Neutrophils are active in total joint implant loosening.
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.
Wozniak
Waldemar
W
Department of Orthopedics, Poznan University of Medical Sciences, Poland. wwozniak@sk4.am.poznan.pl
Markuszewski
Jacek
J
Wierusz-Kozlowska
Malgorzata
M
Wysocki
Henryk
H
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
D015415:Biomarkers; D009569:Nitric Oxide