Local and systemic exposure assessment of metallic wear and corrosion products from orthopedic implants

Besides septic complications, another major problem in joint arthroplasty is early aseptic implant failure induced by wear and corrosion products from implant materials. To identify responsible triggers and thresholds of adverse local and systemic effects, we established methods to assess the exposure to metallic wear products in intraoperatively harvested samples. This comprises metal level determination in various periprosthetic tissues and systemic body fluids as well as the physicochemical characterization of in vivo generated wear particles. However, simultaneous and spatially-resolved quantification of released metals in peri-implant bone and bone marrow remains elusive. Today, there is no prove that particles originating from implant components accumulate in the adjacent bone and BM. Thus, our aim is the simultaneous multi-elemental exposure assessment by synchrotron-based X-ray fluorescence (XRF) imaging of peri-implant cancellous bone from patients with arthroplasty implants in situ. We consider ex vivo XRF mapping of human peri-implant samples as an expedient tool to support risk-benefit evaluation in arthroplasty, to guide individual implant choice in the future and for realistic appraisal of wear-related biological effects.