Ultra-high Molecular Weight Polyethylene Particles Research Articles

Biochemical analyses of human macrophages activated by polyethylene particles retrieved from interface membranes after failed total hip arthroplasty

Human monocyte/macrophages (M/M) were exposed to retrieved ultra-high molecular weight polyethylene (UHMWPE) particles isolated after enzymatic digestion of revision total hip arthroplasty interface membrane tissue samples. The cellular response of human M/M to UHMWPE was compared with the response of these cells to latex particles and culture medium alone. We incubated macrophages in good contact with polyethylene particles using an inverted culture system. Chamber slides on which macrophages were attached were filled with polyethylene particle suspension and sealed with plastic sheets. After the slides were inverted, the incubation was completed. Retrieved UHMWPE particulate debris stimulated human M/M to secrete interleukin (IL)-1β, IL-6, and tumor necrosis factor (TNF)-α. Human M/M exposed to retrieved UHMWPE particles secreted significantly more IL-1β, IL-6, and TNF-α compared with M/M exposed to latex particles (P<.05).

Inflammatory responses to orthopaedic biomaterials in the murine air pouch

An in vivo model of the inflammatory response to orthopaedic biomaterials was used to examine cellular and cytokine responses to polymer particles of ultra high molecular weight polyethylene (UHMWPE) and polymethylmethacrylate (PMMA), and metal particles of cobalt–chrome (Co–Cr) and titanium alloy (Ti–6Al–4V). Responses were determined separately and in combinations, to examine interactions between different forms of biomaterials. Murine air pouches were injected with particle suspensions, and reactions evaluated using histological, immunological, and molecular techniques. All particulate biomaterials caused significant increases in membrane thickness compared with control (saline) air pouches, with the highest reaction seen in response to Ti–6Al–4V particles. A synergistic increase in membrane thickness was observed when PMMA was combined with UHMWPE, suggesting that multiple biomaterial stimuli markedly increase the inflammatory reaction. Cellular analysis indicated that all particles increased the absolute number and the percentage of macrophages in the membrane over the control level, with the most pronounced increase due to individual biomaterial occurring with UHMWPE particles. Cytokine analysis revealed that biomaterials provoked a strong IL-1 response. Ti–6Al–4V stimulated the highest IL-6 gene transcription and the lowest IL-1 gene transcription. The data suggest that synergism in the inflammatory response to biomaterials may be important in adverse responses to orthopaedic wear debris.

Ceramic and PMMA particles differentially affect osteoblast phenotype

There is increasing evidence that wear debris particles present in periprosthetic tissues have direct effects on osteoblasts. The nature of the cell response varies with the chemistry of the particle and the number of particles. Most studies have used Ti, Ti–6Al–4V, and ultrahigh molecular weight polyethylene (UHMWPE) particles since these materials are most frequently used in implants and as a result, these particles predominate in peri-prosthetic tissues. Ceramics have also been used successfully as load-bearing surfaces in implants for years, although it is unknown how wear debris from these surfaces may contribute to aseptic bone loss. Further, particles resulting from polymethylmethacrylate (PMMA) cements used for fixation may also be involved in aseptic loosening of implants, but how these particles may affect bone formation is unknown. In the present study, we examined whether aluminum oxide (Al2O3), zirconium oxide (ZrO2), and PMMA particles exert effects on osteoblast proliferation, phenotypic expression, and local factor production, and if so, whether the effects were specific to the particle type. ZrO2 particles were produced in a custom-made axial mixer in which ZrO2 containers were filled with ZrO2 bars and 95% ethanol and then rotated continuously at room temperature. PMMA particles were prepared in a ZrO2 roller mill. Al2O3 was produced and provided by Aesculap AG. Particles were endotoxin-free with equivalent circle diameters <3μm; Al2O3 particles were significantly smaller than ZrO2 or PMMA particles. Particle suspensions were added to confluent cultures of MG63 osteoblast-like cells after diluting them 1:100, 1:10, and 1:1 with culture medium. Cells were incubated with the particles for 24h. Transmission electron microscopy showed that MG63 cells phagocytosed Al2O3 particles and exhibited ultrastructural changes consistent with cytotoxicity. This was supported by biochemical changes as well. Proliferation, alkaline phosphatase activity, and TGF-β1 levels were decreased. ZrO2 and PMMA particles increased proliferation and alkaline phosphatase specific activity. The effect of ZrO2 on alkaline phosphatase was targeted to matrix vesicles; the effect of PMMA was greater on the cells. All particles increased prostaglandin E2 production. These results show that Al2O3, ZrO2, and PMMA particles elicit direct effects on osteoblasts and that cell response depends on the particle type. None of the particles tested had the same effect as noted previously for UHMWPE: increased proliferation and decreased alkaline phosphatase. These results may indicate that the response of peri-prosthetic tissues to wear particles may be modulated by the relative contributions of the various particle types present.

Electrical behavior and structure of polypropylene/ultrahigh molecular weight polyethylene/carbon black immiscible blends

AbstractThis study investigates the electrical behavior, which is the positive temperature coefficient/negative temperature coefficient (PTC/NTC), and structure of polypropylene (PP)/ultrahigh molecular weight polyethylene (UHMWPE)/carbon black (CB) and PP/γ irradiated UHMWPE (XL‐UHMWPE)/CB blends. As‐received UHMWPE or XL‐UHMWPE particles are chosen as the dispersed phase because of their unusual structural and rheological properties (extremely high viscosity), which practically prevent CB particles penetration. Because of their stronger affinity to PE, CB particles initially form conductive networks in the UHMWPE phase, followed by distribution in the PP matrix, thus interconnecting the CB‐covered UHMWPE particles. This unusual CB distribution results in a reduced electrical percolation threshold and also a double‐PTC effect. The blends are also investigated as filaments for the effect of shear rate and processing temperature on their electrical properties using a capillary rheometer. Because of the different morphologies of the as‐received and XL‐UHMWPE particles in the filaments, the UHMWPE containing blends exhibit unpredictable resistivities with increasing shear rates, while their XL‐UHMWPE containing counterparts depict more stable trends. The different electrical properties of the produced filaments are also related to differences in the rheological behavior of PP/UHMWPE/CB and PP/XL‐UHMWPE/CB blends. Although the flow mechanism of the former blend is attributed to polymer viscous flow, the latter is attributed to particle slippage effects. © 2001 John Wiley &amp; Sons, Inc. J Appl Polym Sci 81: 104–115, 2001

Thermo‐electric behavior (PTC) of carbon black–containing PVDF/UHMWPE and PVDF/XL‐UHMWPE blends

AbstractThis paper describes the structure and electrical performance of PTC/NTC (positive temperature coefficient/negative temperature coefficient) effects and their reproducibility upon healing/cooling cycles. The following three‐component blends were studied: PVDF/UHMWPE/CB, PVDF/XL‐UHMWPE/CB and γ‐irradiated compression molded plaques of these blends. Carbon black (CB) particles are attracted to the UHMWPE (ultra high molecular weight polyethylene) and XL (cross‐linked)UHMWPE particles, which constitute the dispersed phase in the PVDF (polyvinylidene fluoride) matrix, but practically cannot or only very slightly penetrate them because of their extremely high viscosity. A double‐PTC effect was exhibited by all unirradiated samples. Irradiation of compression molded PVDF/UHMWPE/CB plaques does not add to their already outstanding reproducibility, and it results In a wide single‐PTC effect. Irradiation of compression molded PVDF/XL‐UHMV/PE/CB plaque, slabilizes their structure upon heating/cooling cycles and thus makes them reproducible PTC/NTC materials, still exhibiting a double‐PTC effect. The carbon black concentrations studied in this report are extremely low (&lt; 2 phr CB) in comparison to other literature reports.

Enhanced cytokine production from human macrophages stimulated by polyethylene particles retrieved from interface membranes after failed total hip arthroplasty

Little is known about the specific effects of the ultra-high molecular weight polyethylene (UHMWP) debris that is obtained from human interface membranes after revision for a failed total hip arthroplasty. This paper reports the effects of retrieved polyethylene particles on human monocyte/macrophages (M/M). Macrophages were prepared from normal human peripheral blood by the conventional Ficoll–Hypaque method. Polyethylene wear debris was obtained from human interface membranes and prepared by the method of papain digestion. Human M/M were dispensed at 1.0 × 106 cells/well in a 24-well culture plate. UHMWP and latex particles were added immediately after plating the cells and directly onto the cells (1 × 106 cells/well) at final particle concentrations of 100 μg/well, 200 μg/well, and 500 μg/well. At the end of 24 h incubation, the culture supernatant was removed and assayed for IL-1β, IL-6, and TNF-α activities by ELISA. Cellular morphology and architecture were studied using light and electron microscopy. Human M/M cultured with retrieved UHMWP particles caused significantly more IL-1β, IL-6, and TNF-α release than macrophages cultured with latex (P < 0.05). The addition of latex and polyethylene particles to human M/M resulted in a dose-dependent increase in IL-1β, IL-6, and TNF-α release. Electron microscopy revealed that 90% of the UHMWP particles were less than 1 μm diameter. The average particle size was approximately 0.7 μm diameter (range 0.1–15 μm). Human M/M exposed to PE particles demonstrated extensive filopodia formation as compared with the cells exposed to latex particles. In summary, we have demonstrated that polyethylene particles isolated from interfacial membranes obtained at revision surgery are potent stimulators of human M/M.

Phagocytosis of wear debris by osteoblasts affects differentiation and local factor production in a manner dependent on particle composition

Wear debris is considered to be one of the main factors responsible for aseptic loosening of orthopaedic endoprostheses. Whereas the response of cells in the monocytic lineage to foreign materials has been extensively studied, little is known about cells at the bone formation site. In the present study, we examined the hypothesis that the response of osteoblasts to wear debris depends on the chemical composition of the particles. We produced particles from commercially pure titanium (cpTi), Ti–6Al–4V (Ti-A), and cobalt-chrome (CoCr) and obtained ultrahigh molecular weight polyethylene (UHMWPE; GUR 4150) particles from a commercial source. The equivalent circle diameters of the particles were comparable: 1.0±0.96 μm for UHMWPE; 0.84±0.12 μm for cpTi; 1.35±0.09 μm for Ti-A, and 1.21±0.16 μm for CoCr. Confluent primary human osteoblasts and MG63 osteoblast-like cells were incubated in the presence of particles for 24 h. Harvested cultures were examined by transmission electron microscopy to determine if the cells had phagocytosed the particles. Particles were found intracellularly, primarily in the cytosol, in both the primary osteoblasts and MG63 cells. The chemical composition of the particles inside the cells was confirmed by energy-dispersive X-ray analysis. Morphologically, both cell types had extensive ruffled cell membranes, less-developed endoplasmic reticulum, swollen mitochondria, and vacuolic inclusions compared with untreated cells. CpTi, Ti-A, and CoCr particles were also added to cultures of MG63 cells to assess their effect on proliferation (cell number) and differentiation (alkaline phosphatase activity), and PGE 2 production. All three types of particles had effects on the cells. The effect on cell number was dependent on the chemical composition of the particles; Ti-A and CoCr caused a dose-dependent increase, while cpTi particles had a biphasic effect with a maximal increase in cell number observed at the 1 : 10 dilution. Alkaline phosphatase specific activity was also affected and cpTi was more inhibitory than Ti-A or CoCr. PGE 2 production was increased by all particles, but the magnitude of the effect was particle-dependent: CoCr>cpTi>Ti-A. This study demonstrates clearly that human osteoblast-like cells and MG63 cells can phagocytose small UHMWPE, CoCr, Ti-A, and cpTi particles. Phagocytosis of the particles is correlated with changes in morphology, and analysis of MG63 response shows that cell proliferation, differentiation, and prostanoid production are affected. This may have negative effects on bone formation adjacent to an orthopaedic implant and may initiate or contribute to the cellular events that cause aseptic loosening by inhibiting bone formation. The effects on alkaline phosphatase and PGE 2 release are dependent on the chemical composition of the particles, suggesting that both the type and concentration of wear debris at an implant site may be important in determining clinical outcome.

Bioactivity Responses of Different Uhmwpe Particles from In-Vivo and In-Vitro Tests

AbstractThis paper describes the results of bioactivity responses to different ultra high molecular weight polyethylene (UHMWPE) particles. Particles were produced by a wear tester using two different textures of steel counters, one with cross-hatched and the other with uni-hatched grooves. These two textured surfaces produced two distinct populations of wear particles. One is larger and more elongated (fibril shapes) than the other. The mean sizes and aspect ratios of the particles are in the ranges of 5 μm to 25 μm and about 1.5 to 3, respectively. These two distinct UHMWPE particles were examined through in-vitro and in-vivo tests. Macrophages RAW 264.7 and the murine air-pouch model of inflammation were employed to characterize the effect of the particle size and shape. Preliminary in-vivo tests results showed that more elongated and larger particles enhanced bio-reactions.

Quantitative analysis of ultrahigh molecular weight polyethylene (UHMWPE) wear debris associated with total knee replacements.

The size and morphology of particulate wear debris retrieved from tissues around 18 failed total knee replacements (TKR) were characterized. Interfacial membranes from nine cemented and nine uncemented TKR were harvested from below the tibial components during revision surgery. Wear debris were extracted using papain and potassium hydroxide digestion. Ultrahigh molecular weight polyethylene (UHMWPE) particles from around cemented or uncemented TKR were similar in size and morphology. The mean size was 1.7 +/- 0. 7 microm with a range of 0.1-18 microm. Thirty-six percent of the particles were less than 1 microm and 90% were less than 3 microm. Morphologically the particles were predominantly spherical with occasional fibrillar attachments and flakes. Particles from TKR were greater than threefold larger than previously characterized particles from total hip replacements, which were 0.5 microm in mean size. Differences in joint conformity and wear patterns between the hip and knee articulations may explain the disparity in size of the wear debris. Since particle size represents an important variable influencing the magnitude of the biological response, it is possible that in vivo the larger TKR debris results in a diminished mediator release, which in turn may account for the lower incidence of osteolysis and aseptic loosening in some designs of TKR.

The effect of ultra-high molecular weight polyethylene wear debris on MG63 osteosarcoma cells in vitro.

Focal osteolysis due to ultra-high molecular weight polyethylene wear debris involves effects on both bone resorption and bone formation. The response of MG63 osteoblast-like osteosarcoma cells to ultra-high molecular weight polyethylene wear debris isolated by enzymatic digestion of granulomatous tissue obtained from the sites of failed total hip arthroplasties was examined. Scanning electron microscopy, particle-size analysis, and Fourier transform infrared spectroscopy were used to characterize the number, morphology, size distribution, and chemical composition of the particles. Cell response was assessed by adding particles at varying dilutions to confluent cultures and measuring changes in cell proliferation (number of cells and [3H]-thymidine incorporation), osteoblast function (alkaline-phosphatase-specific activity and osteocalcin production), matrix production (collagen production and proteoglycan sulfation), and local cytokine production (prostaglandin-E2 production). The mean size of the particles was 0.60 micrometer, and 95 percent of the particles had a size of less than 1.5 micrometers. The number of particles per gram of tissue ranged from 1.39 to 3.38x10(9). Three of the four batches of particles were endotoxin-free. Exposure of the cells to particles of wear debris significantly increased the number of cells (p<0.05) and the [3H]-thymidine incorporation (p<0.05) in a dose-dependent manner. In contrast, the addition of particles decreased alkaline-phosphatase-specific activity and osteocalcin production. Collagen production and proteoglycan sulfation were also decreased, while prostaglandin-E2 synthesis was increased by the addition of particles. Ultra-high molecular weight polyethylene particles isolated from human tissue stimulated osteoblast proliferation and prostaglandin-E2 production and inhibited cell differentiation and matrix production. These results indicate that particles of wear debris inhibit cell functions associated with bone formation and that osteoblasts may produce factors in response to wear debris that influence neighboring cells, such as osteoclasts and macrophages. Particles of wear debris, especially ultra-high molecular weight polyethylene, have been implicated in the loosening of implants and the development of osteolysis. The present study shows that particles of ultra-high molecular weight polyethylene isolated from human tissue inhibit osteoblast functions associated with bone formation. In addition, particles of wear debris induced osteoblasts to secrete factors capable of influencing neighboring cells, such as osteoclasts and macrophages. These results suggest that osteoblasts may play a role in the cascade of events leading to granuloma formation, osteolysis, and failure of orthopaedic implants.

Ultrahigh molecular weight polyethylene particles have direct effects on proliferation, differentiation, and local factor production of MG63 osteoblast-like cells.

Small particles of ultrahigh molecular weight polyethylene stimulate formation of foreign-body granulomas and bone resorption. Bone formation may also be affected by wear debris. To determine if wear debris directly affects osteoblasts, we characterized a commercial preparation of ultrahigh molecular weight polyethylene (GUR4150) particles and examined their effect on MG63 osteoblast-like cells. In aliquots of the culture medium containing ultrahigh molecular weight polyethylene, 79% of the particles were less than 1 microm in diameter, indicating that the cells were exposed to particles of less than 1 microm. MG63 cell response to the particles was measured by assaying cell number, [3H]thymidine incorporation, alkaline phosphatase specific activity, osteocalcin production, [35S]sulfate incorporation, and production of prostaglandin E2 and transforming growth factor-beta. Cell number and [3H]thymidine incorporation were increased in a dose-dependent manner. Alkaline phosphatase specific activity, a marker of cell differentiation for the cultures, was significantly decreased, but osteocalcin production was not affected. [35S]sulfate incorporation, a measure of extracellular matrix production, was reduced. Prostaglandin E2 release was increased, but transforming growth factor-beta production was decreased in a dose-dependent manner. This shows that ultrahigh molecular weight polyethylene particles affect MG63 proliferation, differentiation, extracellular matrix synthesis, and local factor production. These effects were direct and dose dependent. The findings suggest that ultrahigh molecular weight polyethylene wear debris particles with an average size of approximately 1 microm may inhibit bone formation by inhibiting cell differentiation and reducing transforming growth factor-beta production and matrix synthesis. In addition, increases in prostaglandin E2 production may not only affect osteoblasts by an autocrine pathway but may also stimulate the proliferation and activation of cells in the monocytic lineage. These changes favor decreased bone formation and increased bone resorption as occur in osteolysis.

Proinflammatory mediator release in response to particle challenge: Studies using the bone harvest chamber

This study reports on the effects of phagocytosable particles on proinflammatory mediator release in an animal model. Bone harvest chambers (BHCs) were implanted bilaterally into mature rabbits; phagocytosable ultrahigh molecular weight polyethylene (UHMWPE) and polystyrene (PS) particles, and the carrier sodium hyaluronate (HE) were tested for their ability to stimulate proinflammatory mediator release. Tissues were harvested after 3, 4, or 6 weeks. Retrieved tissues were placed into culture medium. The release of the proinflammatory mediators interleukin-6 (IL-6), interleukin-1beta (IL-1β), and tumor necrosis factor alpha (TNF-α) into the culture medium was assessed using bioassays. DNA content and dry weights were also measured. The maximal biological response to the PE particles with respect to TNF-α and IL-1β was observed at three weeks with 11- and fivefold stimulations over controls, respectively. The maximal response to PE particles with respect to IL-6 was observed at 4 weeks with a twofold stimulation over controls. Similar patterns were seen with PS particles; however, PE particles stimulated higher cytokine release. PE particles stimulated the expression of IL-1β, IL-6, and TNF-α in the BHC model. Cell culture and human retrieval studies also implicate these proinflammatory mediators in loosening and osteolysis of total joint replacements. Thus, the BHC is a useful in vivo model to document the effects of particles on the evolution of biological responses to particulate debris. © 1999 John Wiley & Sons, Inc. J Biomed Mater Res (Appl Biomater) 48: 434–439, 1999

Proinflammatory mediator release in response to particle challenge: studies using the bone harvest chamber.

This study reports on the effects of phagocytosable particles on proinflammatory mediator release in an animal model. Bone harvest chambers (BHCs) were implanted bilaterally into mature rabbits; phagocytosable ultrahigh molecular weight polyethylene (UHMWPE) and polystyrene (PS) particles, and the carrier sodium hyaluronate (HE) were tested for their ability to stimulate proinflammatory mediator release. Tissues were harvested after 3, 4, or 6 weeks. Retrieved tissues were placed into culture medium. The release of the proinflammatory mediators interleukin-6 (IL-6), interleukin-1beta (IL-1beta), and tumor necrosis factor alpha (TNF-alpha) into the culture medium was assessed using bioassays. DNA content and dry weights were also measured. The maximal biological response to the PE particles with respect to TNF-alpha and IL-1beta was observed at three weeks with 11- and fivefold stimulations over controls, respectively. The maximal response to PE particles with respect to IL-6 was observed at 4 weeks with a twofold stimulation over controls. Similar patterns were seen with PS particles; however, PE particles stimulated higher cytokine release. PE particles stimulated the expression of IL-1beta, IL-6, and TNF-alpha in the BHC model. Cell culture and human retrieval studies also implicate these proinflammatory mediators in loosening and osteolysis of total joint replacements. Thus, the BHC is a useful in vivo model to document the effects of particles on the evolution of biological responses to particulate debris.

Macrophage phagocytosis of polyethylene particulate in vitro.

In this study, an in vitro model has been developed to examine the interactions of macrophages with ultrahigh molecular-weight polyethylene (UHMWPE) and high-density polyethylene (HDPE) particles. Polyethylene particles are the major constituent of the material debris formed as a result of orthopedic implant wear. However, the study of polyethylene particle interactions with cells has been limited. UHMWPE (18-20 microns) and HDPE (4-10 microns) were suspended in soluble collagen type I and subsequently solidified on glass coverslips. The particle chemistry was characterized by Fourier transform infra-red spectroscopy (FT-IR) and X-ray photoelectron spectroscopy (XPS). Mouse cell line macrophages (IC-21) were established on the collagen-particle substrata and maintained for up to 24 h. The response of the cells to the particles was examined by light and transmission electron microscopy (LM and TEM), as well as by scanning electron microscopy (SEM), and compared to cells on control collagen surfaces without particles. Histological analysis of the samples revealed that the macrophages surrounded larger particles (18-20 microns) and the cells appeared to be attached to the surface of the particles, and the smaller particles (4-10 microns) had been phagocytosed within 2 h. Inflammatory cytokines (TNF-alpha, IL-1 alpha, IL-1 beta, and IL-6), lysosomal enzymes (beta-galactosidase and hexosaminidase), and prostaglandin E2 were released into the medium, and IL-1 alpha, IL-1 beta, PGE2, beta-galactosidase, and hexosaminidase levels were significantly increased over collagen control values. The results demonstrate active phagochemotaxis by macrophages for wear particulates and validate this model as a means of studying the specific in vitro interactions of polyethylene with cells.

Electrical properties of polymer composites prepared by sintering a mixture of carbon black and ultra‐high molecular weight polyethylene powder

AbstractConductive polymer composites were prepared by sintering a mixture of ultrahigh molecular weight polyethylene (UHMWPE) powder and carbon black. Two processing parameters—time and temperature—were shown to have a notable effect on the resistivity of the composites. The relationships between the processing parameters and morphology were studied using optical microscopy and transmission electron microscopy (TEM). The results of the optical microscopy studies indicate that the carbon black is distributed in the interfacial regions between the UHMWPE particles. The dimension of the carbon black channels increases with the carbon black concentration. TEM micrographs show that a high degree of intermixing between the carbon black and the polymer occurs at higher temperatures and longer processing times, resulting in higher resistivities. A positive temperature coefficient (PTC) effect was observed for these materials. A mechanism for the PTC effect in this system is proposed. The magnitude of the PTC effect is found to be inversely proportional to the dimension of the carbon black channels in the composites. The dimension is directly related to the carbon black concentration. The PTC effect is a result of the polymer volume expansion caused by melting of the crystallites. A large PTC effect is observed for the composites with a low carbon black concentration and vice versa. No negative temperature effect (NTC) is observed at temperatures substantially above the melting point of the polymer.

Application of numerical descriptors to the characterization of wear particles obtained from joint replacements.

The application of image analysis techniques to the characterization of wear particles from failed joint replacements has been described. Wear particles were extracted from periprosthetic tissues collected during revision surgery. Chemical digestive methods were used to separate the wear particles from the biological soft material. The particles isolated were examined by optical and scanning electron microscopy. Digitized particle images were analysed on a Macintosh computer by a specially developed software and by the image analysis program 'Prism'. The following numerical descriptors were used to characterize the particles: particle size, boundary fractal dimension and shape parameters such as form factor, roundness, convexity and aspect ratio. Elemental composition of the particles was determined by energy dispersive X-ray spectroscopy. Three selected types of wear particles were analysed and compared: titanium (Ti)-based and calcium (Ca)-based particles from a hip prosthesis and ultra-high molecular weight polyethylene (UHMWPE) particles from a knee prosthesis. The particles exhibited significantly different sizes and their shape numerical descriptors were also different. From the results obtained it appears that computer image analysis of wear particle morphology can be employed to determine the wear processes occurring in the joints. In some cases, the condition of the joint can also be assessed based on this analysis.

Low‐voltage scanning electron microscopic imaging of ultrahigh‐molecular‐weight polyethylene

Submicron ultrahigh-molecular-weight polyethylene (UHMWPE) wear particles from total joint prostheses may contribute to implant failure through particle-mediated aseptic loosening. The purpose of this study was to examine the microstructure of virgin UHMWPE powder to determine its morphology for future comparison with wear debris. A new method of low-voltage scanning electron microscopy (LVSEM) in an oil-free vacuum was applied, which produced high-resolution images of UHMWPE micromorphology, while minimizing specimen damage and obviating the need for image processing. GUR 415 UHMWPE virgin powder particles were examined by using routine high-voltage SEM, LVSEM, and image analyses. LVSEM showed that UHMWPE particles were composed of submicron-size spherical subparticles connected by numerous nanometer-size fibrils. These spherical subparticles had a highly textured surface morphology seen only by LVSEM. Fracture of the nanometer-size fibrils was observed. Routine high-voltage SEM obfuscates the intricate and delicate UHMWPE micromorphology as well as the damage done by the accompanying high-voltage electrons. This study suggests that the micromorphology of wear particles previously studied with routine high-voltage SEM was overlooked or damaged, justifies the need for LVSEM in future studies, and raises the question of what is the true morphology of polyethylene wear debris retrieved from human tissues.

Formation of UHMWPE polymeric transfer films on sliding glass counterfaces: early and steady-state wear studied by transmission electron microscopy

At a temperature of 30°C polymeric transfer films were generated on glass counterfaces during small-amplitude oscillatory sliding contact with an ultra-high molecular weight polyethylene (UHMWPE) pin under a constant load of 6.5 MPa. Early discontinuous and continuous (steady-state) transfer films were studied with vertical platinum-carbon replication and transmission electron microscopy (TEM). Nanometre-scale UHMWPE deposits in these transfer films have been visualized for the first time. Nanometre-scale particles averaging 20.6 ±6.3nm (5–40nm) were deposited on glass in the early stages of UHMWPE film transfer. After formation of a continuous transfer film, UHMWPE particles of slightly smaller dimensions, 13.5±6.1 nm (2–41 nm), were deposited on the transfer film surface. In addition, micrometre-scale particles (0.1–6.4 μm) were found at the ends of the wear track. At high magnification, a fraction of the UHMWPE polymer chains observed in particle surfaces and in the transfer film surface nearby were not oriented in the sliding direction. Some crystal- or plate-like particles of UHMWPE were seen in the transfer film. Plate-like and micrometre-scale spherulitic inclusions were also identified on the mostly amorphous UHMWPE pin surface fractured at liquid nitrogen temperatures. The high frequency of nanometre-scale UHMWPE particles in contrast to the less numerous micrometre-scale deposits near the ends of the wear track suggests that the nanometre-scale deposits contribute significantly to transfer film formation and to the wear characteristics of UHMWPE.

Fate of Ultrahigh Molecular Weight Polyethylene (UHMW-PE) Wear Debris in Patients with Hip Implants

The process of ultrahigh molecular weight polyethylene (UHMW-PE) breakdown, started at the articular surface of the cup, continues in small fragments after generation. An assiduous interaction between the UHMW-PE particles and the host cells leads to oxidative changes of the UHMW-PE and to size reduction of the particles simultaneous with transporting them toward, and finally by, lymphatic or blood vessels. The particles are mobilized by means of enzymatic, extracellular matrix-degrading activity of cells that have phagocytosed them or adhered to them. Together, these characteristics indicate an attempt by the natural cellular immunity system to eliminate the implant wear debris. Macrophages are the main effector cells acting as scavengers; however, excessive amount of the wear debris evokes phagocytic activity of cells other than macrophages as well.

Quantitative characterization of cells at the interface of long-term implants of selected polymers.

Comprehensive understanding of the relationship between biologic response and biomaterial characteristic requires quantitative evaluation of the cells at the interface of the material and descriptions of ultrastructural features of these cells. The purpose of this study was to qualitatively and quantitatively characterize the long term in vivo tissue and cellular response to two polymeric materials presently employed in the fabrication of surgical implants. Ultrahigh molecular weight polyethylene (PE) and polysulfone (PSF) particles were implanted subcutaneously into rats for 100-118 weeks. Specimens were embedded in paraffin and ERL embedding medium in preparation for light and transmission electron microscopy. Percentage of the particle surface covered by various cell types was determined using a computer interactive image analysis system. PE and PSF particles were sequestered within a subcutaneous fibrous capsule. Cell types present included macrophages, fibroblasts and giant cells characteristic of a foreign body granuloma. Statistical comparison of the percent particle surface covered by each cell type revealed no significant difference between PSF and PE. However, surface texture appeared to influence the tissue response. TEM confirmed the identity of the cells at the interface and consistently revealed a layer of amorphous extracellular substance including cell debris on the material surface. Results evidence the tissue compatibility of PE and PSF and indicate no significant difference in the tissue response to these polymers.