In Vitro Inflammatory Cell-Induced Corrosion Using a Lymphocyte and Macrophage Co-Culture

Madison Brown; Lisa Phan; Danielle Bryant; Richard A Smith; Brian R Morrow; William M Mihalko

doi:10.1016/j.arth.2024.05.008

In Vitro Inflammatory Cell-Induced Corrosion Using a Lymphocyte and Macrophage Co-Culture

J Arthroplasty. 2024 May 9:S0883-5403(24)00441-8. doi: 10.1016/j.arth.2024.05.008. Online ahead of print.

Authors

Madison Brown¹, Lisa Phan¹, Danielle Bryant², Richard A Smith¹, Brian R Morrow³, William M Mihalko⁴

Affiliations

¹ Department of Orthopaedic Surgery and Biomedical Engineering, School of Medicine, University of Tennessee Health Science Center, 1211 Union Avenue, Suite 520, Memphis, TN, 38104.
² College of Medicine, University of Tennessee Health Science Center, 910 Madison Avenue, Suite 1031, Memphis, TN, 38163.
³ School of Dentistry, University of Tennessee Health Science Center, 875 Union Avenue, Memphis, TN, 38103.
⁴ Department of Orthopaedic Surgery and Biomedical Engineering, School of Medicine, University of Tennessee Health Science Center, 1211 Union Avenue, Suite 520, Memphis, TN, 38104; Campbell Clinic Orthopaedics, 1400 S Germantown, Road, Germantown, TN, 38138. Electronic address: wmihalko@campbellclinic.com.

PMID: 38734327
DOI: 10.1016/j.arth.2024.05.008

Abstract

Introduction: Cobalt-chromium-molybdenum (CoCrMo) and titanium alloys have been used for orthopaedic implants for decades. However, recent evidence has shown that inflammatory cell-induced corrosion (ICIC) can damage these metal alloys. This study aimed to investigate the mechanisms of ICIC by co-culturing macrophages with lymphocytes. We hypothesized that macrophages would be able to alter the surface oxide layer of CoCrMo and titanium alloy (Ti6Al4V) disks, with greater oxide layer damage occurring in groups with a co-culture compared to a macrophage monoculture and in groups with inflammatory activators compared to nonactivated groups.

Methods: Murine macrophages were cultured on American Society for Testing and Materials (ASTM) F1537 CoCrMo and ASTM F136 Ti6Al4V disks for 30 days and activated with interferon gamma and lipopolysaccharide. Interferon gamma and lipopolysaccharide were added to the culture medium to simulate local inflammation. Macrophages were either cultured alone or in a co-culture with T helper lymphocytes. After the 30-day experiment, scanning electron microscopy was used to examine the disk surfaces, and oxide levels were found using energy dispersive x-ray spectroscopy.

Results: Pitting features consistent with previous reports of ICIC were found on disks cultured with cells. Both CoCrMo and Ti6Al4V disks had significantly lower oxide levels in all groups with cells compared to control groups with no cells (P < 0.01). Additionally, CoCrMo disks had significantly lower oxide levels when cultured with activated macrophages and lymphocytes compared to nonactivated macrophages alone (P < 0.001), activated macrophages alone (P < 0.01), and nonactivated macrophages and lymphocytes (P < 0.05). No differences in the oxide levels were found among the Ti6Al4V groups.

Conclusion: This study demonstrates the ability of macrophages to alter the surface chemistry of commonly used orthopaedic alloys. We found that the addition of lymphocytes and a simulated local inflammatory response may contribute to the ICIC of CoCrMo implants.

Keywords: cobalt-chromium-molybdenum; inflammatory cell-induced corrosion; lymphocytes; macrophages; orthopaedic alloy; titanium alloy.