Hallab Nadim James, McAllister Kyron, Brady Mark, Jarman-Smith Marcus
Department of Orthopedic Surgery, Rush University Medical Center, Chicago, Illinois 60612; BioEngineering Solutions Inc., Oak Park, Illinois 60304.
J Biomed Mater Res B Appl Biomater. 2012 Feb;100(2):480-92. doi: 10.1002/jbm.b.31974. Epub 2011 Nov 21.
Biologic reactivity to orthopedic implant debris is generally the main determinant of long-term clinical performance where released polymeric particles of Ultra-high molecular weight polyethylene (UHMWPE) remain the most prevalent debris generated from metal-on-polymer bearing total joint arthroplasties. Polymeric alternatives to UHMWPE such as polyetherether-ketone (PEEK) may have increased wear resistance but the bioreactivity of PEEK-OPTIMA particles on peri-implant inflammation remains largely uncharacterized. We evaluated human monocyte/macrophage responses (THP-1s and primary human) when challenged by PEEK-OPTIMA, UHMWPE, and X-UHMWPE particles of three particle sizes (0.7 um, 2 um, and 10 um) at a dose of 20 particles-per-cell at 24- and 48-h time points. Macrophage responses were measured using cytotoxicity assays, viability assays, proliferation assays and cytokine analysis (IL-1b, IL-6, IL-8, MCP-1, and TNF-α). In general, there were no significant differences between PEEK-OPTIMA, UHMWPE, and X-UHMWPE particles on macrophage viability or proliferation. However, macrophages demonstrated greater cytotoxicity responses to UHMWPE and X-UHMWPE than to PEEK-OPTIMA at 24 and 48 h, where 0.7 μm-UHMWPE particles produced the highest amount of cytotoxicity. Particles of X-UHMWPE more than PEEK-OPTIMA and UHMWPE induced IL-1β, IL-6, MCP-1, and TNF-α at 24 h, p < 0.05 (no significant differences at 48 h). On average, cytokine production was more adversely affected by larger 10 μm particles than by 0.7 and 2 μm sized particles. While limitations of in vitro analysis apply to this study, PEEK-OPTIMA particles were more biocompatible than UHMWPE particles, in that they induced less inflammatory cytokine responses and thus, in part, demonstrates that PEEK-OPTIMA implant debris does not represent an increased inflammatory risk over that of UHMWPE.
对骨科植入物碎片的生物反应通常是长期临床性能的主要决定因素，其中超高分子量聚乙烯（UHMWPE）释放的聚合物颗粒仍然是金属对聚合物承重全关节置换术中产生的最普遍的碎片。UHMWPE的聚合物替代品，如聚醚醚酮（PEEK），可能具有更高的耐磨性，但PEEK-OPTIMA颗粒对植入物周围炎症的生物反应性在很大程度上仍未得到充分研究。我们评估了人单核细胞/巨噬细胞（THP-1细胞和原代人细胞）在24小时和48小时时间点受到三种粒径（0.7微米、2微米和10微米）的PEEK-OPTIMA、UHMWPE和交联UHMWPE（X-UHMWPE）颗粒刺激时的反应，剂量为每个细胞20个颗粒。使用细胞毒性测定、活力测定、增殖测定和细胞因子分析（IL-1β、IL-6、IL-8、MCP-1和TNF-α）来测量巨噬细胞反应。总体而言，PEEK-OPTIMA、UHMWPE和X-UHMWPE颗粒在巨噬细胞活力或增殖方面没有显著差异。然而，在24小时和48小时时，巨噬细胞对UHMWPE和X-UHMWPE的细胞毒性反应比对PEEK-OPTIMA更大，其中0.7微米的UHMWPE颗粒产生的细胞毒性最大。在24小时时，X-UHMWPE颗粒比PEEK-OPTIMA和UHMWPE颗粒更能诱导IL-1β、IL-6、MCP-1和TNF-α，p<0.0
