title: Is monocyte chemotactic protein 1 elevated in aseptic loosening of TKA? A pilot study.
abstract: BACKGROUND
  Failure of TKA from aseptic loosening is a growing concern, as TKA is performed with increasing frequency. Loosening is multifactorial and may be associated with elevated inflammatory cytokines in addition to biomechanical failure.
  
  
  OBJECTIVE
  We asked whether proinflammatory cytokines and chemokines are elevated in synovial fluid from patients undergoing revision surgery as compared to those with osteoarthritis (OA) or rheumatoid arthritis (RA).
  
  
  METHODS
  We obtained synovial fluid samples from 20 patients: six with aseptic loosening of TKA (all with bone loss), 10 with primary OA, and four with RA. A panel of cytokines/chemokines was screened using a SearchLight(®) Array (Pierce Biotechnology, Rockford, IL, USA) in one revision sample. Using these data, we assayed the synovial fluids for monocyte chemotactic protein 1 (MCP-1) by ELISA.
  
  
  RESULTS
  We observed an increase in synovial MCP-1 levels in samples from patients planned for TKA revision compared to those with OA or RA. In patients undergoing revision arthroplasty, the mean (± SD) MCP-1 concentration was 21,233 ± 18,966 pg/mL (range, 1550-50,657 pg/mL; n = 6). In patients with OA, the mean MCP-1 level was 3012 ± 3321 pg/mL. In patients with RA, the mean MCP-1 concentration was 690 ± 561 pg/mL.
  
  
  CONCLUSIONS
  All patients undergoing revision TKA showed elevated concentrations of MCP-1 compared to patients with OA and RA, suggesting MCP-1 may serve as a potential marker or predictor of bone loss in patients undergoing revision surgery.
  
  
  CONCLUSIONS
  MCP-1 may be a novel biomarker in patients showing early symptoms of aseptic loosening of TKA.
authors: Department of Orthopaedics, Louisiana State University Health Sciences Center, 1542 Tulane Avenue, New Orleans, LA 70115, USA. vdasa@lsuhsc.edu
authors: Vinod
authors: V
authors: Dasa
authors: Jill M
authors: JM
authors: Kramer
authors: Sarah L
authors: SL
authors: Gaffen
authors: Keith L
authors: KL
authors: Kirkwood
authors: William M
authors: WM
authors: Mihalko
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001172:Arthritis, Rheumatoid / Q000276:immunology / Q000601:surgery*; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects / Q000295:instrumentation*; D015415:Biomarkers / Q000032:analysis; D018932:Chemokine CCL2 / Q000032:analysis*; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D018836:Inflammation Mediators / Q000032:analysis*; D008297:Male; D008875:Middle Aged; D009518:New York; D020370:Osteoarthritis, Knee / Q000276:immunology / Q000601:surgery*; D010865:Pilot Projects; D011475:Prosthesis Failure; D012086:Reoperation; D013582:Synovial Fluid / Q000276:immunology*; D017211:Treatment Failure; D015854:Up-Regulation
chemical_list: D015415:Biomarkers; C111835:CCL2 protein, human; D018932:Chemokine CCL2; D018836:Inflammation Mediators