Orthopaedic implant components as a source of nanoparticles Ingrid Milošev Jožef Stefan Institute, Ljubljana, and Valdoltra Orthopaedic Hospital, Ankaran,

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Presentation transcript:

Orthopaedic implant components as a source of nanoparticles Ingrid Milošev Jožef Stefan Institute, Ljubljana, and Valdoltra Orthopaedic Hospital, Ankaran, Slovenia Conference on Nano-Safety, Ljubljana, April 2009

Number of implants and devices for USA (global numbers 2-3 times higher) Type of implantNumber Intraocular implants Intraocular lenses Contact lenses Cardiovascular implants Pace makers Vascular grafts Stents Heart valves Orthopaedic implants Total hip replacements Total knee replacements Dental implants Biomaterial Science, B.D. Ratner, A.S. Hoffman, F.J. Schoen, J.E. Lemons, 2004

Indications for total hip replacement: - osteoarthritis - osteoarthritis secondary to dysplasia - aseptic femoral head necrosis - rheumatoid arthritis - post-traumatic arthritis

Radigraph image of THR: (A) Post implantation (B) Prior revision surgery – aseptic loosening with osteolytic zones along the stem and changed cup position Animation:

Survivorship curve is a long-term indicator of the successfulness of a particular prosthesis. Data are created based in the Valdoltra Register of hip and knee prostheses. Time in situ / years Cumulative survivorship At 12 years post-op, 90% of prostheses still implanted

71% Aseptic loosening related to the formation of wear debris and consequent osteolysis is reason for revision in >70%.

Origin of wear Surface wear damage Wear particles Polyethylene particles Metal particles Cement particles Novel bearing combinations Metal-on-metal Ceramic-on-ceramic Biological consideration of particulate debris Introduction

Polyethylene particles origin: acetabular cup, acetabular inlay Wear debris

e f Mode 1: two primary bearing surfaces (a,b) Mode 2: primary surface moving against a secondary surface (c, d) Mode 3: primary surfaces including third particles interposed (e, f) d ba c ef

Metal particles For SEM analysis – filtrate the bottom layer through 0.2 um polycarbonate filter paper and coat with gold Polyethylene particles For SEM analysis - filtrate the top layer through 0.2 um polycarbonate filter paper and coat with gold Isolation procedure by NaOH digestion