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Total disc replacements, comprising all-metal articulations, are compromised by wear and particle production. Metallic wear debris and ions trigger a range of biological responses including inflammation, genotoxicity, cytotoxicity, hypersensitivity and pseudotumour formation, therefore we hypothesise that, due to proximity to the spinal cord, glial cells may be adversely affected.
Clinically relevant cobalt chrome (CoCr) and stainless steel (SS) wear particles were generated using a six-station pin-on-plate wear simulator. The effects of metallic particles (0.5–50 μm3 debris per cell) and metal ions on glial cell viability, cellular activity (glial fibrillary acidic protein (GFAP) expression) and DNA integrity were investigated in 2D and 3D culture using live/dead, immunocytochemistry and a comet assay, respectively.
CoCr wear particles and ions caused significant reductions in glial cell viability in both 2D and 3D culture systems. Stainless steel particles did not affect glial cell viability or astrocyte activation. In contrast, ions released from SS caused significant reductions in glial cell viability, an effect that was especially noticeable when astrocytes were cultured in isolation without microglia. DNA damage was observed in both cell types and with both biomaterials tested. CoCr wear particles had a dose-dependent effect on astrocyte activation, measured through expression of GFAP.
The results from this study suggest that microglia influence the effects that metal particles have on astrocytes, that SS ions and particles play a role in the adverse effects observed and that SS is a less toxic biomaterial than CoCr alloy for use in spinal devices.
These slides can be retrieved under Electronic Supplementary Material.
Online Resources 1. High-resolution scanning electron micrograph and corresponding trace produced by energy-dispersive X-ray analysis (EDX) of cobalt chromium particles (PPTX 717 kb)586_2019_6177_MOESM1_ESM.pptx
Supplementary material 2 (PPTX 716 kb)586_2019_6177_MOESM2_ESM.pptx
Online Resources 2. High-resolution scanning electron micrograph and corresponding trace produced by energy-dispersive X-ray analysis (EDX) of stainless steel particles (PPTX 64 kb)586_2019_6177_MOESM3_ESM.pptx
Supplementary material 4 (PPTX 58 kb)586_2019_6177_MOESM4_ESM.pptx
Supplementary material 5 (PPTX 9687 kb)586_2019_6177_MOESM5_ESM.pptx
BBC News (2012) http://www.bbc.co.uk/news/health-17337993. Accessed 15 Apr 2014
Pasko K (2016) Ceramic coatings for cervical total disc replacement. Ph.D. thesis, University of Leeds
Pare PE, Chan FW, Powell ML et al (2007) Wear characteristics of the A-MAV anterior motion replacement using a spine wear simulator. Wear 263:1055–1059 CrossRef
Kurtz SM, Ciccarelli L, Siskey R et al (2012) Comparison of in vivo and simulator retrieved metal-on-metal cervical disc replacements. Int J Spine Surg 6:145–156 CrossRef
Guyer RD, Shellock J, MacLennan B et al (2013) Early failure of metal-on-metal artificial disc prostheses associated with lymphocytic reaction: diagnosis and treatment experience in four cases. Spine 36:E492–E497 CrossRef
Mody DR, Esses SI, Heggeness MH (1994) A histologic study of soft tissue reactions to spinal implants. Spine 19:1153–1156 CrossRef
Takahashi S, Delecrin J, Passuti N (2001) Intraspinal metallosis causing delayed neurologic symptoms aster spinal instrumentation surgery. Spine 26:1495–1499 CrossRef
Gaine WJ, Andrew SM, Chadwick P et al (2001) Late operative site pain with isola posterior instrumentation requiring implant removal. Spine 26:583–587 CrossRef
Senaran H, Atilla P, Kaymaz F et al (2004) Ultrastructural analysis of metallic debris and tissue reaction around spinal implants in patients with late operative site pain. Spine 29:1618–1623 CrossRef
Cunningham BW, Orbegoso CM, Dmitriev AE et al (2002) The effect of titanium particulate on development and maintenance of a posterolateral spine arthrodesis. Spine 27:1971–1981 CrossRef
Cunningham BW, Hallab NJ, Hu N et al (2013) Epidural application of spinal instrumentation particulate wear debris: a comprehensive evaluation of neurotoxicity using an in vivo animal model. J Neurosurg Spine 19:336–350 CrossRef
Wang JC, Yu WD, Sandhu HS et al (2002) Metal debris from titanium spinal implants. Spine 24:899–903 CrossRef
Yoshihara H (2013) Rods in spinal surgery: a review of the literature. Spine J 13:1350–1358 CrossRef
Papageorgiou I, Marsh L, Tipper JL et al (2014) Interaction of micron and nano-sized particles with cells of the dura mater. J Biomed Mater Res Part B 102B:1496–1505 CrossRef
Behl B, Papageorgiou I, Brown C et al (2014) Biological effects of cobalt chromium particles and ions on dural fibroblasts and dural epithelial cells. Biomaterials 34:3547–3558 CrossRef
Papageorgiou I, Abberton T, Fuller M et al (2014) Biological effects of clinically relevant CoCr nanoparticles in the dura mater: an organ culture study. Nanomaterials 4:485–504 CrossRef
Chang B-S, Brown PR, Sieber A et al (2004) Evaluation of the biological response of wear debris. Spine J 4:S239–S244 CrossRef
Stoodley MA, Jones NR, Brown CJ (1996) Evidence for rapid fluid flow from the subarachnoid space into the spinal cord central canal in the rat. Brain Res 707:155–164 CrossRef
Stoodley MA, Brown SA, Brown CJ et al (1997) Arterial pulsation-dependent perivascular cerebrospinal fluid flow into the central canal in the sheep spinal cord. J Neurosurg 86:686–693 CrossRef
Germain M, Hatton A, Williams S et al (2003) Comparison of the cytotoxicity of clinically relevant cobalt–chromium and alumina ceramic wear particles in vitro. Biomaterials 24:469–479 CrossRef
East E, Golding JP, Phillips JB (2009) A versatile 3D culture model facilitates monitoring of astrocytes undergoing reactive gliosis. J Tissue Eng Regen Med 3:634–646 CrossRef
Chou YK, Evans CJ (1997) Tool wear mechanism in continuous cutting of hardened tool steels. Wear 212:59–65 CrossRef
Bailey LO, Lipiatt S, Biancanello FS et al (2005) The quantification of cellular viability and inflammatory response to stainless steel alloys. Biomaterials 26:5296–5302 CrossRef
Li M, Yin T, Wang Y et al (2014) Study of biocompatibility of medical grade high nitrogen nickel free austenitic stainless steel in vitro. Mater Sci Eng C 43:641–648 CrossRef
Kanaji A, Orhue V, Caicedo MS et al (2014) Cytotoxic effect of cobalt and nickel ions on osteocytes in vitro. J Orthop Surg Res 9:1–8 CrossRef
DeGuzman RC, VandeVord PJ (2007) Variations in astrocyte and fibroblast response due to biomaterial particulates in vitro. J Biomed Mater Res Part A 85:14–24
- Neural cell responses to wear debris from metal-on-metal total disc replacements
J. B. Phillips
R. M. Hall
Joanne L. Tipper
- Springer Berlin Heidelberg
European Spine Journal
Print ISSN: 0940-6719
Elektronische ISSN: 1432-0932
Neu im Fachgebiet Orthopädie und Unfallchirurgie
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