DEVELOPMENT OF NEW CLINICAL DIAGNOSTIC TECHNIQUES IN PROSTHESIS REJECTION CASES BY USING PARTICLE INDUCED X-RAY EMISSION (PIXE)

Hip prosthesis replacement is one of the most frequent and costly treatments in developed countries. The increased number of patients and the insufficient understanding of physiological processes leading to prosthesis failure make necessary the use of complementary techniques to better understand the degradation of implants [1]. We present two cases of prosthesis failure: Patient 2, with a modular hip prosthesis made of TiAlV alloy (Profemur®), presents a broken neck; and Patient 7, with a Ceramic on Ceramic articulation made of zirconia toughtened alumina (Biolox® Delta), presents a broken acetabular inlay. The presence of metallic debris coming from the prosthesis has been studied by using Particle-Induced X-ray Emission (PIXE). This technique combines high elemental sensitivity (detection limit 0,1 ppm) with high lateral resolution (600 nm) [2]. The analysis was performed with the 2 MV tandem accelerator available at Jožef Stefan Institute (JSI) [3]. [1] Fokter SK, et al., Acta Orthopaedica, 87(2), p.197-202, 2016. [2] P. Vavpetič et al., Nuclear Instruments and Methods in Physics Research B, vol. 306, pp. 140-143, 2013. [3] Primoz Pelicon et al., Nuclear Instruments and Methods in Physics Research B, vol. 332, pp. 229-233, 2014