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Joint German Congress of Orthopaedics and Trauma Surgery

02. - 06.10.2006, Berlin

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Local and systemic reactions to wear debris of titanium and stainless steel - an in-vivo study

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  • B. Burian - Klinik und Poliklinik für Orthopädie, Rheinische-Friedrich-Wilhelms Universität Bonn, Bonn, Germany
  • M.A. Wimmer - Department of Orthopedics, Rush Medical Center, Chicago, United States of America
  • C. Sprecher - Bio-Performance, AO-Forschungsinstitut, Davos, Switzerland
  • J. Kunze - Abteilung Chemische Analytik, TU Hamburg-Harburg, Hamburg, Germany
  • P.H. Pennekamp - Klinik und Poliklinik für Orthopädie, Rheinische-Friedrich-Wilhelms Universität Bonn, Bonn, Germany
  • C.N. Kraft - Klinik und Poliklinik für Orthopädie, Heinrich-Heine-Universität Düsseldorf, Düsseldorf, Germany

Deutscher Kongress für Orthopädie und Unfallchirurgie. 70. Jahrestagung der Deutschen Gesellschaft für Unfallchirurgie, 92. Tagung der Deutschen Gesellschaft für Orthopädie und Orthopädische Chirurgie und 47. Tagung des Berufsverbandes der Fachärzte für Orthopädie. Berlin, 02.-06.10.2006. Düsseldorf, Köln: German Medical Science; 2006. DocE.3.1-278

The electronic version of this article is the complete one and can be found online at: http://www.egms.de/en/meetings/dgu2006/06dgu0081.shtml

Published: September 28, 2006

© 2006 Burian et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

Outline

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Aim: The aim of this study was to elucidate whether there is a systemic spread of wear debris from peripheraly applicated stainless steel and titanium particles into the blood and subsequently to parenchymatous organs. Furthermore we report on histological findings at the implantation site.

Method: In Syrian Gold hamsters we implanted 2mm3 wear debris of stainless steel and titanium into the dorsal skin fold chamber. Over a period of 2 weeks we took blood samples and afterwards explanted the implant area, the heart, lung, liver and spleen. One half of the organs and the implant area were used for histological analysis. The other half of the organs and the blood samples were analysed by optical emission spectrometer with inductively coupled plasma and graphite furnace atomic absorption spectrophotometry for the content of chromium, nickel and titanium.

Results: In the group with titanium particles the histological analysis of the implant site showed moderate phagocyted wear in granulocytes yet no other pathological findings. Animals treated with stainless steel wear had a massive inflammatory reaction, in some cases leading to necrosis. The analysis of the blood and one half of the organs showed increased levels of chromium and already 24 hours after implantation raised values for nickel. The result of the hamsters treated with tinanium showed significantly elevated levels of titanium ions in the organs, yet not in the blood samples. Histology of the organs did not reveal pathologic findings.

Conclusion: In this study we could show a massive inflammatory reaction for stainless steel wear in contrast to titanium wear at the implantation site. The elevated blood levels of chromium and increased values of metalls in the organs suggest the haematogenic distribution of ions from the peripherally implanted wear.

Key words: osteosynthesis, wear debris, hematological distribution, organ analysis