Abstract
Various surface modifications to increase the lifespan of cobalt-chromium (CoCr) joint prostheses are being studied to reduce the wear rate in bone joint applications. One recently proposed modification involves depositing graphene oxide functionalized with hyaluronic acid (a compound present in joints) on CoCr surfaces, which can act as a solid lubricant. This paper analyzes the biological alterations caused by wear-corrosion phenomena that occur in joints, both from the perspective of the worn surface (in vitro model) and the particles generated during the wear processes (in vivo model). The analysis of the inflammatory response of macrophage was performed on CoCr surfaces modified with graphene oxide and functionalized with hyaluronic acid (CoCr-GO-HA), before and after wear-corrosion processes. The wear particles released during the wear-corrosion tests of the CoCr-GO-HA/CoCr ball pair immersed in 3 g/L hyaluronic acid were intra-articularly injected into the experimental animals. The hematological analysis in vivo was made considering a murine model of intra-articular injection into the left knee in male adult Wistar rats, at increasing concentrations of the collected wear particles dispersed in 0.9% NaCl. Non-significant differences in the inflammatory response to unworn CoCr-GO-HA surfaces and control (polystyrene) were obtained. The wear-corrosion of the CoCr-GO-HA disk increased the inflammatory response at both 72 and 96 h of material exposure compared to the unworn CoCr-GO-HA surfaces, although the differences were not statistically significant. The pro-inflammatory response of the macrophages was reduced on the worn surfaces of the CoCr modified and functionalized with graphene oxide (GO) and hyaluronic acid (HA), compared to the worn surfaces of the unmodified CoCr. The hematological analysis and tissue reactions after intra-articular injection did not reveal pathological damage, with average hematological values recorded, although slight reductions in creatinine and protein within non-pathological ranges were found. Some traces of biomaterial particles in the knee at the highest concentration of injected particles were only found but without inflammatory signs. The results show the potential benefits of using graphene in intra-articular prostheses, which could improve the quality of life for numerous patients.