Adverse local tissue reaction (ALTR) associated with corrosion products in metal-on-metal and dual modular neck total hip replacements is associated with upregulation of interferon gamma-mediated chemokine signaling.
Adverse local tissue reactions (ALTR) associated with tribocorrosion following total hip arthroplasty (THA) have become a significant clinical concern in recent years. In particular, implants featuring metal-on-metal bearing surfaces and modular femoral stems have been reported to result in elevated rates of ALTR. These tribocorrosion-related tissue reactions are characterized by marked necrosis and lymphocytic infiltration, which contrasts sharply with the macrophagic and foreign body giant cell inflammation associated with polyethylene wear particle induced peri-implant osteolysis. In this study, we characterize tribocorrosion-associated ALTR at a molecular level. Gene expression profiling of peri-implant tissue around failing implants identifies upregulation of numerous inflammatory mediators in ALTR, including several interferon gamma inducible factors, most notably the chemokines MIG/CXCL9 and IP-10/CXCL10. This expression profile is distinct from that associated with polyethylene wear induced osteolysis, which is characterized by induction of markers of alternative macrophage activation, such as chitotriosidase (CHIT-1). Importantly, MIG/CXCL9 and IP-10/CXCL10 are also elevated at the protein level in the synovial fluid and, albeit more moderately, the serum, of ALTR patients, raising the possibility that these factors may serve as circulating biomarkers for the early detection of ALTR in at-risk patients.
Hospital for Special Surgery, New York, New York.
Kritti
K
Kolatat
Hospital for Special Surgery, New York, New York.
Giorgio
G
Perino
Hospital for Special Surgery, New York, New York.
Gabrielle
G
Wilner
Hospital for Special Surgery, New York, New York.
Elianna
E
Kaplowitz
Hospital for Special Surgery, New York, New York.
Benjamin F
BF
Ricciardi
Hospital for Special Surgery, New York, New York.
Friedrich
F
Boettner
Hospital for Special Surgery, New York, New York.
Geoffrey H
GH
Westrich
Hospital for Special Surgery, New York, New York.
Seth A
SA
Jerabek
Hospital for Special Surgery, New York, New York.
Steven R
SR
Goldring
Hospital for Special Surgery, New York, New York.
P Edward
PE
Purdue
D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects*; D018925:Chemokines / Q000378:metabolism*; D005260:Female; D005549:Foreign-Body Reaction / Q000209:etiology* / Q000378:metabolism; D020869:Gene Expression Profiling; D006622:Hip Prosthesis / Q000009:adverse effects*; D006801:Humans; D007371:Interferon-gamma / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D010014:Osteolysis / Q000378:metabolism; D012189:Retrospective Studies; D013582:Synovial Fluid / Q000378:metabolism
D018925:Chemokines; D007371:Interferon-gamma
ALTR; ALVAL; THA; chemokines; chitotriosidase; peri-implant osteolysis