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Tissue reactions of particles of different biomaterials to bone marrow
WS4-K-2-03
TISSUE REACTIONS OF PARTICLES OF DIFFERENT BIOMATERIALS TO BONE MARROW T. Kubo 1, K. Sawada 1 , C. Simizu 1, S. Inoue1, Y. Hirasawa 1, T. Takamatsuz 1 ) Dept. of Orthopaedic Surgery, 2) 2nd Dept. of Pathology, Kyoto Prefectural Univ. of Medicine, Kyoto, Japan The most frequent long-term complication of joint replacement is "loosening". Recently, the cause of this "loosening" was thought to be a foreign-body reaction to wear particles of biomaterials. But, little is known about effects of different size and different biomaterials of wear particles on bone marrow tissue in vivo. In order to assess these problems, particles in different diameters (small and large) and different biomaterials (high density polyethylene (HDP), AIzO3, Co-Cr, and stainless steel) were applied to an animal model. A plug of polymethylmetacrylate (PMMA) with longitudinal groove was inserted through the knee joint into the distal part of the femur of rabbit. At that time, groove was filled with each particles in different diameters. After a period of operation ranging from 4 to 20 weeks, the animals were sacrificed and the specimens around the particles were studied histologically. Numerous histiocytes accumulated around small particles of HDP (range 1 . 4 ~ 4 4 / ~ m, mean 11 ~ m), and revealed phagocytosis of the particles. Around large particles of HDP (range 2 2 ~ 176/z m, mean 99 ~ m), however, little histiocytic infiltration was observed without phagocytosis of particles. The bone grew inward with reaction to it. Particles of AIzO3, Co-Cr or stainless steel ,even small particles (range 3 ~ 5 / ~ m , mean 3.9/~m), induced a weak tissue reaction in comparison with small particles of HDP. We concluded that particles of different biomaterials induced different tissue reaction and that among examined biomaterials small particles of HDP induced the strongest tissue reaction including phagocytosis.
WS4-K-2-04 PATHOHISTOLOGY OF RETRIEVED TISSUE FROM REVISED ARTIFICIAL JOINT OF OSTEOLYSIS M. Matsubara, T. Muneta, S. lchinoset), S. Morila, S. Hasegawa, T. Jimlo, K. Funlya Dept. of Orthopaedic Surgery, Tokyo Medical and Dental University, Tokyo, Japan 1)Research Center of Ultrastracture, Tokyo Medical and Dental University, Tokyo, Japan We reported tile pathohistology of tile retrieved tissue from revised artificial hip joint of osteolysis in light- and electroulnicroscope. Material and Methods: Synovial tissue was obtained from each poi]ll, such as l:joinl capsule near tile l'emcu'al head, 2: star tissue from the dorsal area of femoral stem, 3: tissue around the tip of the femoral stem, 4: star tissue around the neck of the femoral stem, 5: the tissue from inter-articular ( between the imler head and the outer head) surlacc, of revised artificial joint of sixty-year-old female. These specimen were examined by polarized light microsct!pe alld electron nlicrl~sc(,pe aht~ul tile pOilll where was showl] abtwe. Results: Wear debris of UHMWPE (PE) were seen in everywhere but the spccimell No.5 that had only necrotic tissue. While there were relatively mnall(le.ss than It) micrometer ill diameter) size of UHMWPE particle in the j~int capsule t~f the I'emoral head area (No.l), there were large(over 100 micrometer in diameter) size of particles with mixture c*f particles in small size in tile dorsal area of femoral stem (No.2), and there were mainly particles in large size in the tissue o1' the tip of the femoral stem(No.3). Macrophage were obsewed only in the tissue of distal tip of the femoral stem and very small(less than 1 micrometer in diameter) particles were observed in these cells. There were large number of the polynuclear giant cells in the tissue associated with many large UHMWI'E I~articles, and m~uW of those particles under one hundred micrometer in diameter were trapped in those giant cells. Aud the degeneration of polynuclear giant cells were observed in some of these tissues. In electron micn~scopically, polynuclear giant cells had a lot of round shaped UHMWPE in the size from 0.1 to 20 micrometer in diameter. Discussions: The UHMWI'E wear particles were observed in the tissues from revision surgery in ever),where, but tile size of them were different in each part (from No.1 to No.5). It was supposed that tile wear particle was made ntH only at the site of articulating surface(small round shaped wear debris), but at the site of the shoulder of the I'em~ral stem by impingement(large fretted wear debris) ill this case. A]ld at tile same time, whell luicro motion had occurred betwecn the l'cmoral stem and the femur, the stem and femur composite would play a ;ole of pump that would transport the wear debris iutt~ the distal part of the femur, then the bone would be lysed on the way to the distal femur, and even at the tip of the stem. The mechanism of the osteolysis and loosening of the artificial joint may be different between the group of early developing osteolysis and loosening after arthroplasty and the group of late onset of them, and the difference may be caused by the size and the shape of the UHMWPE wear particles.
283
TISSUE REACTIONS OF PARTICLES OF DIFFERENT BIOMATERIALS TO BONE MARROW T. Kubo 1, K. Sawada 1 , C. Simizu 1, S. Inoue1, Y. Hirasawa 1, T. Takamatsuz 1 ) Dept. of Orthopaedic Surgery, 2) 2nd Dept. of Pathology, Kyoto Prefectural Univ. of Medicine, Kyoto, Japan The most frequent long-term complication of joint replacement is "loosening". Recently, the cause of this "loosening" was thought to be a foreign-body reaction to wear particles of biomaterials. But, little is known about effects of different size and different biomaterials of wear particles on bone marrow tissue in vivo. In order to assess these problems, particles in different diameters (small and large) and different biomaterials (high density polyethylene (HDP), AIzO3, Co-Cr, and stainless steel) were applied to an animal model. A plug of polymethylmetacrylate (PMMA) with longitudinal groove was inserted through the knee joint into the distal part of the femur of rabbit. At that time, groove was filled with each particles in different diameters. After a period of operation ranging from 4 to 20 weeks, the animals were sacrificed and the specimens around the particles were studied histologically. Numerous histiocytes accumulated around small particles of HDP (range 1 . 4 ~ 4 4 / ~ m, mean 11 ~ m), and revealed phagocytosis of the particles. Around large particles of HDP (range 2 2 ~ 176/z m, mean 99 ~ m), however, little histiocytic infiltration was observed without phagocytosis of particles. The bone grew inward with reaction to it. Particles of AIzO3, Co-Cr or stainless steel ,even small particles (range 3 ~ 5 / ~ m , mean 3.9/~m), induced a weak tissue reaction in comparison with small particles of HDP. We concluded that particles of different biomaterials induced different tissue reaction and that among examined biomaterials small particles of HDP induced the strongest tissue reaction including phagocytosis.
WS4-K-2-04 PATHOHISTOLOGY OF RETRIEVED TISSUE FROM REVISED ARTIFICIAL JOINT OF OSTEOLYSIS M. Matsubara, T. Muneta, S. lchinoset), S. Morila, S. Hasegawa, T. Jimlo, K. Funlya Dept. of Orthopaedic Surgery, Tokyo Medical and Dental University, Tokyo, Japan 1)Research Center of Ultrastracture, Tokyo Medical and Dental University, Tokyo, Japan We reported tile pathohistology of tile retrieved tissue from revised artificial hip joint of osteolysis in light- and electroulnicroscope. Material and Methods: Synovial tissue was obtained from each poi]ll, such as l:joinl capsule near tile l'emcu'al head, 2: star tissue from the dorsal area of femoral stem, 3: tissue around the tip of the femoral stem, 4: star tissue around the neck of the femoral stem, 5: the tissue from inter-articular ( between the imler head and the outer head) surlacc, of revised artificial joint of sixty-year-old female. These specimen were examined by polarized light microsct!pe alld electron nlicrl~sc(,pe aht~ul tile pOilll where was showl] abtwe. Results: Wear debris of UHMWPE (PE) were seen in everywhere but the spccimell No.5 that had only necrotic tissue. While there were relatively mnall(le.ss than It) micrometer ill diameter) size of UHMWPE particle in the j~int capsule t~f the I'emoral head area (No.l), there were large(over 100 micrometer in diameter) size of particles with mixture c*f particles in small size in tile dorsal area of femoral stem (No.2), and there were mainly particles in large size in the tissue o1' the tip of the femoral stem(No.3). Macrophage were obsewed only in the tissue of distal tip of the femoral stem and very small(less than 1 micrometer in diameter) particles were observed in these cells. There were large number of the polynuclear giant cells in the tissue associated with many large UHMWI'E I~articles, and m~uW of those particles under one hundred micrometer in diameter were trapped in those giant cells. Aud the degeneration of polynuclear giant cells were observed in some of these tissues. In electron micn~scopically, polynuclear giant cells had a lot of round shaped UHMWPE in the size from 0.1 to 20 micrometer in diameter. Discussions: The UHMWI'E wear particles were observed in the tissues from revision surgery in ever),where, but tile size of them were different in each part (from No.1 to No.5). It was supposed that tile wear particle was made ntH only at the site of articulating surface(small round shaped wear debris), but at the site of the shoulder of the I'em~ral stem by impingement(large fretted wear debris) ill this case. A]ld at tile same time, whell luicro motion had occurred betwecn the l'cmoral stem and the femur, the stem and femur composite would play a ;ole of pump that would transport the wear debris iutt~ the distal part of the femur, then the bone would be lysed on the way to the distal femur, and even at the tip of the stem. The mechanism of the osteolysis and loosening of the artificial joint may be different between the group of early developing osteolysis and loosening after arthroplasty and the group of late onset of them, and the difference may be caused by the size and the shape of the UHMWPE wear particles.
283