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Related Experiment Videos

Apoptosis in peri-implant tissue.

S Stea1, M Visentin, D Granchi

  • 1Laboratory for Medical Technology, Istituti Ortopedici Rizzoli, Bologna, Italy. susanna.stea@ior.it

Biomaterials
|June 13, 2000
PubMed
Summary

Metal debris from hip implants significantly increases apoptotic cell death in surrounding tissues. This finding highlights a previously underestimated mechanism of cellular damage in implant failure, distinct from bone cement or implant duration.

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Area of Science:

  • Biomaterials Science
  • Cell Biology
  • Orthopedic Surgery

Background:

  • Loosened hip joint prostheses are a significant clinical challenge.
  • Understanding cellular responses to implant wear debris is crucial for improving implant longevity.
  • Apoptosis, or programmed cell death, is a key cellular process that can be triggered by various stimuli.

Purpose of the Study:

  • To investigate the correlation between wear debris from hip joint prostheses and apoptosis in surrounding tissues.
  • To determine if bone cement or implant failure duration influences apoptosis.
  • To elucidate the role of apoptosis in implant loosening.

Main Methods:

  • Analysis of 54 biopsies from tissues around loosened hip joint prostheses.
  • In situ identification of apoptotic cells via detection of DNA strand breaks using fluoresceine-dUTP and terminal deoxynucleotidyl transferase (TdT).

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  • Correlation of apoptotic cell presence with types of wear debris (metal, plastic, ceramic) and bone cement usage.

    • Main Results:

    • A significantly higher percentage of apoptotic cells (24%) was observed in tissues with metal wear particles compared to tissues with no wear (6%), plastic wear (2.8%), or ceramic wear (1.5%).
    • Apoptosis was not found to be related to the use of bone cement.
    • Apoptosis was not correlated with the time to implant failure.

    Conclusions:

    • Metal wear debris from hip implants is a significant inducer of apoptosis in surrounding tissues.
    • Apoptosis represents an important, potentially underestimated, mechanism of tissue damage in implants associated with metal ion release.
    • The findings suggest that apoptosis plays a role in implant loosening, independent of bone cement or implant duration.