Cellular profile and cytokine production at prosthetic interfaces. Study of tissues retrieved from revised hip and knee replacements.
The tissues surrounding 65 cemented and 36 cementless total joint replacements undergoing revision were characterised for cell types by immunohistochemistry and for cytokine expression by in situ hybridisation. We identified three distinct groups of revised implants: loose implants with ballooning radiological osteolysis, loose implants without osteolysis, and well-fixed implants. In the cemented series, osteolysis was associated with increased numbers of macrophages (p = 0.0006), T-lymphocyte subgroups (p = 0.03) and IL-1 (p = 0.02) and IL-6 (p = 0.0001) expression, and in the cementless series with increased numbers of T-lymphocyte subgroups (p = 0.005) and increased TNF alpha expression (p = 0.04). For cemented implants, the histological, histochemical and cytokine profiles of the interface correlated with the clinical and radiological grade of loosening and osteolysis. Our findings suggest that there are different biological mechanisms of loosening and osteolysis for cemented and cementless implants. T-lymphocyte modulation of macrophage function may be an important interaction at prosthetic interfaces.
Goodman
S B
SB
Stanford University School of Medicine, California, USA.
Huie
P
P
Song
Y
Y
Schurman
D
D
Maloney
W
W
Woolson
S
S
Sibley
R
R
D000368:Aged; D019644:Arthroplasty, Replacement, Hip; D019645:Arthroplasty, Replacement, Knee; D002452:Cell Count; D002484:Cementation; D016207:Cytokines / Q000096:biosynthesis* / Q000235:genetics; D005786:Gene Expression Regulation; D006622:Hip Prosthesis; D006801:Humans; D007150:Immunohistochemistry; D017403:In Situ Hybridization; D007375:Interleukin-1 / Q000096:biosynthesis / Q000235:genetics; D015850:Interleukin-6 / Q000096:biosynthesis / Q000235:genetics; D007720:Knee Prosthesis; D018655:Lymphocyte Count; D008264:Macrophages / Q000473:pathology* / Q000502:physiology; D008875:Middle Aged; D016348:Osseointegration; D010014:Osteolysis / Q000000981:diagnostic imaging / Q000276:immunology / Q000473:pathology; D011475:Prosthesis Failure; D011859:Radiography; D012086:Reoperation; D016176:T-Lymphocyte Subsets / Q000473:pathology; D013601:T-Lymphocytes / Q000276:immunology / Q000473:pathology*; D014409:Tumor Necrosis Factor-alpha / Q000096:biosynthesis / Q000235:genetics
D016207:Cytokines; D007375:Interleukin-1; D015850:Interleukin-6; D014409:Tumor Necrosis Factor-alpha