실패한 시멘트형 및 무시멘트형 인공고관절 대퇴스템으로부터 추출한 마멸입자에 대한 분석 = Analysis of Wear Debris Retrieved from Failed Cemented and Cementless Hip Prostheses

다국어 초록 (Multilingual Abstract)

Macrophages and giant cells activated by particulate debris play an important role in osteolysis and aseptic loosening of prosthetic hip components. Histological amd chemical analysis of interface membrane retrieved from failed hip prostheses have demonstrated that a large number of polyethylene( PE ) particles induce a major inflammatory reaction by activating macrophages. But, there were still debatable reports concerning inflammatory reaction between cemented and cementless hip prostheses. The objective of this study was to isolate particles from failed cemented and cementless hip prostheses interface membranes and characterize their morphology using Scanning Electron Microscopy (SEM). We obtained 18 interface membrane from failed femoral components(11; cementless, 7; cemened). Tissues were digested using a papain buffer and then hydrolysed using 4M KOH. After several washing and centrifugation, particles were extracted and seperated using a established protocol in which suspected PE debris is retrieved from a ethanol-hexane interface and suspended in ethanol prior to analysis. A SEM in conjunction with an Energy Dispersive x-ray(EDX) spectroscopy unit was used to conduct elemental and morphologic analysis: PE particles were variable; small rounded(mostly submicron sized, 98%) and its agglomeration with variable size up to 15 u were dispersed on whole fields. More larger irregular flake shaped particles ranged from 9-18 u were seen sparsely. Sometimes, elongated thick beaded or scale like(2-3 u) and thin fibrils were seen. We couldn't find any significant differences in morphology of PE particle(ie, shape, size and distribution) between cemented and cementless hip prostheses. It was very difficult to detect metal particles in which only 2 Titanum particles were found, suggesting further analysis is necessary. We also characterized cement(PMMA, Barium), bone and ather contaminant particles.