Early aseptic loosening of a total knee arthroplasty due to Gore-Tex particle-induced osteolysis.
ABSTRACT Anterior cruciate ligament reconstruction with the use of synthetic graft material has been used as an alternative to biologic grafts. The use of these grafts has largely been abandoned in reconstruction of the anterior cruciate ligament because of mechanical failure of the graft and production of wear debris leading to synovitis and recurrent effusions. This article presents a case of early, extensive periprosthetic osteolysis around a total knee arthroplasty associated with wear debris from retained fragments of a Gore-Tex (WL Gore and associates, Inc, Flagstaff, Ariz) (polytetrafluoroethylene) anterior cruciate ligament graft.
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ABSTRACT: The authors first reviewed the history of clinical application of artificial ligaments. Then, the status of clinical application of artificial ligaments was detailed. Some artificial ligaments possessed comparable efficacy to, and fewer postoperative complications than, allografts and autografts in ligament reconstruction, especially for the anterior cruciate ligament. At the end, the authors focused on the development of two types of artificial ligaments: polyethylene glycol terephthalate artificial ligaments and tissue-engineered ligaments. In conclusion, owing to the advancements in surgical techniques, materials processing, and weaving methods, clinical application of some artificial ligaments so far has demonstrated good outcomes and will become a trend in the future.02/2015; 6(1). DOI:10.1016/j.asmart.2014.11.001
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ABSTRACT: We present a concept for a new regenerative and resorbable prosthesis for tendon and ligament and characterize the physicomechanical and biological behavior of one of its components, a hollow braid made of poly-lactide acid (PLA) which is the load-bearing part of the prosthesis concept. The prosthesis consists of a braid, microparticles in its interior serving as cell carriers, and a surface non-adherent coating, all these parts being made of biodegradable materials. The PLA braid has a nonlinear convex stress-strain behavior with a Young modulus of 1370 ± 90 MPa in the linear, stretched state, and after 12 months of hydrolytic degradation the modulus shows a reduction by a factor of four. Different disinfection methods were tested as to their efficiency in cleansing the braid and preparing it for cell culture. Fibroblasts of L929 line were grown on the PLA braid for 14 days, showing good adherence and proliferation. These studies validate the PLA braid for the intended purpose in the regenerative prosthesis concept. © 2013 Wiley Periodicals, Inc. J Biomed Mater Res Part A, 2013.Journal of Biomedical Materials Research Part A 01/2013; DOI:10.1002/jbm.a.34633 · 2.83 Impact Factor
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ABSTRACT: The biological response to orthopaedic wear debris is central to peri-prosthetic tissue inflammation and osteolysis, through mechanisms that include local inflammatory cytokine production. In particular, interleukin-1 beta (IL-1beta) and tumor necrosis factor-alpha (TNF-alpha|) are generated in high quantities following monocyte accumulation in periprosthetic inflammatory tissue, and these cytokine combine with other inflammatory mediators to trigger osteolysis. Since the precise mechanisms involved in debris-associated inflammation remain unclear, it is important to understand how wear debris particles initially interact with inflammatory cells. We have previously demonstrated that the severity of the inflammation response is influenced by the size, shape, and quantity of particles accumulated in tissues. The current in vitro and in vivo results indicate that heat-shock protein (Hsp) expression is elevated when monocytes are exposed to wear debris particles. We have also addressed the mechanisms by which heat-shock protein 60 (Hsp60) positively modulates inflammatory cytokines via Toll-like receptor-4 (TLR4) signal transduction pathway on mononuclear cells. Furthermore, down-regulation of TLR4 expression using antisense oligonucleotides targeted to TLR4 mRNA suppressed cytokine production in both exogenous Hsp60 and particles stimulated cultures. Collectively, these data indicate that monocytic Hsp60 is an additional inducible immunoregulatory mediator in response to particle-induced cell stress.Journal of Biomedical Materials Research Part A 01/2009; 92(4):1373-81. DOI:10.1002/jbm.a.32474 · 2.83 Impact Factor