Isolation and analysis of articular joints wear debris generated in vitro

The total replacement of damaged or diseased synovial joints represents one of the greatest advances in orthopaedic surgery of the 20th century. Whereas replacements are available for the shoulder, ankle, elbow, and knee, hip accounts particularly for the most surgical interventions. In France, 100,000 hip joints per year are replaced and all the implants consist of a sliding pair represented by a hard counter face, either metal or ceramic, and commonly a softer polymer. Ultra high molecular weight polyethylene (UHMWPE) was first used in joint replacement in the early 1960s. Since that time, it had been the dominant polymer for bearing surfaces in orthopaedic surgery. However, generation of UHMPWE wear debris from bearing surfaces in patients is the major problem for long term implants. Both volume and morphology of the wear particles determine the response of the body to debris, and subsequent effects on secure fixing. This paper presents a review of the type of particles most frequently found in biopsies of tissues from explanted prostheses. Indeed, the size and the amount of these debris are very important factors for a better understanding of wear and corrosion wear processes in artificial joints. Real wear particles are also described in this paper. (c) 2006 Elsevier B.V. All rights reserved.