TY - JOUR
T1 - Cobalt and Chromium Ion Release in Metal-on-Polyethylene and Ceramic-on-Polyethylene THA
T2 - A Simulator Study With Cellular and Microbiological Correlations
AU - Wyles, Cody C.
AU - Paradise, Christopher R.
AU - Masters, Thao L.
AU - Patel, Robin
AU - van Wijnen, Andre J.
AU - Abdel, Matthew P.
AU - Trousdale, Robert T.
AU - Sierra, Rafael J.
N1 - Funding Information:
Source of funding: A minority portion of this study was funded by a research support grant from CeramTec (Plochingen, Germany). The remainder was funded with institutional resources.
Publisher Copyright:
© 2019 Elsevier Inc.
PY - 2020/4
Y1 - 2020/4
N2 - Background: The aims of this study were to determine the levels of cobalt (Co) and chromium (Cr) ions generated in simulators from metal-on-polyethylene (MoP) and ceramic-on-polyethylene (CoP) constructs. Furthermore, we aimed to investigate the cytotoxic effect of these ion levels on native tissues and their potential to modify periprosthetic joint infection risk. Methods: We used in vitro culture of human adipose-derived mesenchymal stem cells (AMSCs) and Staphylococcus epidermidis cultures, respectively. Ten hip simulator constructs (5 MoP and 5 CoP) were assembled and run for 1,000,000 cycles in bovine serum and evaluated for CoCr concentration. Cytotoxicity and growth impact on AMSCs and S. epidermidis was compared between CoCr and inert silicon dioxide. Results: After 1,000,000 cycles, mean MoP and CoP Co concentration was 2264 and 0.6 ng/mL, respectively (P < .001). Mean MoP and CoP Cr concentration was 217 and 4.3 ng/mL, respectively (P < .001). Mean MoP Co:Cr ratio was 10:1. Co ions were significantly more toxic to human AMSCs than control silicon dioxide in a dose-response manner (P < .001). S. epidermidis growth was not significantly impacted by Co concentrations observed in the simulators. Conclusion: MoP constructs built in ideal conditions generated substantial CoCr debris, highlighting a baseline risk with these implants that may be exacerbated by host factors or imperfect surgical technique. Evaluation of impact on AMSCs suggests that debris levels produced under simulator conditions can be cytotoxic. In addition, these concentrations did not potentiate or inhibit S. epidermidis growth, suggesting that elevated periprosthetic joint infection rates with adverse local tissue reaction are related to other factors potentially associated with tissue necrosis.
AB - Background: The aims of this study were to determine the levels of cobalt (Co) and chromium (Cr) ions generated in simulators from metal-on-polyethylene (MoP) and ceramic-on-polyethylene (CoP) constructs. Furthermore, we aimed to investigate the cytotoxic effect of these ion levels on native tissues and their potential to modify periprosthetic joint infection risk. Methods: We used in vitro culture of human adipose-derived mesenchymal stem cells (AMSCs) and Staphylococcus epidermidis cultures, respectively. Ten hip simulator constructs (5 MoP and 5 CoP) were assembled and run for 1,000,000 cycles in bovine serum and evaluated for CoCr concentration. Cytotoxicity and growth impact on AMSCs and S. epidermidis was compared between CoCr and inert silicon dioxide. Results: After 1,000,000 cycles, mean MoP and CoP Co concentration was 2264 and 0.6 ng/mL, respectively (P < .001). Mean MoP and CoP Cr concentration was 217 and 4.3 ng/mL, respectively (P < .001). Mean MoP Co:Cr ratio was 10:1. Co ions were significantly more toxic to human AMSCs than control silicon dioxide in a dose-response manner (P < .001). S. epidermidis growth was not significantly impacted by Co concentrations observed in the simulators. Conclusion: MoP constructs built in ideal conditions generated substantial CoCr debris, highlighting a baseline risk with these implants that may be exacerbated by host factors or imperfect surgical technique. Evaluation of impact on AMSCs suggests that debris levels produced under simulator conditions can be cytotoxic. In addition, these concentrations did not potentiate or inhibit S. epidermidis growth, suggesting that elevated periprosthetic joint infection rates with adverse local tissue reaction are related to other factors potentially associated with tissue necrosis.
KW - cobalt
KW - ions
KW - periprosthetic joint infection
KW - simulator
KW - total hip arthroplasty
KW - trunnionosis
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U2 - 10.1016/j.arth.2019.11.031
DO - 10.1016/j.arth.2019.11.031
M3 - Article
C2 - 31852609
AN - SCOPUS:85076535311
SN - 0883-5403
VL - 35
SP - 1123
EP - 1129
JO - Journal of Arthroplasty
JF - Journal of Arthroplasty
IS - 4
ER -