Clinical Orthopaedics and Related Research®

, Volume 469, Issue 1, pp 113–122 | Cite as

Continuous Infusion of UHMWPE Particles Induces Increased Bone Macrophages and Osteolysis

  • Pei-Gen Ren
  • Afraaz Irani
  • Zhinong Huang
  • Ting Ma
  • Sandip Biswal
  • Stuart B. Goodman
Symposium: Papers Presented at the Annual Meetings of the Knee Society



Aseptic loosening and periprosthetic osteolysis resulting from wear debris are major complications of total joint arthroplasty. Monocyte/macrophages are the key cells related to osteolysis at the bone-implant interface of joint arthroplasties. Whether the monocyte/macrophages found at the implant interface in the presence of polyethylene particles are locally or systemically derived is unknown.


We therefore asked (1) whether macrophages associated with polyethylene particle-induced chronic inflammation are recruited locally or systemically and (2) whether the recruited macrophages are associated with enhanced osteolysis locally.


Noninvasive in vivo imaging techniques (bioluminescence and microCT) were used to investigate initial macrophage migration systemically from a remote injection site to polyethylene wear particles continuously infused into the femoral canal. We used histologic and immunohistologic staining to confirm localization of migrated macrophages to the polyethylene particle-treated femoral canals and monitor cellular markers of bone remodeling.


The values for bioluminescence were increased for animals receiving UHMWPE particles compared with the group in which the carrier saline was infused. At Day 8, the ratio of bioluminescence (operated femur divided by nonoperated contralateral femur of each animal) for the UHMWPE group was 13.95 ± 5.65, whereas the ratio for the saline group was 2.60 ± 1.14. Immunohistologic analysis demonstrated the presence of reporter macrophages in the UHMWPE particle-implanted femora only. MicroCT scans showed the bone mineral density for the group with both UHMWPE particles and macrophage was lower than the control groups.


Infusion of clinically relevant polyethylene particles, similar to the human scenario, stimulated systemic migration of remotely injected macrophages and local net bone resorption.


Bone Mineral Density UHMWPE Wear Debris Wear Particle Total Joint Arthroplasty 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



We thank Dr Afraaz Irani for performing the bone mineral density analysis of the microCT scans. We thank Dr Gobalakrishnan Sundaresan who supplied the Fluc and GFP expressing RAW264.7 macrophage cell line, Dr Timothy Wright (Hospital for Special Surgery, New York, NY) who supplied the UHMWPE particles, and Stephanie Byun for sectioning of samples used in this study. We also thank Dr Lane Smith, Dr Sam Gambhir, and Dr Chris Contag for their helpful advice.


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Copyright information

© The Association of Bone and Joint Surgeons® 2010

Authors and Affiliations

  • Pei-Gen Ren
    • 1
  • Afraaz Irani
    • 1
  • Zhinong Huang
    • 1
  • Ting Ma
    • 1
  • Sandip Biswal
    • 2
  • Stuart B. Goodman
    • 1
    • 3
  1. 1.Department of Orthopaedic SurgeryStanford UniversityStanfordUSA
  2. 2.Department of RadiologyStanford UniversityStanfordUSA
  3. 3.Department of Orthopaedic SurgeryStanford University Medical Center Outpatient CenterRedwood CityUSA

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