title: Immunological changes in patients with primary osteoarthritis of the hip after total joint replacement.
abstract: We aimed to assess whether the immunological abnormalities which have been observed in patients with loose total hip replacements (THRs) are present in patients with a well-fixed prosthesis. We examined blood samples from 39 healthy donors, 22 patients before THR and 41 with well-fixed THRs of different types (15 metal-on-metal, 13 metal-on-polyethylene, 13 ceramic-on-ceramic). Before THR, the patients showed a decrease in leukocytes and myeloid cells in comparison with healthy donors, and a prevalence of type-1 T lymphocytes, which was confirmed by the increase in ratio of interferon-gamma to interleukin 4. Moreover, patients with metal-on-metal or metal-on-polyethylene implants showed a significant decrease in the number of T lymphocytes and a significant increase in the serum level of chromium and cobalt, although no significant correlation was observed with the immunological changes. In the ceramic-on-ceramic group, leukocytes and lymphocyte subsets were not significantly changed, but a significant increase in type-2 cytokines restored the ratio of interferon-gamma to interleukin 4 to normal values. We conclude that abnormalities of the cell-mediated immune response may be present in patients with a well-fixed THR, and that the immunological changes are more evident in those who have at least one metal component in the articular coupling.
authors.affiliation: Laboratorio dei Fisiopatologia degli Impianti Ortopedici, Istituti Ortopedici Rizzoli, Bologna, Italy.
authors.forename: Donatella
authors.initials: D
authors.lastname: Granchi
authors.forename: Lucia
authors.initials: L
authors.lastname: Savarino
authors.forename: Gabriela
authors.initials: G
authors.lastname: Ciapetti
authors.forename: Elisabetta
authors.initials: E
authors.lastname: Cenni
authors.forename: Roberto
authors.initials: R
authors.lastname: Rotini
authors.forename: Michele
authors.initials: M
authors.lastname: Mieti
authors.forename: Nicola
authors.initials: N
authors.lastname: Baldini
authors.forename: Armando
authors.initials: A
authors.lastname: Giunti
mesh_terms: D000328:Adult; D000368:Aged; D015703:Antigens, CD / Q000097:blood; D019644:Arthroplasty, Replacement, Hip; D001402:B-Lymphocytes / Q000276:immunology; D002516:Ceramics; D005260:Female; D006801:Humans; D007111:Immunity, Cellular / Q000276:immunology; D007962:Leukocytes / Q000276:immunology; D008297:Male; D008670:Metals / Q000097:blood; D008875:Middle Aged; D022423:Myeloid Cells / Q000276:immunology; D015207:Osteoarthritis, Hip / Q000276:immunology*; D010835:Phytohemagglutinins / Q000276:immunology; D020959:Polyethylene / Q000276:immunology; D013601:T-Lymphocytes / Q000276:immunology
chemical_list: D015703:Antigens, CD; D008670:Metals; D010835:Phytohemagglutinins; D020959:Polyethylene