:Carbon Fiber; D016207:Cytokines; D007659:Ketones; D011108:Polymers; C063834:polyetheretherketone; D011092:Polyethylene Glycols; D002244:Carbon; D010232:Paraffin