Prosthetic metals have a variable necrotic threshold in human fibroblasts: an in vitro study.

Abstract

The generation of metal particles from prosthetic joints has been an evolving problem in orthopedics. Numerous factors have been involved including cells, metals, and responding cytokines, but determining roles of these factors or cascades of factors has been elusive. This laboratory has published threshold levels for commercially pure titanium (CpTi), which led to cell necrosis, but noted that cell viability differed among donor patients. To compliment the previous work we examined two other metals, Tantalum (Ta) and cobalt-chrome (CoCr), while making comparative measurements in these different donor patients. Retrieved human fibroblasts (superior medial plica) were cultured in a standard manner and exposed to various dosages of the three metals. Cell counts and interleukin (IL) 6 were used as dependent variables within a three-way analysis of variance. The data show that fibroblast necrosis was significantly affected by both type and mass of metal, with each metal having a distinct threshold (CpTi most necrotic, followed by Ta and CoCr). The cell counts and IL-6 at control levels varied significantly among all three donors. However, the response to the metals and dosages did not differ among tissue donors. Thus, although each patient had a different starting value for cell counts and IL-6, they responded to the metal particles in the same proportionate manner.