Immunological Responses to Total Hip Arthroplasty
The use of total hip arthroplasties (THA) has been continuously rising to meet the demands of the increasingly ageing population. To date, this procedure has been highly successful in relieving pain and restoring the functionality of patients’ joints, and has significantly improved their quality of...
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| Format: | Article |
| Language: | English |
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MDPI AG
2017-08-01
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| Series: | Journal of Functional Biomaterials |
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| Online Access: | https://www.mdpi.com/2079-4983/8/3/33 |
| _version_ | 1811306853564416000 |
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| author | Kenny Man Lin-Hua Jiang Richard Foster Xuebin B Yang |
| author_facet | Kenny Man Lin-Hua Jiang Richard Foster Xuebin B Yang |
| author_sort | Kenny Man |
| collection | DOAJ |
| description | The use of total hip arthroplasties (THA) has been continuously rising to meet the demands of the increasingly ageing population. To date, this procedure has been highly successful in relieving pain and restoring the functionality of patients’ joints, and has significantly improved their quality of life. However, these implants are expected to eventually fail after 15–25 years in situ due to slow progressive inflammatory responses at the bone-implant interface. Such inflammatory responses are primarily mediated by immune cells such as macrophages, triggered by implant wear particles. As a result, aseptic loosening is the main cause for revision surgery over the mid and long-term and is responsible for more than 70% of hip revisions. In some patients with a metal-on-metal (MoM) implant, metallic implant wear particles can give rise to metal sensitivity. Therefore, engineering biomaterials, which are immunologically inert or support the healing process, require an in-depth understanding of the host inflammatory and wound-healing response to implanted materials. This review discusses the immunological response initiated by biomaterials extensively used in THA, ultra-high-molecular-weight polyethylene (UHMWPE), cobalt chromium (CoCr), and alumina ceramics. The biological responses of these biomaterials in bulk and particulate forms are also discussed. In conclusion, the immunological responses to bulk and particulate biomaterials vary greatly depending on the implant material types, the size of particulate and its volume, and where the response to bulk forms of differing biomaterials are relatively acute and similar, while wear particles can initiate a variety of responses such as osteolysis, metal sensitivity, and so on. |
| first_indexed | 2024-04-13T08:52:58Z |
| format | Article |
| id | doaj.art-24a1de8cca1b415b8469204f2bd44982 |
| institution | Directory Open Access Journal |
| issn | 2079-4983 |
| language | English |
| last_indexed | 2024-04-13T08:52:58Z |
| publishDate | 2017-08-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Functional Biomaterials |
| spelling | doaj.art-24a1de8cca1b415b8469204f2bd449822022-12-22T02:53:24ZengMDPI AGJournal of Functional Biomaterials2079-49832017-08-01833310.3390/jfb8030033jfb8030033Immunological Responses to Total Hip ArthroplastyKenny Man0Lin-Hua Jiang1Richard Foster2Xuebin B Yang3Biomaterials and Tissue Engineering Group, School of Dentistry, University of Leeds, Leeds LS2 9JT, UKSchool of Biomedical Sciences, Faculty of Biological Sciences, University of Leeds, Leeds LS2 9JT, UKSchool of Chemistry, University of Leeds, Leeds LS2 9JT, UKBiomaterials and Tissue Engineering Group, School of Dentistry, University of Leeds, Leeds LS2 9JT, UKThe use of total hip arthroplasties (THA) has been continuously rising to meet the demands of the increasingly ageing population. To date, this procedure has been highly successful in relieving pain and restoring the functionality of patients’ joints, and has significantly improved their quality of life. However, these implants are expected to eventually fail after 15–25 years in situ due to slow progressive inflammatory responses at the bone-implant interface. Such inflammatory responses are primarily mediated by immune cells such as macrophages, triggered by implant wear particles. As a result, aseptic loosening is the main cause for revision surgery over the mid and long-term and is responsible for more than 70% of hip revisions. In some patients with a metal-on-metal (MoM) implant, metallic implant wear particles can give rise to metal sensitivity. Therefore, engineering biomaterials, which are immunologically inert or support the healing process, require an in-depth understanding of the host inflammatory and wound-healing response to implanted materials. This review discusses the immunological response initiated by biomaterials extensively used in THA, ultra-high-molecular-weight polyethylene (UHMWPE), cobalt chromium (CoCr), and alumina ceramics. The biological responses of these biomaterials in bulk and particulate forms are also discussed. In conclusion, the immunological responses to bulk and particulate biomaterials vary greatly depending on the implant material types, the size of particulate and its volume, and where the response to bulk forms of differing biomaterials are relatively acute and similar, while wear particles can initiate a variety of responses such as osteolysis, metal sensitivity, and so on.https://www.mdpi.com/2079-4983/8/3/33total hip arthroplastyimplant materialswear particlesimmunological response |
| spellingShingle | Kenny Man Lin-Hua Jiang Richard Foster Xuebin B Yang Immunological Responses to Total Hip Arthroplasty Journal of Functional Biomaterials total hip arthroplasty implant materials wear particles immunological response |
| title | Immunological Responses to Total Hip Arthroplasty |
| title_full | Immunological Responses to Total Hip Arthroplasty |
| title_fullStr | Immunological Responses to Total Hip Arthroplasty |
| title_full_unstemmed | Immunological Responses to Total Hip Arthroplasty |
| title_short | Immunological Responses to Total Hip Arthroplasty |
| title_sort | immunological responses to total hip arthroplasty |
| topic | total hip arthroplasty implant materials wear particles immunological response |
| url | https://www.mdpi.com/2079-4983/8/3/33 |
| work_keys_str_mv | AT kennyman immunologicalresponsestototalhiparthroplasty AT linhuajiang immunologicalresponsestototalhiparthroplasty AT richardfoster immunologicalresponsestototalhiparthroplasty AT xuebinbyang immunologicalresponsestototalhiparthroplasty |