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Particle debris from titanium implants may harm osteoblasts, weaken bone

Titanium particles caused recruitment of osteoclasts and altered matrix metalloproteinase activity.

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The microscopic titanium particles generated by titanium joint prosthesis wear may weaken an implant's bond with bone and could weaken the bone itself, suggests a new study involving rats.

"As replacement joints are becoming increasingly common in aging populations, our results explain how such devices fail and suggest that improvements should be made in artificial joint design," K.L. Paul Sung, PhD, a professor of orthopedic surgery at the University of California, San Diego (UCSD), said in a press release.

Sung conducted the study with colleagues at UCSD, Duke University, Durham, N.C., and Emory University, Atlanta. The researchers implanted titanium pins into rat tibias and measured the loss of integration strength associated with titanium particles from four size groups.

The study found that the pins released from bones more easily when titanium particles were present, particularly particles from the smallest and largest groups, according to the release.

"Radiographic evidence indicates a loss of fixation at the implant-bone interface, and we believe that the accumulation of [titanium] particles may act on the bone-remodeling process and impact both long- and short-term implant-fixation strengths," the authors said in the study.

The researchers also found that small- and medium-sized titanium particles were concentrated inside osteoblast cells, weakening their adhesions. These osteoblasts also increased production of the RANKL protein (receptor activator of nuclear factor B ligand). RANKL acts as a dominant recruiter and activator of osteoclasts, which further weakened bone at the pin insertion sites, according to the study.

Zymography studies showed the larger titanium particles increased activity of matrix metalloproteinase-2 and MMP-9, the authors note.

The study was published online in the Proceedings of the National Academy of Sciences.

For more information:

• Choi MG, Koh HS, Kluess D, et. al. Effects of titanium particle size on osteoblast functions in vitro and in vivo. Proc Natl Acad Sci USA. 2005; Mar 8 [Epub ahead of print].