Particles of wear debris have been implicated in osteolysis around and
aseptic loosening of total joint prostheses, but the number and size
distribution of particles present in periprosthetic tissues are unknown. A
method of particle assay was developed, consisting of nitric-acid digestion
of tissue followed by collection of particles, electronic quantitation, and
parallel morphological and chemical characterization. Nitric acid had
minimum deleterious effects on control samples of titanium, cobalt-chromium
alloy, and polyethylene particles, as determined by atomic absorption
spectroscopy, scanning electron microscopy, and electronic measurements of
the sizes of the particles. Acid digestion of twelve control samples of
tissue, including tissue rich in hemosiderin, resulted in particle counts
that were no higher than that in the digestion solution background. Other
digestion preparations, including hydrochloric acid and sodium
hypophosphate, were not as effective as nitric acid. With the low size
limit of detection of approximately 0.58 micrometer, particle analysis of
tissue adjacent to twenty retrieved total joint implants indicated a range
of concentration of 0.85 to 141.85 x 10(9) particles per gram of tissue
(dry weight). Although a few particles of more than 100 micrometers were
detected, the mode of particle diameter from each sample ranged from the
lower limit of detection (approximately 0.58 micrometer) to 0.79
micrometer. The findings of morphological studies and x-ray spectroscopy of
isolated particles corresponded with those of light microscopy of the
fibrous membranes. These data indicate that most of the particles in
implant membranes are smaller than the resolution of the light microscope
and that tissue digestion is necessary for quantitation and
characterization.