Particle Induced X-ray Emission (PIXE) for elemental tissue imaging in hip modular prosthesis fracture case

The increased modularity in the total hip arthroplasty (THA) allows adapting the prosthesis to the specific anatomical characteristics of each patient. However, the advantages of the modular THA are shadowed by the increased number of prosthesis failures observed in patients. The presence of junction in modular THA may increase its risk of mechanical failure. Moreover, the micro movements between neck and stem could lead to the production of metallic debris which may cause tissue inflammation and unsealing of prosthesis due to osseous dissolution. It is necessary to understand the mechanism of dispersion of the metal particles from the prosthesis into the tissue. Techniques currently applied in hospitals, such as X-ray scans or optical tissue microscopies, are able to distinguish metal particles, but unable to identify their specific metallic origin. In this work, within the TissueMaps project, we have proved that Proton Induced X-ray Emission (PIXE) is able to provide the distribution and elemental composition of particles from the prosthesis into the pseudo capsular tissue samples (near the femoral head) and identify the features observed under optical microscopy, in a case of broken neck prosthesis.