title: Nano-analyses of wear particles from metal-on-metal and non-metal-on-metal dual modular neck hip arthroplasty.
abstract: Increased failure rates due to metallic wear particle-associated adverse local tissue reactions (ALTR) is a significant clinical problem in resurfacing and total hip arthroplasty. Retrieved periprosthetic tissue of 53 cases with corrosion/conventional metallic wear particles from 285 revision operations for ALTR was selected for nano-analyses. Three major classes of hip implants associated with ALTR, metal-on-metal hip resurfacing arthroplasty (MoM HRA) and large head total hip replacement (MoM LHTHA) and non-metal-on-metal dual modular neck total hip replacement (Non-MoM DMNTHA) were included. The size, shape, distribution, element composition, and crystal structure of the metal particles were analyzed by conventional histological examination and electron microscopy with analytic tools of 2D X-ray energy dispersive spectrometry and X-ray diffraction. Distinct differences in size, shape, and element composition of the metallic particles were detected in each implant class which correlate with the histological features of severity of ALTR and variability in implant performance.
authors.affiliation: Centre for Nanohealth, Swansea University Medical School, Swansea, UK. Electronic address: zhidao.xia@gmail.com.
authors.forename: Zhidao
authors.initials: Z
authors.lastname: Xia
authors.affiliation: Hospital for Special Surgery, Department of Orthopedic Surgery, New York, USA.
authors.forename: Benjamin F
authors.initials: BF
authors.lastname: Ricciardi
authors.affiliation: Centre for Nanohealth, Swansea University Medical School, Swansea, UK.
authors.forename: Zhao
authors.initials: Z
authors.lastname: Liu
authors.affiliation: Electron and Light Microscopy Facility, Central Biotechnology Services, School of Medicine, Cardiff University, Cardiff, UK.
authors.forename: Christopher
authors.initials: C
authors.lastname: von Ruhland
authors.affiliation: Leeds Electron Microscopy and Spectroscopy Centre, Institute for Materials Research, School of Chemical and Process Engineering, University of Leeds, UK.
authors.forename: Mike
authors.initials: M
authors.lastname: Ward
authors.affiliation: Centre for Nanohealth, Swansea University Medical School, Swansea, UK.
authors.forename: Alex
authors.initials: A
authors.lastname: Lord
authors.affiliation: Bio-Imaging Unit, Department of Biological and Medical Sciences, Oxford Brookes University, Oxford, UK.
authors.forename: Louise
authors.initials: L
authors.lastname: Hughes
authors.affiliation: Hospital for Special Surgery, Division of Research, New York, USA.
authors.forename: Steven R
authors.initials: SR
authors.lastname: Goldring
authors.affiliation: Hospital for Special Surgery, Division of Research, New York, USA.
authors.forename: Edward
authors.initials: E
authors.lastname: Purdue
authors.affiliation: Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Science, University of Oxford, Oxford, UK.
authors.forename: David
authors.initials: D
authors.lastname: Murray
authors.affiliation: Hospital for Special Surgery, Department of Pathology and Laboratory Medicine, New York, USA.
authors.forename: Giorgio
authors.initials: G
authors.lastname: Perino
mesh_terms: D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects*; D003343:Corrosion; D005260:Female; D006622:Hip Prosthesis / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008670:Metals / Q000009:adverse effects*; D008875:Middle Aged; D053758:Nanoparticles / Q000009:adverse effects* / Q000648:ultrastructure; D011474:Prosthesis Design; D011475:Prosthesis Failure / Q000009:adverse effects
chemical_list: D008670:Metals
keywords: Adverse local tissue reaction (ALTR); Hip arthroplasty; Metal-on-metal hip resurfacing arthroplasty (MoM HRA); Metal-on-metal large head total hip replacement (MoM LHTHA); Non-metal-on-metal dual modular neck total hip replacement (non-MoM DMNTHA)