Local Cellular Responses to Titanium Dioxide from Orthopedic Implants

Jie J. Yao, Eric A. Lewallen, William H. Trousdale, Wei Xu, Roman Thaler, Christopher G. Salib, Nicolas Reina, Matthew P. Abdel, David G. Lewallen, Andre J. Van Wijnen

Research output: Contribution to journalReview articlepeer-review

14 Scopus citations


We evaluated recently published articles relevant to the biological effects of titanium dioxide (TiO2) particles on local endogenous cells required for normal bone homeostasis, repair, and implant osseointegration. Structural characteristics, size, stability, and agglomeration of TiO2 particles alter the viability and behavior of multiple bone-related cell types. Resulting shifts in bone homeostasis may increase bone resorption and lead to clinical incidents of osteolysis, implant loosening, and joint pain. TiO2 particles that enter cells (through endocytosis or Trojan horse mechanism) may further disrupt implant retention. We propose that cellular responses to titanium-based nanoparticles contribute to pathological mechanisms underlying the aseptic loosening of titanium-based metal implants.

Original languageEnglish (US)
Pages (from-to)94-103
Number of pages10
JournalBioResearch Open Access
Issue number1
StatePublished - Jul 2017


  • adverse local tissue reaction
  • joint replacement
  • nanoparticle
  • total hip arthroplasty
  • total knee arthroplasty

ASJC Scopus subject areas

  • General Biochemistry, Genetics and Molecular Biology


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