Identification and Characterization of Polymeric and Metallic Wear Debris from Periprosthetic Tissues after Total Hip Revision Surgery

Abstract

In spite of the growing interest in the field of orthopedic wear debris, there is no standardized technique to simultaneously isolate and analyze both ultra-high-molecular-weight polyethylene (UHMWPE) and metallic debris from periprosthetic tissues. Using a modification of the previously employed base-digestion protocol involving solvent and mechanical treatment, we were able to separate the wear particles from the tissue. Subsequently, using environmental scanning electron microscopy (ESEM) and energy-dispersive spectrometry (EDS), we characterized individual particulate species. Metallic debris, particularly Co, Cr, and Mo, appeared as irregular and amorphous-like structures, whereas UHMWPE and Ti appeared as crystalline-like structures, some as small as 15 nm. The investigation revealed that UHMWPE forms the bulk (~82%), followed by Ti (~8%-9%), Co (~5%-6%), and Cr (~3%-4%), along with many other trace elements, such as Mo, Pb, Fe, Pb, Fe, Si (~1%-2%).