title: Neutrophils are active in total joint implant loosening.
abstract: BACKGROUND
  Polymorphonuclear neutrophils (PMN) are the first cells to take part in the local foreign body reaction in aseptic loosening of endoprostheses. The aim of this study was to evaluate the systemic host reaction to total joint replacement by measuring the production of nitric oxide by neutrophils before and after total joint replacement.
  
  
  METHODS
  Blood samples were collected from 33 patients (27 hips and 6 knees) before surgery, and 2 weeks, 2 months and 2.5-3 years after surgery. The levels of nitric oxide produced by PMN were measured by the method described by Markert et al. (1994).
  
  
  RESULTS
  Patients reporting pain in the region of the implant 3 years after surgery, and also patients with radiographic signs of loosening, had higher production of NO in the early period and 3 years after the implantation than those with good clinical results.
  
  
  CONCLUSIONS
  We propose that elevated levels of nitric oxide production by PMNs may serve as a marker of total joint prosthesis loosening.
authors.affiliation: Department of Orthopedics, Poznan University of Medical Sciences, Poland. wwozniak@sk4.am.poznan.pl
authors.forename: Waldemar
authors.initials: W
authors.lastname: Wozniak
authors.forename: Jacek
authors.initials: J
authors.lastname: Markuszewski
authors.forename: Malgorzata
authors.initials: M
authors.lastname: Wierusz-Kozlowska
authors.forename: Henryk
authors.initials: H
authors.lastname: Wysocki
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000378:metabolism; D006622:Hip Prosthesis; D006801:Humans; D007595:Joint Prosthesis; D007720:Knee Prosthesis; D008875:Middle Aged; D009504:Neutrophils / Q000378:metabolism / Q000502:physiology*; D009569:Nitric Oxide / Q000096:biosynthesis; D011475:Prosthesis Failure
chemical_list: D015415:Biomarkers; D009569:Nitric Oxide