Analysis of debris from brushing the femoral canal with a plastic brush--a potential cause of loosening in total hip replacement.

Abstract

The generation of submicrometre sized polyethylene particles has been shown to be one of the major causes of osteolysis, loosening and failure of total replacement joints. It has been reported that intramedullary brushing of the femoral canal with polymer brushes prior to total hip arthroplasty results in the release of polymer particles into the femoral canal. The aim of this study was to isolate and characterize these particles on the basis of morphology and size and to determine whether these particles may play a role in osteolysis and loosening of the total hip prostheses. It was found that the majority of the particles shed by the polymer brushes were submicrometre in size and were similar in morphology to UHMWPE wear particles isolated from periprosthetic tissues. In addition, the majority of the particles released by the brushes were in the biologically active size range (0.1-10 microns), and may contribute to osteolysis and loosening of hip prostheses.