Consequences of particles formation - Urad Republike Slovenije 颗粒形成——乌拉特Republike维尼亚绿党的后果.pptVIP

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2018-04-13 发布于江西
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Consequences of particles formation - Urad Republike Slovenije 颗粒形成——乌拉特Republike维尼亚绿党的后果.ppt

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Consequences of particles formation - Urad Republike Slovenije 颗粒形成——乌拉特Republike维尼亚绿党的后果.ppt

Consequences of particles formation Increase in total surface area Local tissue response and release of cytokines involved in bone resorption Consequences of particles formation Increase in total surface area Local tissue response and release of cytokines involved in bone resorption Systemic effects Consequences of particles formation Increase in total surface area Local tissue response and release of cytokines involved in bone resorption Systemic effects Transport of particles to distant organs Potential for carcinogenesis and hypersensitivity Metal sensitivity Willert HG et al., Osteologie (2000), World Tribology Forum in Artroplasty (2001) Delayed Type Hypersensitivity (DTH) related to the use of metal-on-metal prostheses: Diffuse and perivascularly oriented lymphocyte infiltration Macrophages (sometimes with drop-like inclusions) Plasma cells* Infiltrates of B-lymphocytes* Massive fibrin exudations* Clinical status: pain Concluding remarks Benefits of total joint replacements are most important fot the patient. We should be aware, however, that loosened implant components are a source of various types of nanoparticles – metal, polyethylene, PMMA and ceramic. Knowledge on their morphology and composition contributes to the understanding of failure mechanism. Efforts are directed to the prolongation of life-time of implants by increasing their wear resistance. Joint collaboration studies between medical and research community are necessary. Acknowledgments Orhopaedic surgeons at the Valdoltra Orthopaedic Hospital (V. Pi?ot, R. Treb?e, S. Kova?) Vesna Leva?i?, MD, Arthroplasty register Prof. Andrej Coer, University of Primorska, pathology specialist Dr. Maja Rem?kar, Jo?ef Stefan Institute Ceramic particles origin: femoral headacetabular inlay Primary hip and knee total hip replacements at the Valdoltra Orthopaedic Hospital Bone cement particles origin: femoral stem acetabular cup Ceramic wear particles * Biological response B.F. Mor