Orthopaedic implant components as a source of nanoparticles Ingrid Milošev Jožef Stefan Institute, Ljubljana, a Jožef Stefan Institute, Ljubljana, a Valdoltra Orthopaedic Hospital, Ankaran, S Valdoltra Orthopaedic Hospital, Ankaran, S Conference on Nano-Safety, Conference on Nano-Safety, Ljubljana, 22-24 April 2009 Ljubljana, 22-24 April 2009
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Orthopaedic implant components as a source of nanoparticles Ingrid Milošev Jožef Stefan Institute, Ljubljana, and Valdoltra Orthopaedic Hospital, Ankaran,
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Orthopaedic implant components as a source of
nanoparticlesIngrid Milošev
Jožef Stefan Institute, Ljubljana, andJožef Stefan Institute, Ljubljana, andValdoltra Orthopaedic Hospital, Ankaran, SloveniaValdoltra Orthopaedic Hospital, Ankaran, Slovenia
Conference on Nano-Safety, Conference on Nano-Safety, Ljubljana, 22-24 April 2009Ljubljana, 22-24 April 2009
Number of implants and devices for USA (global numbers 2-3 times higher)
Indications for total hip replacement: - osteoarthritis- osteoarthritis secondary to dysplasia- aseptic femoral head necrosis- rheumatoid arthritis- post-traumatic arthritis
Ingrid Milosev
Radigraph image of THR: (A) Post implantation (B) Prior revision surgery – aseptic loosening with
osteolytic zones along the stem and changed cup position
Animation: http://www.wmt.com/
Survivorship curve is a long-term indicator of the successfulness
of a particular prosthesis.
Data are created based in the Valdoltra
Register of hip and knee prostheses.
fu12,5010,007,505,002,500,00
Cum
Sur
viva
l
1,00
0,95
0,90
0,85
0,80
MP-censoredMM-censoredMPMM
proteza
Time in situ / yearsTime in situ / years
Cu
mu
lati
ve s
urv
ivors
hip
Cu
mu
lati
ve s
urv
ivors
hip
At 12 years post-op, 90% At 12 years post-op, 90% of prostheses still of prostheses still
implantedimplanted
826 hip revision operations in the period from 2002 to 2007
585
183
258
144
6748
30 26 23 8 19 20
0
100
200
300
400
500
600
700
Loosening Looseningof acetab.
part
Looseningof femoral
part
Looseningof bothparts
Deepinfection
Fracture ofthe femur
Dislocation Two-stagerevision
Osteolysisof femoral
part
Pain Fracture ofthe
prosthesis
Other
Reason for revision
Num
ber
of r
evis
ions
71%
Aseptic loosening related to the formation of wear debris and consequent osteolysis is reason for revision in >70%.
Origin of wearSurface wear damageWear particles
Polyethylene particles Metal particlesCement particles