A Biochemical, Histologic, and Immunohistologic Analysis of Membranes Obtained From Failed Cemented and Cementless Total Knee Arthroplasty

Chiba, Junji; Schwendeman, Leslie J.; Booth, Robert E.; Crossett, Lawrence S.; Rubash, Harry E.

doi:10.1097/00003086-199402000-00015

Cited by 71 publications

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“…Different mechanisms of cell activation in aseptic loosening were recently reviewed by Sundfeldt et al (2006). Several research groups have detected substantial production of TNF-α, IL-1β, and IL-6 in interface tissue from patients with loosening of prostheses but no infection (Al-Saffar and Revell 1994, Chiba et al 1994, Goodman et al 1998). …”

Section: Discussionmentioning

confidence: 99%

Inflammatory response in 85 patients with loosened hip prostheses: A prospective study comparing inflammatory markers in patients with aseptic and septic prosthetic loosening

Nilsdotter-Augustinsson

Briheim

Herder

et al. 2007

Acta Orthopaedica

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Background The most common complications of prosthetic hip joints are aseptic mechanical failure and infection. Delayed low-grade infections are seen most often, and they are also most difficult to distinguish from aseptic mechanical failures.Methods We conducted a prospective study to compare inflammatory markers in patients diagnosed with aseptic or septic prosthetic loosening. The diagnostic criteria were based on the decisions of experienced orthopedic surgeons and microbiological analysis of periprosthetic tissue samples taken perioperatively.Results Coagulase-negative staphylococci were the commonest pathogens in the infected patients. Pre-or perioperative elevation of C-reactive protein and erythrocyte sedimentation rate were significantly greater in the infection group, as were white blood cell count and levels of cytokines in synovial fluid. The patterns of infiltration of inflammatory cells in periprosthetic tissue were also significantly different between the groups.Interpretation A combination of clinical judgment and multiple tissue samples constitutes a good platform for distinguishing between septic and aseptic loosening of prostheses. Moreover, the combined use of several laboratory and histopathological markers of inflammation, especially infiltration of polymorphonuclear cells, further helps the diagnosis.

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Section: Discussionmentioning

confidence: 99%

Inflammatory response in 85 patients with loosened hip prostheses: A prospective study comparing inflammatory markers in patients with aseptic and septic prosthetic loosening

Nilsdotter-Augustinsson

Briheim

Herder

et al. 2007

Acta Orthopaedica

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“…Cells of this periprosthetic soft tissue, including fibroblasts, are under strong activation pressure due to the continuously generated particulate wear debris, which maintains a chronic state of inflammation. 19,[33][34][35] Fibroblasts are actively involved in the detrimental process of osteolysis in that (i) they are continuously stimulated by both prosthetic wear debris and cytokines/growth factors produced by activated macrophages, osteoblasts, and fibroblast (self)-secreted products; (ii) they suppress osteoblast function; and (iii) they directly or indirectly contribute to osteoclast activation. 11,12,14,15,20,21,36 To gain insight into the complex mechanisms taking place in the periprosthetic space, and to understand how fibroblasts are involved in the formation of IFM and osteolysis, we and others have used fibroblasts from different sources (synovial tissues of normal and pathological joints, and from IFMs) and tested their responsiveness under different conditions.…”

Section: Discussionmentioning

confidence: 99%

Role of fibroblasts and fibroblast‐derived growth factors in periprosthetic angiogenesis

Tunyogi-Csapó

Koreny

Vermes

et al. 2007

Journal Orthopaedic Research

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ABSTRACT:The periprosthetic granulomatous soft tissue [designated iterfacial membrane (IFM) in this study] exhibits heterogeneous histopathological features, in which highly vascularized areas with dense cellularity alternate with fibrotic and pseudocapsule-like tissue structures. Although macrophage/monocyte activation is a prominent event in the periprosthetic environment, fibroblasts also phagocytose particulate wear debris both in vivo and in vitro. Particulate wear debris and/or cytokines/growth factors alone or in combination (e.g., in conditioned media of explant cultures of IFMs) stimulated normal synovial and IFM fibroblasts to express inflammatory mediators and growth factors such as interleukin (IL)-1b, IL-6, IL-8, three isoforms of vascular endothelial growth factor (VEGF), monocyte/macrophage chemoattractant protein-1 (MCP-1), macrophagecolony-stimulating factor (M-CSF), cycloxygenases (Cox-1 and Cox-2), acid-and basic-fibroblast growth factors (FGF-1 and FGF-2), leukemia inhibitory factor-1 (LIF-1), transforming growth factor b-1 (TGF-b1), receptor activator of nuclear factor-kappa B ligand (RANKL), and osteoprotegerin (OPG). Thus, the fibroblast is capable of expressing a wide array of angiogenic and osteoclastogenic factors which are involved in the detrimental processes of the periprosthetic osteolysis. ß

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“…This would imply that PEP activate the mononuclear cells in a differentiated manner which favors a monocyte attraction that may be initiated by MCAF. Monocytic cells have also been described in the pseudomembrane surrounding loose prosthetic components, often in close connection with PEP (Chiba et al 1994). As MCAF can induce the secretion of the two osteolytic cytokines, IL-la and IL-6 (Jiang et al 1992), there is reason to believe that PEP in these areas can support the osteolytic process by triggering the cytokine cascade in monocytic cells.…”

Section: Discussionmentioning

confidence: 99%

Polyethylene particles stimulate monocyte chemotactic and activating factor production in synovial mononuclear cells in vivo:An immunohistochemical study in rabbits

Frøkjær¹,

Lind²,

Overgaard³

et al. 1995

Acta Orthopaedica Scandinavica

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A Biochemical, Histologic, and Immunohistologic Analysis of Membranes Obtained From Failed Cemented and Cementless Total Knee Arthroplasty

Cited by 71 publications

References 0 publications

Inflammatory response in 85 patients with loosened hip prostheses: A prospective study comparing inflammatory markers in patients with aseptic and septic prosthetic loosening

Inflammatory response in 85 patients with loosened hip prostheses: A prospective study comparing inflammatory markers in patients with aseptic and septic prosthetic loosening

Role of fibroblasts and fibroblast‐derived growth factors in periprosthetic angiogenesis

Polyethylene particles stimulate monocyte chemotactic and activating factor production in synovial mononuclear cells in vivo:An immunohistochemical study in rabbits

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