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Nano Research & Applications
ISSN 2471-9838 Advanced Nano 2017
Page 82
September 11-12, 2017 Amsterdam, Netherlands
20th International Conference on
Advanced Nanotechnology
Metallosis: The battle of the five armies
Zhidao Xia
Swansea University Medical School, UK
Metals and their alloys have been widely used as
implantablematerials such as artificial joint prosthesis;
internal fixation nails, plates and rods; dental implants
and stents. Metallosis including adverse reactions to
metal debris (ARMD) in hip arthroplasty is an aseptic
fibrosis, local necrosis, inflammation, or loosening of an
implanted device secondary to metallic corrosion and
release of wear debris. The mechanism of inflammation
in metallosis is controversial due to the complexity of the
morphology, composition of the wear particles and cell/
tissue responses involved. Metal allergy can partially
explain some clinical cases but the causes of many are
still unknown. We have recently analyzed 285 cases of
metallosis from hip replacement. It is identified that five
key factors have played an important role in metallosis: (1)
wear metal nanoparticles; (2) metal corrosion products;
(3) macrophages; (4) master cells; and (5) lymphocytes. In
the cases of hip arthroplasty, there are distinct differences
between wear metal particles and metal corrosion
products, both are recognized as foreign body invasion
and induce a battle led by host macrophages, master
cells and lymphocytes. Macrophages respond to both
types of metal materials by phagocytosis and engulfment
in all cases with metallosis. Master cells are seen in some
cases and located between macrophages/metal particles
and blood vessels. Lymphocytes are dissociated with
metal particles but with more severe clinical manifestation
following their infiltration. Consequently, it results in large
area of cell apoptosis and necrosis, inflammation, fibrosis
or pseudotumor formation and failure of the implants.
Nano Research & Applications