Scientists studied Immunological Responses to Total Hip Arthroplasty

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Scientists studied Immunological Responses to Total Hip Arthroplasty

Total hip arthroplasties (THA) have been fabulously successful in relieving pain from the suffered joints and restoring healthy joint function, resulting in consequent enhancement in patient’s quality of life. However, the implant may fail later on and require revision surgery, which can incur an enhanced risk of the problem and auxiliary costs.

In 1989, Kavanagh et al. (1989) reexamined the execution of 166 Charnley THA accomplish at the Mayo Clinic after a minimum of 15 years postoperatively. That indicates that the chance of failure was 0.9% at one year, 4.1% at five years, 8.9% at ten years, and 12.7% at fifteen years. Using total hip arthroplasties (THA) has been continuously enhancing to meet the demands of the increasingly aging population. To date, this process has been highly affluent in relieving pain and restoring the functionality of patients’ joints and has consequently improved their quality of life. However, these implants are presumed to eventually fail after 15–25 years in situ due to slow progressive inflammatory reaction at the bone-implant interface. Such inflammatory reactions are primarily conciliated by immune cells such as macrophages, triggered by implant wear particles. As a result, aseptic loosening is the primary cause for revision surgery over the mid and long-term and is liable for more than 70% of hip changes. In some patients implanted with metal-on-metal (MoM) implant, the metallic implant wear particles can give increase to metal sensitivity. Consequently, engineering biomaterials, which are immunologically inert or help the healing process, need an in-depth understanding of the host inflammatory and wound-healing reaction to implanted materials.

This review explores the immunological response initiated by biomaterials extensively used in THA, ultra-high-molecular-weight polyethylene (UHMWPE), cobalt chromium (CoCr), and alumina ceramics. The biological reaction of these biomaterials in bulk and particulate forms are also explained. In conclusion, the immunological responses to the amount and particulate biomaterials differ significantly based on the implant material classes. The size and volume of particulate, and where the reaction to bulk forms of varying biomaterials are moderately acute and similar, while wear particles can initiate a variety of response such as osteolysis, metal sensitivity, and so on.


J. Funct. Biomater.

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Original title of the article:

Immunological Responses to Total Hip Arthroplasty


Kenny; M. et al.


Diagnostic, Pain, Total hip arthroplasties, Hip, Immunological Responses
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