Factors regulating bone remodeling processes in aseptic implant loosening.
This study was undertaken to screen periprosthetic tissues (PPTs) under specified conditions for a series of molecular components and describe them in bone remodeling processes within aseptic loosening. PPT samples were obtained from patients undergoing revision surgery of endoprostheses (n = 24) and synovial tissues from patients with OA (control) (n = 18), patients with any form of inflammatory arthritides were excluded. Tissue samples were examined via microbiology, histology (H&E, TRAP), immunohistochemistry (CD68/anti-S100a4), quantitative real-time PCR (ALP, COL1A1, cathepsin K, M-CSF, MMP13, OPG, RANK, RANKL, TNF-α, and TRAP) and an endotoxin-assay. PPT samples contained a variety of cellular components and stained positive for TRAP (56%), CD68 (100%), and S100a4 (100%). Wear debris were found in cells staining positive for CD68 and S100a4. In PPTs significantly higher ALP, COL1A1, MMP-13, RANK, RANKL, and TRAP expression were found along with a significantly higher RANKL/OPG ratio and a significantly lower OPG expression. No significant difference was observed for M-CSF, TNF-α, cathepsin K, and endotoxin levels. In conclusion we found osteogenic proteins (ALP, COL1A1), a proteolytic enzyme (MMP-13), markers for osteoclast differentiation (RANK, RANKL), and osteoclast activity (TRAP) to be increased in PPT, whereas OPG expression decreased significantly in comparison to control. We present data about a large series of molecular components in PPT and describe novel and key findings about their expression levels in regards to aseptic implant loosening. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 35:248-257, 2017.
Department of Orthopaedic Surgery, Physical Medicine and Rehabilitation, Campus Großhadern, Ludwig-Maximilians-University, Marchioninistr 15, Munich 81377, Germany.
Eliza S
ES
Hartmann
Department of Orthopaedic Surgery, Physical Medicine and Rehabilitation, Campus Großhadern, Ludwig-Maximilians-University, Marchioninistr 15, Munich 81377, Germany.
Miriam I
MI
Köhler
Department of Orthopaedic Surgery, Physical Medicine and Rehabilitation, Campus Großhadern, Ludwig-Maximilians-University, Marchioninistr 15, Munich 81377, Germany.
Felicitas
F
Huber
Department of Orthopaedic Surgery, Physical Medicine and Rehabilitation, Campus Großhadern, Ludwig-Maximilians-University, Marchioninistr 15, Munich 81377, Germany.
Julia I
JI
Redeker
Department of Orthopaedic Surgery, Physical Medicine and Rehabilitation, Campus Großhadern, Ludwig-Maximilians-University, Marchioninistr 15, Munich 81377, Germany.
Baerbel
B
Schmitt
Department of Orthopaedic Surgery, Physical Medicine and Rehabilitation, Campus Großhadern, Ludwig-Maximilians-University, Marchioninistr 15, Munich 81377, Germany.
Marcus
M
Schmitt-Sody
Department of Dermatology, Ludwig-Maximilians-University, Frauenlobstr 9-11, Munich 80337, Germany.
Burkhard
B
Summer
Department of Orthopaedic Surgery, Physical Medicine and Rehabilitation, Campus Großhadern, Ludwig-Maximilians-University, Marchioninistr 15, Munich 81377, Germany.
Andreas
A
Fottner
Department of Orthopaedic Surgery, Physical Medicine and Rehabilitation, Campus Großhadern, Ludwig-Maximilians-University, Marchioninistr 15, Munich 81377, Germany.
Volkmar
V
Jansson
Department of Orthopaedic Surgery, Physical Medicine and Rehabilitation, Campus Großhadern, Ludwig-Maximilians-University, Marchioninistr 15, Munich 81377, Germany.
Susanne
S
Mayer-Wagner
D000368:Aged; D000369:Aged, 80 and over; D016723:Bone Remodeling; D001842:Bone and Bones / Q000378:metabolism* / Q000473:pathology; D016022:Case-Control Studies; D004731:Endotoxins / Q000032:analysis; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011475:Prosthesis Failure; D012333:RNA, Messenger / Q000378:metabolism
D004731:Endotoxins; D012333:RNA, Messenger
aseptic implant loosening; bone remodeling; molecular components; periprosthetic tissue