JP2015006444A - Medical implant with abrasion particles excellent in response of body - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide an additive to a UHMWPE material for use in manufacturing a medical implant for imparting excellent response of body to the medical implant, by using a material selected from the group consisting of an anti-inflammatory substance, an antimicrobial substance, an antitumor substance, an antiviral substance, and/or a bone stimulant.SOLUTION: In an embodiment, the material is blended with a natural additive having excellent response of body such as anti-inflammatory properties, antitumor properties, and antimicrobial properties.

Description

  The present invention relates generally to medical implants, and more particularly to medical implants that cause a good body response.

  Ultra high molecular weight polyethylene (`` UHMWPE '') is the most commonly used support material for total joint replacement and was introduced by John Charnley in the early 1960s (The UHMWPE Handbook, edited by S. Kurtz). Elsevier, 2004). Since then, various applications in total joint replacement have been developed as a result of the high toughness and good mechanical properties of this material. UHMWPE is one of the best polymers without additives, used in pure form (ASTM F 648-07).

  Although “traditional” UHMWPE has excellent clinical experience, the maximum useful life of the implant system is limited by the release of wear particles from the UHMWPE bearing surface (Willert HG, Bertram H., Buchhorn GH, Clin Orthop 258, 95, 1990). The negative biological effects of wear particles are considered the most important limiting factor for long implant life. Release of submicron sized wear debris into human tissue causes chronic inflammation. The persistent inflammation caused by UHMWPE particles activates inflammatory cells (macrophages), which stimulate bone resorbable cells (osteoclasts) and thus promote implant loosening.

  In the 1970s, viaducted UHMWPE was introduced to improve the wear resistance of materials (Oonishi H., Kadoya Y., Masuda S., Journal of Biomedical Materials Research, 58, 167, 2001; Grobbelaar CJ Du Plessis TA, Marais F., The Journal of Bone and Joint Surgery, 60-B, 370, 1978). UHMWPE material was gamma irradiated at high doses up to 100 Mrad. This is significantly different from gamma sterilized UHMWPE, which typically receives doses in the range of 2.5-4.0 Mrad. By using such a high dose, the material cross-linking process was facilitated, thereby increasing the wear resistance. Thus, this cross-linking process also resulted in a reduction of wear particles and thus a deleterious body response response. The disadvantage of the highly cross-linked material was that free radicals were still present in the material, which could cause oxidative degradation.

  The energy of the gamma rays is sufficient to break some of the carbon-carbon bonds or carbon-hydrogen bonds of the polyethylene chain to form free radicals. Some of these free radicals recombine, but some of them are long-lived and can react with oxygen that is present in or packaged around the implant. (Costa L., Jacobson K., Bracco P., Brach del Prever. EM, Biomaterials 23, 1613, 2002). Oxidative degradation reactions can embrittle the material and, at the same time, reduce the mechanical properties of the material and cause implant failure (Kurtz SM, Hozack W., Marcolongo M., Turner J., Rimnac C. Edidin A., J Arthroplasty 18, 68-78, 2003).

  Free radical quenching by heat treatment above or below the crystal melting temperature of UHMWPE has been known for some time (S. Kurtz, The UHMWPE Handbook, Elsevier Academic Press, 2004, p. 112). Therefore, residual free radicals are quenched during the heat treatment process, so in the 1990s, a highly cross-linked material that had improved wear stability and oxidation stability by heat treatment (annealing or remelting) after the irradiation process. developed.

  Clinical studies have confirmed that the rate of wear of the highly cross-linked UHMWPE is relatively low, and hence the volume of wear particles, but nonetheless osteolysis has not completely disappeared. Several studies have described osteolysis or radiation transmission areas for implant systems using viaducted UHMWPE (JA D'Antonio et al., Clinical Orthopaedics and Related Research, 441, 2005; CA Engh et al., The Journal of Arthroplasty, 21 (6 Suppl. 2), 2006; G. Digas et al., Clinical Orthopaedics and Related Research, 417, 2003). Thus, even a small amount of wear particles generated by the highly cross-linked UHMWPE can initiate an inflammatory response, ultimately causing osteolysis.

  Curcumin, a component of Indian turmeric, is well documented for its pharmacological effects in Indian medicine. Apart from other beneficial properties, curcumin has been described to have antioxidant and anti-inflammatory properties (RK Maheshwari et al., Life Sciences, 78 (18), 2006; A. Sahu, Acta Biomaterialia, Article in Press, 2008; J. Merell et al., Presentation at the World Biomaterials Conference, Amsterdam 2008; The University of Texas MD Anderson Cancer Center, web page: http://www.mdanderson.org/departments/cimer/).

  Other literature studies have described the beneficial properties of various substances. A very recent study has described that quercetin promotes bone formation when mixed in a collagen matrix (R. W. K. Wong et al., Journal of Orthopedic Research, 26 (8), 2008). Another study describes that osteolysis induced by tumor extracts is reduced by the addition of diphosphonate (A. Jung et al., Schweiz. Med. Wochenschr., 109 (47), 1979). Similar effects of diphosphonates have been shown in other studies (C. S. B. Galasko et al., Paper published in the Fourth Tripartite Surgical Meeting, Oxford, England, July 5-7, 1979).

The UHMWPE Handbook, S. Kurtz, Elsevier, 2004 Willert H. G., Bertram H., Buchhorn G. H., Clin Orthop 258, 95, 1990 Oonishi H., Kadoya Y., Masuda S., Journal of Biomedical Materials Research, 58, 167, 2001 Grobbelaar C. J., du Plessis T. A., Marais F., The Journal of Bone and Joint Surgery, 60-B, 370, 1978 Costa L., Jacobson K., Bracco P., Brach del Prever. E. M., Biomaterials 23, 1613, 2002 Kurtz S. M., Hozack W., Marcolongo M., Turner J., Rimnac C., Edidin A., J Arthroplasty 18, 68-78, 2003 S. Kurtz, The UHMWPE Handbook, Elsevier Academic Press, 2004, p.112 J. A. D’ Antonio et al., Clinical Orthopaedics and Related Research, 441, 2005 C. A. Engh et al., The Journal of Arthroplasty, 21 (6 Suppl. 2), 2006 G. Digas et al., Clinical Orthopedics and Related Research, 417, 2003 R. K. Maheshwari et al., Life Sciences, 78 (18), 2006 A. Sahu, Acta Biomaterialia, Article in Press, 2008 J. Merell et al., Presentation at the World Biomaterials Conference, Amsterdam 2008 The University of Texas MD Anderson Cancer Center, web page: http://www.mdanderson.org/departments/cimer/ R. W. K. Wong et al., Journal of Orthopedic Research, 26 (8), 2008 A. Jung et al., Schweiz. Med. Wochenschr., 109 (47), 1979 C. S. B. Galasko et al., Paper presented at the Fourth Tripartite Surgical Meeting, Oxford, England, July 5-7, 1979

  Given the above problems associated with UHMWPE materials for use in medical implants, the purpose of the present invention is to overcome the negative biological effects associated with previously known medical implant materials. It is to provide an improved UHMWPE material that allows the formation of.

  The goal of the present invention is to provide materials for use in medical plants that produce wear particles that exhibit good body response characteristics, particularly in the form of artificial joint replacements. To date, wear particles generated by artificial joint replacements have often been associated with inflammation, osteolysis or other negative body responses.

  In one embodiment of the present invention, materials blended with natural additives that exhibit good body response properties, such as anti-inflammatory properties, anti-tumor properties, anti-microbial properties, etc., are described.

  Thus, the teachings of the present invention represent a turning point in strategies for improving the long-term biological effects of medical plants. Previous approaches to improve the long-term biological effects of medical implants are to reduce the generation of wear particles associated with inflammation, osteolysis and other negative body responses. The focus was on improving the wear resistance of these materials. In contrast, embodiments of the present invention provide materials for use in medical implants that produce wear particles that exhibit good body response characteristics. In some embodiments, the material can also improve the wear resistance of the material.

  Some preferred embodiments of medical implants according to the invention, more precisely some of which are described in detail below with reference to the accompanying drawings.

It is a graph which shows the result of a hip joint simulator (hip simulator) test. It is a graph which shows the result which shows an anti-inflammatory action.

  In one embodiment, the present invention provides an anti-inflammatory substance, an antimicrobial substance, an antitumor substance, an antiviral as an additive to a UHMWPE material for manufacturing a medical implant to impart good body response characteristics to the medical implant Covers the use of one or more substances selected from the group consisting of substances and / or bone stimulating substances.

  The inventors have surprisingly discovered that the use of such materials as additives to UHMWPE materials significantly improves the cellular response characteristics to such materials.

  In a preferred embodiment, the additive is in the form of curcumin, gingerol, gingerone, helenalin, salicin, salicylic acid, cannabichromene, flavonoids, in particular quercetin, resveratrol and / or myricetin, tannin, terpene, malvinin and / or steroidal anti-steroids. Anti-inflammatory substances in the form of inflammatory drugs, in particular in the form of corticosteroids, and / or antimicrobial substances, for example peptide-based substances, in particular lactoferrin, or non-peptide-based substances, in particular penicillin and / or silver, and / or anti-tumor Substances such as anthracyclines, curcumin and / or helenalin and / or antiviral substances such as tannins and / or bone stimulating substances such as peptide-based substances, in particular lactoferrin, and / or non-peptide-based substances In particular in the form of quercetin and / or diphosphonates, and / or growth factors, in particular one or more of the BMP family, especially BMP-2.

  In a particularly preferred embodiment, the additive is curcumin.

  The additive is used in a wide range of amounts. A preferred embodiment is the use of additives in an amount of 0.0001-5% by weight, preferably 0.001-1% by weight, more preferably 0.02-0.1% by weight, based on the total weight of the medical implant.

  The additive is useful for any type of medical implant, but is particularly useful in artificial joint replacements. Such artificial joint replacements produce a significant number of wear particles that exhibit good body response characteristics when the additives are used.

In a further aspect, embodiments of the present invention are directed to UHMWPE materials for use in medical implants, particularly orthopedic joint replacements, that include the following properties:
The wear strip has anti-inflammatory properties, thereby reducing the osteolysis cascade that results from inflammation.
The wear piece has other beneficial properties such as anti-tumor properties, anti-microbial properties (eg anti-bacterial properties), anti-viral properties, bone stimulation properties or bone resorption inhibition properties.
-Depending on the material, an easy and simple manufacturing method is possible. Curcumin powder or another anti-inflammatory additive is mixed with UHMWPE powder and then sintered. Irradiation can be performed in the air without using a complex protective environment. Alternatively, the material can be used without irradiation.
-Addition of curcumin or the like protects the material from oxidative degradation as demonstrated by accelerated aging tests (see Example 1).

  In a further aspect, embodiments of the present invention provide anti-inflammatory substances, antimicrobials as additives to UHMWPE and UHMWPE materials for manufacturing medical implants to provide good body response characteristics to medical implants. Intended are UHMWPE materials with good body response characteristics, including one or more additives selected from the group consisting of substances, antitumor substances, antiviral substances and / or bone stimulating substances.

  In a preferred embodiment, the additive is in the form of curcumin, gingerol, gingerone, helenalin, salicin, salicylic acid, cannabichromene, flavonoids, in particular quercetin, resveratrol and / or myricetin, tannin, terpene, malubiin and / or steroidal Anti-inflammatory substances in the form of anti-inflammatory drugs, in particular in the form of corticosteroids, and / or antimicrobial substances such as peptide substances, in particular lactoferrin, or non-peptide substances, in particular penicillin and / or silver, and / or anti Tumor substances such as anthracyclines, curcumin and / or helenalin and / or antiviral substances such as tannins and / or bone stimulating substances such as peptide-based substances, in particular lactoferrin and / or non-peptide-based substances , In particular in the form of quercetin and / or diphosphonates, and / or growth factors, in particular the BMP family, especially BMP-2.

  In a particularly preferred embodiment, the additive is curcumin.

  In a further preferred embodiment, the additive is present in the UHMWPE material in an amount of 0.0001-5 wt%, preferably 0.001-1 wt%, more preferably 0.02-0.1 wt%, based on the total weight of the medical implant. Use in quantity.

  Embodiments of the present invention are also directed to medical implants made from a preform material in the form of the UHMWPE material.

  The term “preform” is used throughout this specification to refer to a consolidated block, sheet or rod of UHMWPE material, particularly a final product in the form of a medical implant that is subsequently subjected to further processing. Used to mean what can be obtained.

  The material according to this embodiment of the invention can be irradiated, but is not necessary. Irradiation of the UHMWPE preform with gamma rays or electron beam rays increases the crosslink density. Corresponding to the crosslink density of this material is the size of the molecular weight between the crosslinks. Clearly, the greater the crosslink density between individual UHMWPE polymers, the lower the molecular weight between crosslinks. Preferably, the gamma or electron beam irradiation is performed at a dose of 5-20 Mrad, and this value can be selected depending on the final properties of the required UHMWPE material. The change in irradiation dose will result in a difference in molecular weight between crosslinks and should be selected based on the intended final product.

  A further preferred embodiment is the medical implant wherein the preform material is irradiated by gamma or electron beam irradiation at a dose of 2-20 Mrad, preferably 4-20 Mrad, more preferably 5-20 Mrad, particularly preferably 5-15 Mrad. It is. The exact value of irradiation dose can be selected depending on the required final properties of the UHMWPE material. Irradiation can be carried out in air at ambient conditions. In another aspect, the irradiation can be performed under vacuum or in a protective environment such as a nitrogen or argon gas atmosphere.

  On the other hand, the preform material according to this embodiment of the present invention can be used without irradiation, or it can be irradiated with a very small irradiation dose.

  Therefore, in another embodiment of the present invention, the material is not irradiated by gamma ray or electron beam irradiation, or is irradiated by gamma ray or electron beam irradiation at a dose of less than 2 Mrad.

  A further preferred embodiment is a medical implant in which the preform material is irradiated in air.

  In a further preferred embodiment, the preform material has not been annealed or further heated after irradiation.

  Preferably, the medical implant according to this embodiment of the invention is an artificial joint replacement.

  In another embodiment, the present invention is directed to said medical implant for the treatment of inflammatory diseases, microbial diseases, neoplastic diseases, viral diseases and / or bone-degrading diseases. . Preferably, the additive is curcumin and the medical implant is for the treatment of inflammatory diseases.

In another embodiment, the present invention provides:
Mixing a material comprising UHMWPE with an amount of an additive selected from the group consisting of an anti-inflammatory substance, an antimicrobial substance, an antitumor substance, an antiviral substance and / or a bone stimulating substance;
The method is directed to a method of processing UHMWPE material having good body response characteristics, comprising forming the mixture by applying a temperature above the melting point of UHMWPE to produce a preform.

  In another embodiment of the invention, an additive selected from the group consisting of an anti-inflammatory substance, an antimicrobial substance, an antitumor substance, an antiviral substance and / or a bone stimulating substance is diffused into the preform or final implant. Can be incorporated into. Diffusion can be performed by immersing the preform or final implant directly in a pure additive or additive solution in a suitable solvent. The additive can also be incorporated into the preform or final implant with the aid of a supercritical gas such as, but not limited to, supercritical carbon dioxide.

  In a preferred embodiment of the method, the additive is in the form of curcumin, gingerol, gingerone, Helenaline, salicin, salicylic acid, cannabichromene, flavonoids, in particular quercetin, resveratrol and / or myricetin, tannin, terpene, malubiin and / or Or anti-inflammatory substances in the form of steroidal anti-inflammatory drugs, in particular corticosteroids, and / or antimicrobial substances, for example peptide substances, in particular lactoferrin or non-peptide substances, in particular penicillin and / or silver, and / or anti Tumor substances such as anthracyclines, curcumin and / or helenalin and / or antiviral substances such as tannins and / or bone stimulating substances such as peptide-based substances, in particular lactoferrin and / or non-peptide systems Quality, in particular in the form of quercetin and / or diphosphonates, and / or growth factors, is especially one or more of the BMP family (especially BMP-2).

  The formation of UHMWPE material according to some embodiments of the invention typically begins with the mixing of additives and UHMWPE powder. In the examples described below, the UHMWPE powder consists of Ticona GUR® 1020 medical grade UHMWPE. Such powders are well known and are commercially available. Of course, any other UHMWPE powder can be used (eg, Ticona GUR® 1050, DSM UH210, Basell 1900, which are high purity UHMWPE powders). It is preferred that a completely uniform mixture be obtained during the mixing process of the additive and UHMWPE powder. Once the additive and UHMWPE powder are thoroughly mixed, the preform is molded at a temperature higher than the melting point of the UHMWPE powder. At this stage, further temperature designation is not particularly important for the molding step. Increasing the temperature will result in faster molding of the material into the preform.

  Typically, the molding of the additive material and the UHMWPE powder is performed at a temperature above the melting point of the UHMWPE powder, but preferably below the decomposition temperature of the additive material. It is clear that temperature affects most compounds, and in fact the same applies to additive materials. Keeping the temperature of the molding step below the decomposition temperature of the additive material leads to improvement of the final product, but is not necessary but is preferred. In one embodiment of the invention, the UHMWPE powder is formed in an inert atmosphere such as argon or nitrogen.

  Typically, the molding step to produce the preform is performed by compression molding of a sheet, slab or rod. In another embodiment of the present invention, the shaping step comprises directly compressing the final implant or a nearly final implant that requires little machining after molding, or the final or nearly final implant. It can also be implemented by other means of direct generation. In yet another embodiment, the preform can also be produced by ram extrusion of a UHMWPE powder blend.

  In a preferred embodiment, the method according to the invention comprises the further step of irradiating the preform with either a 2-20 Mrad dose of gamma rays or electron beam rays. This irradiation can be carried out in air under ambient conditions. In another aspect, the irradiation can be performed under vacuum or in a protective environment such as a nitrogen or argon gas atmosphere.

  In an alternative embodiment, the method according to the invention comprises the further step of irradiating the preform with either a dose of less than 2 Mrad of gamma rays or electron beam rays.

  Preferably, the preform is not annealed or further heated.

The method according to a particularly preferred embodiment of the invention comprises:
Shaping the preform into an implant;
It further comprises one or more of the steps of packaging the implant and sterilizing by gamma irradiation between 2-4 Mrad or sterilizing the implant by exposure to ethylene oxide or gaseous plasma.

  Production of the final product from the preform is performed using any known standard method, most typically by removing unwanted portions of the preform or forming the final shaped product by machining. This preform can be subjected to a stress relief annealing process as described in the ISO 5834-2 standard.

  In a further embodiment, the present invention provides for the treatment of inflammatory diseases, microbial infections, neoplastic diseases, viral infections and / or osteolytic diseases in animals and humans, characterized in that the medical implant is applied Target method.

  Paying attention to the comparative example shown at the end of the specification, several examples of materials according to this embodiment of the invention are shown. In these comparative examples, samples with no additive material or samples with curcumin as additive material are shown.

  Focusing on the data shown in Example 1, especially the data shown in Table 1 in Example 1, free radical content for samples with and without curcumin at various irradiation doses. The maximum oxidation index after aging (maximum OI), the bulk oxidation index after aging (bulk OI) and the molecular weight MC between crosslinks are shown. As shown, the UHMWPE sample containing the additive material curcumin has a free radical content and cross-linking comparable to the UHMWPE material irradiated with the same dose of gamma radiation but without the additive material according to this embodiment of the invention. Has a molecular weight MC. However, there are significant differences in the maximum oxidation index and bulk oxidation index after artificial aging. This artificial aging was carried out for 14 days at an oxygen pressure of 5 atm and 70 ° C. in an oxygen cylinder as instructed by ASTM F2003. It is immediately apparent that UHMWPE samples with curcumin have significantly lower post-aging maximum and bulk oxidation indices when compared to UHMWPE samples without curcumin. This increase in oxidation index means that UHMWPE preforms oxidize more easily during storage or use as an implant, causing rather troublesome problems such as material embrittlement and increased wear or damage to the implant. This is not desirable.

  Many mechanical properties of the material are shown in Example 2 and Table 2 in Example 2. As can be seen from this table, the yield stress, tensile strength, elongation at break and Charpy impact strength of the material according to this embodiment of the present invention are compared to a standard material without additives.

  The results in this example and the examples clearly show that the addition of additive material in such amounts does not significantly adversely affect the final mechanical properties of the UHMWPE material containing the additive. ing. Thus, the material according to this embodiment of the present invention not only shows improved oxidation properties compared to the material without additive, but the incorporation of additive does not significantly affect the final mechanical properties . This is also a considerable advantage if the material is to be used as an implant since the material retains cohesion and is still useful as an implant.

  According to Example 3, a hip simulator test of two materials was performed on a 28 mm ceramic ball on an AMTI hip simulator that reproduces the human walking cycle, with a frequency of 1.2 Hz and bovine neogenesis as a lubricant. It was carried out using pup serum (protein concentration 30 g / l). Gravimetric wear was measured by weighing acetabular cups every 0.5 mio cycle and correcting the results obtained with an immersion control cup.

  The two samples were UHMWPE material containing 0.1% by weight of curcumin irradiated with 14 Mrad (sample according to this embodiment of the invention) and gamma sterilized PE sample (comparative). As can be seen from the data shown in FIG. 1, the UHMWPE material according to this embodiment of the present invention shows much less wear weight when compared to the comparative gamma sterilized PE material in the hip simulator.

According to the results of all experiments carried out, the following properties can be mentioned for UHMWPE materials where the wear pieces will exhibit an anti-inflammatory response.
The material according to the invention can be a mixture of UHMWPE resin powder and one or more anti-inflammatory agents.
The anti-inflammatory agent can be, but is not limited to curcumin.
The anti-inflammatory agent can be mixed with UHMWPE powder before sintering the preform.
• Orthopedic implant support members made from materials according to embodiments of the present invention can generate wear pieces having anti-inflammatory properties, thereby reducing the osteolysis cascade resulting from inflammation.

  One advantage of embodiments of the present invention compared to the prior art is the release of wear particles released from orthopedic implants with good body response properties, particularly anti-inflammatory properties. To date, osteolysis reduction has been achieved primarily by reducing the number of wear particles using via-bridged UHMWPE.

  This embodiment of the present invention shows a decrease in osteolytic bone resorption primarily due to anti-inflammatory wear particles. Furthermore, the number of wear particles is not necessary, but can be reduced by crosslinking of UHMWPE with gamma rays or electron beam rays.

  Thus, the osteolytic cascade that results from inflammation will be reduced not only by a decrease in the number of particles, but also by the anti-inflammatory properties of the particles themselves.

Comparative Example Gamma sterilized UHMWPE was compression molded into sheet form (GUR® 1020, Quadrant, Germany), machined, packaged in an inert gas atmosphere, and gamma sterilized at a dose of 3 Mrad. Curcumin blend samples are generated by mixing UHMWPE resin powder and 0.03-0.1 wt% curcumin, compression molded into block form, gamma irradiated at a dose of 7-14 Mrad in air to the desired shape Machined. No post-irradiation heat treatment was applied. The following tests were performed using these materials.

(Example)
(Example 1)
Free radical content, oxidation index and molecular weight between crosslinks.

  The oxidation index (OI) was quantified by Fourier transform infrared spectroscopy (FTIR) according to ASTM F2102-06. The oxidation profile was recorded for slices of 150 μm thickness from the surface to a depth of 2.5 mm. Prior to OI measurements, all samples were artificially aged in an oxygen cylinder for 2 weeks at an oxygen pressure of 5 bar and 70 ° C. (ASTM F2003-02).

  The crosslink density expressed by molecular weight (MC) between crosslinks was obtained by swelling experiments on 3 samples per material (10 × 10 × 10 mm) according to ASTM D2767-95 Method C.

(Example 2)
mechanical nature

  Mechanical test: Charpy impact test with double notch is performed according to DIN EN ISO 11542-2 (minimum 4 specimens per material) and tensile test is 50mm according to ASTM D638 (minimum 5 specimens per material) Performed using a test rate of / min.

(Example 3)
Hip joint simulator data
The hip joint simulator test on 28mm ceramic spheres was performed with AMTI hip joint simulator that reproduces human walking cycle, using 1.2Hz frequency and neonatal calf serum (protein concentration 30g / l) as lubricant. The wear weight was measured by weighing the acetabular cup every 0.5 myocycle and correcting the results obtained with an immersion control cup.

  The results of the hip joint simulator test are shown in FIG.

(Example 4)
Anti-inflammatory response Curcumin blend sample is generated by mixing UHMWPE resin powder and 1 wt% curcumin, compression molded into block form, gamma irradiated at a dose of 14 Mrad in air, machined to desired shape processed. No post-irradiation heat treatment was applied. As a control, a standard conventional highly crosslinked / remelted material was used.

The anti-inflammatory effect of 1% curcumin impregnated polyethylene disc on LPS-stimulated PMA differentiated U937 cells was evaluated. U937 human monocyte-like cells were cultured and grown in their appropriate medium. Cells were seeded in 200 μl of medium containing 20 nM PMA in a 24-well insert and an additional 1 ml of the same PMA-containing medium was added to each well outside the insert. The plates were then incubated for 24 hours at 37 ° C. and 5% CO ₂ to differentiate into macrophage-like cells. After 24 hours incubation with PMA, the medium was removed from the cells, replaced with 200 μl of medium, and the insert was transferred to a new 24-well plate containing 1 ml of medium (without PMA). Cells were then returned and incubated for an additional 72 hours at 37 ° C. and 5% CO ₂ . After 72 hours, the inserts were transferred to a new 24-well plate containing sample material (the insert was placed on top of the sample material) and 500 μl of medium. At this point, the medium was also removed from the inside of the insert and replaced with 200 μl of fresh medium. The plates were then incubated for an additional 24 hours at 37 ° C. before LPS was added. Then, after 24 hours, replace the medium (inside and outside of the insert) with medium containing the appropriate amount of LPS (200 μl inside the insert and 500 μl outside the insert) to obtain 0 ng / ml, 1 ng / ml or 20 ng / ml LPS was added. The plate was then returned and incubated at 37 ° C. for 8 hours. At the appropriate incubation time, the media was carefully removed from the inside of the insert and stored at -70 ° C for further cytokine evaluation.

  After collecting the medium, the conditioned medium was thawed at room temperature. The conditioned medium was then evaluated by an ELISA kit specific for TNF-α according to the manufacturer's instructions. Briefly, ELISA plates were coated overnight with the appropriate capture antibody. The plate was then washed 3 times with wash buffer and blocked with assay diluent for 1 hour at room temperature. After blocking, the plates were washed 3 times in wash buffer and 100 μl of each sample solution was added to the wells and incubated for 2 hours at room temperature. After 2 hours of incubation, the plates were washed 5 times in wash buffer and incubated for 1 hour at room temperature (with an enzyme concentrate against TNF) with a specific primary antibody, and then the plates were washed. After extensive washing, the plates were then incubated with substrate solution for 30 minutes in the dark at room temperature. After 30 minutes, stop solution was then added to each well and shaken for 1 minute before reading the plate at 450 nm and 570 nm.

  Results: TNF secreted from U937 cells (macrophage-like cells) after 8 hours incubation with 0, 1 or 20 ng / ml LPS is shown in FIG.

  Curcumin blend UHMWPE reduces TNF secreted from macrophage-like cells (U937) after 8 hours incubation with LPS compared to standard hypercrosslinked / remelted UHMWPE (PE44) and thus has some anti-inflammatory effect showed that.

Claims (26)

  <sub>Selected from the group consisting of antimicrobial substances, antitumor substances, antiviral substances and / or bone stimulating substances as additives to UHMWPE materials for the production of medical implants to give the medical implant good physical response characteristics Use of one or more substances.   The additive is
  Curcumin, gingerol, gingerone, Helenalin, salicin, salicylic acid, cannabichromene, flavonoid forms, especially quercetin, resveratrol and / or myricetin, tannin, terpene, malvinin and / or steroidal anti-inflammatory forms, especially corticosteroids Anti-inflammatory substances in the form of and / or
  Antimicrobial substances such as peptide substances, in particular lactoferrin, or non-peptide substances, in particular penicillin and / or silver, and / or
  Anti-tumor substances such as anthracyclines, curcumin and / or helenalin, and / or
  Antiviral substances such as tannins and / or
  Bone stimulating substances such as peptide substances, in particular lactoferrin and / or non-peptide substances, especially in the form of quercetin and / or diphosphonates, and / or growth factors, in particular the BMP family
The use according to claim 1, which is one or more of the following.
Use that is.   Use according to claim 1 or 2, wherein the additive is curcumin.   4. Use according to any one of claims 1 to 3, wherein the additive is used in an amount of 0.0001-5% by weight, based on the total weight of the medical implant.   Use according to claim 4, wherein the additive is used in an amount of 0.001 to 1% by weight, based on the total weight of the medical implant.   6. Use according to any one of claims 1 to 5, wherein the medical implant is an artificial joint replacement.   A UHMWPE material having good body response characteristics, comprising UHMWPE and one or more substances selected from the group consisting of antimicrobial substances, antitumor substances, antiviral substances and / or bone stimulating substances.   The additive is
  Curcumin, gingerol, gingerone, Helenalin, salicin, salicylic acid, cannabichromene, flavonoid forms, especially quercetin, resveratrol and / or myricetin, tannin, terpene, malvinin and / or steroidal anti-inflammatory forms, especially corticosteroids Anti-inflammatory substances in the form of and / or
  Antimicrobial substances such as peptide substances, in particular lactoferrin, or non-peptide substances, in particular penicillin and / or silver, and / or
  Anti-tumor substances such as anthracyclines, curcumin and / or helenalin, and / or
  Antiviral substances such as tannins and / or
  Bone stimulating substances such as peptide substances, in particular lactoferrin and / or non-peptide substances, especially in the form of quercetin and / or diphosphonates, and / or growth factors, in particular the BMP family
The UHMWPE material according to claim 7, wherein the UHMWPE material is one or more of the following.   9. The UHMWPE material according to claim 8, wherein the additive is curcumin.   10. The UHMWPE material according to any one of claims 7 to 9, wherein the additive is used in an amount of 0.0001-5% by weight, based on the total weight of the medical implant.   11. The UHMWPE material according to claim 10, wherein the additive is used in an amount of 0.001-1% by weight, based on the total weight of the medical implant.   Medical implant made from a preform material in the form of a UHMWPE material according to any one of claims 7 to 9.   13. The medical implant according to claim 12, wherein the preform material is irradiated by either gamma rays or electron beam rays at a dose of 2-20 Mrad.   13. The medical implant according to claim 12, wherein the preform material is not irradiated by gamma ray or electron beam irradiation, or the preform material is irradiated by gamma ray or electron beam irradiation at a dose of less than 2 Mrad.   15. The medical implant according to claim 13 or 14, wherein the preform material is irradiated in air.   16. The medical implant according to any one of claims 13 to 15, wherein the preform material has not been annealed or further heated after irradiation.   The medical implant according to any one of claims 12 to 16, wherein the medical implant is an artificial joint replacement.   18. Medical implant according to any one of claims 12 to 17, for the treatment of inflammatory diseases, microbial infections, neoplastic diseases, viral infections and / or osteolytic diseases.   19. A medical implant according to claim 18 for the treatment of inflammatory diseases, wherein the additive is curcumin.   Mixing a material comprising UHMWPE with an amount of one or more additives selected from the group consisting of anti-inflammatory substances, antimicrobial substances, antitumor substances, antiviral substances and / or bone stimulating substances When,
  Forming the mixture by application of a temperature above the melting point of UHMWPE to produce a preform and optionally forming a medical implant from the preform;
Or alternatively,
  Providing a material comprising UHMWPE, molding the material by application of a temperature above the melting point of UHMWPE, creating a preform and optionally forming a medical implant from the preform;
  Incorporating additives into the preform or the medical implant by diffusion,
    a) directly immersing the preform or the medical implant in a pure additive or additive solution in a suitable solvent,
    b) The additive is incorporated into the preform or the medical implant with the help of one or more supercritical gases, in particular supercritical carbon dioxide.
Steps to be carried out by
A process for processing UHMWPE materials with good body response characteristics, including:   The additive is
  Curcumin, gingerol, gingerone, Helenalin, salicin, salicylic acid, cannabichromene, flavonoid forms, especially quercetin, resveratrol and / or myricetin, tannin, terpene, malubiin and / or steroidal anti-inflammatory forms, especially corticosteroids Anti-inflammatory substances in the form of and / or
  Antimicrobial substances such as peptide substances, in particular lactoferrin, or non-peptide substances, in particular penicillin and / or silver, and / or
  Anti-tumor substances such as anthracyclines, curcumin and / or helenalin, and / or
  Antiviral substances such as tannins and / or
  Bone stimulating substances such as peptide substances, in particular lactoferrin and / or non-peptide substances, especially in the form of quercetin and / or diphosphonates, and / or growth factors, in particular the BMP family
21. The method of claim 20, wherein the method is one or more.   22. A method according to claim 20 or 21, comprising the further step of irradiating the preform with either 2-20 Mrad dose of gamma rays or electron beam rays.   22. A method according to claim 20 or 21, comprising the further step of irradiating the preform with either gamma rays or electron beam rays at a dose of less than 2 Mrad.   24. A method according to any one of claims 20 to 23, wherein the preform is not annealed or further heated.   Shaping the preform into an implant;
  Packaging the implant and sterilizing by gamma irradiation between 2-4 Mrad or sterilizing the implant by exposure to ethylene oxide or gas plasma
25. A method according to any one of claims 20 to 24, further comprising one or more of:   Inflammatory disease, microbial infection, neoplastic disease, viral infection and / or osteolytic disease in animals and humans, characterized in that the medical implant according to any one of claims 10 to 17 is applied. Treatment methods.</sub>

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