Respon inflamasi sendi lutut rattus norvegicus sp. akibat wear debris dari die-drawn GUR 1120 ultrahigh molecular weight polyethylene (UHMWPE) dan stainless steel 316 L

GUSNANIAR, Ir. Rini Dharmastiti, M.Sc.,Ph.D

2010 | Tesis | S2 Rekayasa Biomedis

Pasangan logam dan polyethylene adalah salah satu material yang banyak digunakan sebagai komponen sendi lutut tiruan. Adanya kontak permukaan logam dan polyethylene tersebut menimbulkan partikel keausan berupa wear debris yang terkait dengan munculnya inflamasi jaringan dan osteolisis. Pasangan material die -­‐ drawn UHMWPE dengan Stainless steel 316 L diharapkan memiliki laju keausan yang rendah dan meminimalisasi respon jaringan tubuh akibat wear debris material tersebut. Tujuan penulisan ini adalah untuk mengetahui pengaruh wear debris die-­‐ drawn GUR 1120 UHMWPE dan Stainless Steel 316 L yang dimasukkan ke sendi lutut Ra4us norvegicus sp terhadap jumlah sel neutrofil, limfosit, his5osit dan fibroblas sebagai manifestasi reaksi inflamasi selama 3 hari dan 7 hari. Penelisan diawali dengan uji keausan unidirec9onal pin-­‐on-­‐plate untuk mendapatkan wear debris. Jarak uji yang digunakan adalah 15 km dan 30 km. Pelumas yang digunakan adalah Phosphate-­‐Buffered Saline. Wear debris diisolasi, disterilisasi, lalu dimasukkan ke dalam kapsula sinovium sendi lutut tikus. Tiga puluh ekor Ra4us norvegicus sp., dibagi dalam 6 kelompok perlakuan. Ra4us norvegicus dieutanasi pada hari ke-­‐3 dan hari ke-­‐7. Jaringan femur dan 5bia dikumpulkan dan disiapkan untuk pemeriksaan histologi lalu spesimen diwarnai menggunakan cat Hematoxilin dan Eosin. Spesimen terperiksa diamati menggunakan mikroskop cahaya tidak-­‐terpolarisasi pada perbesaran (400x) dan (1000x). Uji keausan menunjukkan laju keausan die-­‐drawn GUR 1120 UHMWPE dengan Stainless Steel 316L adalah 2,40 x 10-­‐5 mm3/Nm. Hasil pemeriksaan histologi menunjukkan bahwa wear debris dari 15 km dan 30 km tidak meningkatkan jumlah neutrofil 3 hari dan 7 hari (p>0,05). Wear debris 15 km dan 30 km meningkatkan jumlah histiosit 3 hari (p<0,05). Wear debris 15 km dan 30 km meningkatkan jumlah limfosit pada 3 hari dan 7 hari (p<0.05). Wear debris 15 km dan 30 km 5dak meningkatkan jumlah fibroblas 3 hari, tetapi menurunkan jumlah fibroblas pada 7 hari. Dapat disimpulkan bahwa wear debris pasangan die-­‐drawn GUR 1120 UHMWPE dan Stainless Steel 316L berpengaruh terhadap jumlah his5osit, dan limfosit, tetapi menurunkan jumlah fibroblas. Wear debris tidak berpengaruh terhadap jumlah neutrofil.

Metal paired with polyethylene implants are the most widely used in knee joint prosthesis. The presence of particulate wear debris due to sliding of polyethylene components against metal counterface seem to be related to problems such as tissue inflammation and osteolysis. Stainless steel 316L paired with die-­‐drawn GUR 1120 UHMWPE has been expected to have a lower wear factor and minimal tissue responses to wear debris of them. The aim of this research was to investigate the effect of wear debris stainless steel 316L paired with die-­‐drawn UHMWPE which exposed in Rattus norvegicus sp knee joint`s on the number of lymphocytes, neutrophils, histiocytes, and fibroblast as manifestation inflammatory actions in 3 days and 7 days. The studies were started with unidirectional pin-­‐on-­‐plate wear test to get the wear debris. The sliding distance was 15 km and 30 km. The lubricant used in test was Phosphate-­‐Buffered-­‐Saline. The wear debris were isolated, sterilized, and then inserted into knee joint synovial capsule of the rats. Thirty Rattus norvegicus sp. were divided in to six groups. Animals were sacrificed after 3days and 7 days. Both femoral and tibial tissue were collected and prepared for histological sections. They were stained with Hematoxylin an Eosin. The sections were examined under polarized light microscope using high magnification (400x) and (1000x). Wear test shows that wear factor of Stainless steel 316L paired with die-­‐drawn GUR 1120 UHMWPE is 2,40 x 10-­‐5 mm3/Nm. Histological examination shows that wear debris obtained from both of 15 km and 30 km do not either enhance of neutrophils in 3 days and 7 days (p>0,05). Wear debris of 15 km and 30 km enhance of histiocytes in 3 days but do not enhance of histiocytes in 7 days significantly. Wear debris of 15 km and 30 km enhance of lymphocytes in 3 days and 7 days (p<0,05). Wear debris of 15 km and 30 km do not enhance the number of fibroblast in 3 days, but decrease the number of fibroblast in 7 days significantly. In conclusion, the wear debris from Stainless Steel 316L paired with die-­‐drawn GUR 1120 UHMWPE induces the number of histiocytes and lymphocytes, mbut decreases the number of fibroblast. It does not affect on the of neutrophils.

Kata Kunci : Inflamasi sendi,Wear debris,Die,Drawn UHMWPE