Why Artificial Joints Faill Image removed due to copyright considerations Spice, Byron "Particle Disease Seen As Plague on Total Joint Replacement" Pittsburgh Post-Gazette
Why Artificial Joints Fail Image removed due to copyright considerations Image removed due to copyright considerations Spice, Byron. “Particle Disease Seen As Plague on Total Joint Replacement” Pittsburgh Post-Gazette
POLYETHYLENE WEAR PARTICLES H McKellop, 1994 Hip Society The number of particles generated by a hip prosthesis 7x 10 particles/yr 700,000 particles/step
POLYETHYLENE WEAR POLYETHYLENE WEAR PARTICLES PARTICLES H. McKellop McKellop, 1994 Hip Society , 1994 Hip Society The number of particles generated by a hip The number of particles generated by a hip prosthesis prosthesis 7 x 1011 particles/yr. particles/yr. 700,000 particles/step 700,000 particles/step
NUMBER OF INHALED PARTICLES Avg particle burden of urban atmosphere 105 particles/liter Respired volume in man= l liter/min Therefore, 105 particles are inhaled/min, 10%of the inhaled particles are deposited in the ungs Therefore, 104 particles are deposited in the lungs per min 5x 10 particles/yr
NUMBER OF INHALED PARTICLES NUMBER OF INHALED PARTICLES Avg. particle burden of urban atmosphere: Avg. particle burden of urban atmosphere: 10 5 particles/liter particles/liter Respired volume in man = 1 liter/min. Respired volume in man = 1 liter/min. Therefore, 10 Therefore, 10 5 particles are inhaled/min. particles are inhaled/min. 10% of the inhaled particles are deposited in the 10% of the inhaled particles are deposited in the lungs. Therefore, 10 Therefore, 10 4 particles are deposited in the lungs particles are deposited in the lungs per min. per min. 5 x 10 9 particles/yr. particles/yr
Titanium Wear Debris Images removed due to copyright considerations Co-Cr Particles
Titanium Wear Debris Images removed due to ved due to copyright considerations copyright considerations Co-Cr Particles
MACROPHAGE RESPONSE TO MOTION AND PARTICLES UNSTABLE PROSTHESIS Osteoblasts Particles← Motion Bone resorption a (Osteolysis BONE Enzyme PGE IL-1 Macrophage Chemoattractants Osteoclast (15-25μm) Osteoclast precursor cells
UNSTABLE PROSTHESIS UNSTABLE PROSTHESIS Particles Particles Motion Bone Resorption Bone Resorption (Osteolysis) (Osteolysis) Macrophage Macrophage (15 -25 µm) IL - 1 PGE 2 Enzymes Enzymes Chemoattractants Chemoattractants MACROPHAGE RESPONSE MACROPHAGE RESPONSE TO MOTION AND PARTICLES TO MOTION AND PARTICLES BONE Osteoclast Osteoclast precursor cell precursor cell s Osteoclast Osteoclast Osteoblasts Osteoblasts