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J. Funct. Biomater. 2017, 8(3), 33;

Immunological Responses to Total Hip Arthroplasty

Biomaterials and Tissue Engineering Group, School of Dentistry, University of Leeds, Leeds LS2 9JT, UK
School of Biomedical Sciences, Faculty of Biological Sciences, University of Leeds, Leeds LS2 9JT, UK
School of Chemistry, University of Leeds, Leeds LS2 9JT, UK
Medical College and the First Affiliated Hospital, Henan University of Science and Technology, Henan 471023, China
Author to whom correspondence should be addressed.
Academic Editor: Wilson Wang
Received: 6 April 2017 / Revised: 19 July 2017 / Accepted: 25 July 2017 / Published: 1 August 2017
(This article belongs to the Special Issue Orthopaedic Biomaterials, Implants and Devices)
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The use of total hip arthroplasties (THA) has been continuously rising to meet the demands of the increasingly ageing population. To date, this procedure has been highly successful in relieving pain and restoring the functionality of patients’ joints, and has significantly improved their quality of life. However, these implants are expected to eventually fail after 15–25 years in situ due to slow progressive inflammatory responses at the bone-implant interface. Such inflammatory responses are primarily mediated by immune cells such as macrophages, triggered by implant wear particles. As a result, aseptic loosening is the main cause for revision surgery over the mid and long-term and is responsible for more than 70% of hip revisions. In some patients with a metal-on-metal (MoM) implant, metallic implant wear particles can give rise to metal sensitivity. Therefore, engineering biomaterials, which are immunologically inert or support the healing process, require an in-depth understanding of the host inflammatory and wound-healing response to implanted materials. This review discusses the immunological response initiated by biomaterials extensively used in THA, ultra-high-molecular-weight polyethylene (UHMWPE), cobalt chromium (CoCr), and alumina ceramics. The biological responses of these biomaterials in bulk and particulate forms are also discussed. In conclusion, the immunological responses to bulk and particulate biomaterials vary greatly depending on the implant material types, the size of particulate and its volume, and where the response to bulk forms of differing biomaterials are relatively acute and similar, while wear particles can initiate a variety of responses such as osteolysis, metal sensitivity, and so on. View Full-Text
Keywords: total hip arthroplasty; implant materials; wear particles; immunological response total hip arthroplasty; implant materials; wear particles; immunological response

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This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited (CC BY 4.0).

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Man, K.; Jiang, L.-H.; Foster, R.; Yang, X.B. Immunological Responses to Total Hip Arthroplasty. J. Funct. Biomater. 2017, 8, 33.

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J. Funct. Biomater. EISSN 2079-4983 Published by MDPI AG, Basel, Switzerland RSS E-Mail Table of Contents Alert
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