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Titanium Particles Stimulate Bone Resorption by Inducing Differentiation of Murine Osteoclasts
Yanming Bi, PhD; R. Renee VanDeMotter, MS; Ashraf A. Ragab, MD; Victor M. Goldberg, MD; James M. Anderson, MD, PhD; Edward M. Greenfield, PhD
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Investigation performed at the Departments of Orthopaedics and Pathology, Case Western Reserve University, Cleveland, Ohio
Yanming Bi, PhD R. Renee Van De Motter, MS Ashraf A. Ragab, MD Victor M. Goldberg, MD James M. Anderson, MD, PhD Edward M. Greenfield, PhD Departments of Orthopaedics (Y.B., R.R.V.D.M., A.A.R., V.M.G., and E.M.G.) and Pathology (J.M.A.), Case Western Reserve University, 11100 Euclid Avenue, Cleveland, OH 44106-5000. E-mail address for E.M. Greenfield: emg3@po.cwru.edu
No benefits in any form have been received or will be received from a commercial party related directly or indirectly to the subject of this article. Funds were received in total or partial support of the research or clinical study presented in this article. The funding sources were National Institutes of Health Grants AR43769, HL33849, and AR07505.

J Bone Joint Surg Am, 2001 Apr 01;83(4):501-501
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Loosening of orthopaedic implants is mediated by cytokines that elicit bone resorption and are produced in response to phagocytosis of implant-derived wear particles. This accelerated bone resorption could be due to increased osteoclastic activity, survival, or differentiation. Although a number of in vitro studies have shown that wear particles increase osteoclastic activity, the increase was less than twofold in all cases. The objective of the current study was to test the hypothesis that wear particles stimulate bone resorption by inducing osteoclast differentiation.


Conditioned media were prepared from murine marrow cells or human peripheral blood monocytes incubated in the presence or absence of titanium particles. The effects of conditioned media on osteoclast differentiation were examined with use of a recently developed assay in which osteoclast precursors are co-cultured with mesenchymal support cells.


The present study showed that titanium particles induced both murine marrow cells and human peripheral blood monocytes to produce factors that stimulated osteoclast differentiation. The mean increase in osteoclast differentiation was 29.3 ± 9.4-fold. The stimulation of osteoclast differentiation led to a parallel increase in bone resorption. The amount of stimulation was regulated in a dose-dependent manner by the concentration of both titanium particles and conditioned media. The stimulation of osteoclast differentiation required interactions between the cells and the particles themselves and, therefore, was not due to metal ions, soluble contaminants released from the particles, or submicrometer particles. In contrast, conditioned media from control cells incubated in the absence of titanium particles had no detectable effect on any of the examined parameters.


The present study showed that titanium particles stimulate in vitro bone resorption primarily by inducing osteoclast differentiation. In contrast, the titanium particles had only small effects on osteoclast activity or survival.

Clinical Relevance:

The present study provides strong support for the hypothesis that osteoclast differentiation is an important factor in the development of aseptic loosening. The development of therapeutic interventions to reduce osteoclast differentiation may be a useful approach for improving the performance of orthopaedic implants.

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    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
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