The biological response to orthopedic implants for joint replacement. II: Polyethylene, ceramics, PMMA, and the foreign body reaction

• Published in: Journal of biomedical materials research. Part B, Applied biomaterials Vol. 105; no. 6; pp. 1685 - 1691
• Main Authors: Gibon, Emmanuel, Córdova, Luis A, Lu, Laura, Lin, Tzu-Hua, Yao, Zhenyu, Hamadouche, Moussa, Goodman, Stuart B
• Format: Journal Article
• Language: English
• Published: United States Wiley Subscription Services, Inc 01.08.2017
• Subjects: Alloys; Animals; Biocompatibility; Biomaterials; Biomechanics; Biomedical materials; Bone biomaterials; Bone-Implant Interface; Byproducts; Ceramics; Ceramics - adverse effects; Ceramics - chemistry; Foreign-Body Reaction - etiology; Foreign-Body Reaction - metabolism; Foreign-Body Reaction - pathology; Hip Prosthesis - adverse effects; Humans; Infections; Inflammation; Loosening; Materials research; Materials science; Mechanical failure; Metals; Osteolysis; Particulate composites; Polyethylene; Polyethylenes; Polymer matrix composites; Polymers; Polymethyl methacrylate; Polymethyl Methacrylate - adverse effects; Polymethylmethacrylate; Polyurethanes - adverse effects; Polyurethanes - chemistry; Prostheses; Surgical implants; biological response; foreign body response; biomaterials; inflammation; orthopedic implants
• ISSN: 1552-4973; 1552-4981
• DOI: 10.1002/jbm.b.33676

Novel evidence-based prosthetic designs and biomaterials facilitate the performance of highly successful joint replacement (JR) procedures. To achieve this goal, constructs must be durable, biomechanically sound, and avoid adverse local tissue reactions. Different biomaterials such as metals and their alloys, polymers, ceramics, and composites are currently used for JR implants. This review focuses on (1) the biological response to the different biomaterials used for TJR and (2) the chronic inflammatory and foreign-body response induced by byproducts of these biomaterials. A homeostatic state of bone and surrounding soft tissue with current biomaterials for JR can be achieved with mechanically stable, infection free and intact (as opposed to the release of particulate or ionic byproducts) implants. Adverse local tissue reactions (an acute/chronic inflammatory reaction, periprosthetic osteolysis, loosening and subsequent mechanical failure) may evolve when the latter conditions are not met. This article (Part 2 of 2) summarizes the biological response to the non-metallic materials commonly used for joint replacement including polyethylene, ceramics, and polymethylmethacrylate (PMMA), as well as the foreign body reaction to byproducts of these materials. © 2016 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 105B: 1685-1691, 2017.