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Orthopaedic implant components as a source of nanoparticles

Orthopaedic implant components as a source of nanoparticles. Jožef Stefan Institute, Ljubljana, and Valdoltra Orthopaedic Hospital, Ankaran, Slovenia. Ingrid Milošev. Conference on Nano-Safety, Ljubljana, 22-24 April 2009.

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Orthopaedic implant components as a source of nanoparticles

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  1. Orthopaedic implant components as a source of nanoparticles Jožef Stefan Institute, Ljubljana, and Valdoltra Orthopaedic Hospital, Ankaran, Slovenia Ingrid Milošev Conference on Nano-Safety, Ljubljana, 22-24 April 2009

  2. Number of implants and devices for USA (global numbers 2-3 times higher) Biomaterial Science, B.D. Ratner, A.S. Hoffman, F.J. Schoen, J.E. Lemons, 2004

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

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

  5. 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. Cumulative survivorship At 12 years post-op, 90% of prostheses still implanted Time in situ / years

  6. 71% Aseptic loosening related to the formation of wear debris and consequent osteolysis is reason for revision in >70%.

  7. 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

  8. Wear debris Polyethylene particles origin: acetabular cup,acetabular inlay

  9. a b c d e f f e 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)

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

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