Aseptic Loosening of Hip Prostheses A Histologic and Enzyme Histochemical Study

Cellular profile and cytokine production at prosthetic interfaces

“…19 At operation if manual torsional or axial loading of the implant produced movement at the cement-bone, cement-prosthesis or bone-prosthesis interface, the prosthesis was classified as loose. Six distinct groups of implants were identified (Table I): group 1, loose, cemented implants with osteolysis (24); group 2, loose, cemented implants without osteolysis (29); group 3, well-fixed cemented implants without radiological evidence of loosening (12); group 4, loose, cementless implants with osteolysis (9); group 5, loose, cementless implants without osteolysis (13); and group 6, well-fixed, cementless implants without radiological evidence of loosening (14). Radiographs from patients with loose implants and osteolysis showed one or more areas of ballooning and radiolucent zones with scalloped edges.…”

“…[1][2][3] Prostaglandins, cytokines, metalloproteinases, lysosomal enzymes and other substances are produced by the interface tissue, but their relative importance in the resorption of periprosthetic bone is controversial [4][5][6][7][8][9][10][11][12][13][14][15][16] An understanding of the cellular and cytokine profiles of tissues surrounding revised joint prostheses may further elucidate the biological processes of loosening and osteolysis and suggest preventative or therapeutic methods which may favourably affect the survival of the implant. Our aim in this prospective study was to determine the major cell types and cytokines produced by periprosthetic tissues, using immunohistochemistry and in situ hybridisation.…”

Evaluation of the in vitro cell-material interactions and in vivo osteo-integration of a spinal acrylic bone cement

“…Taken together the analyses presented here showed consistency of the overall very positive results between in vitro cytocompatibility and in vivo bio-compatibility, even if some presence of fibrous tissues layer was detected. This could also be attributed to the initial stability of the implant since even micro motion of an implanted material will result in the formation of a fibrous tissue around the implant [35,36]. The comparability between the motion applied in the femoral condyle (our experimental setting) and in a vertebral body (in case of vetebroplasty) might constitute a limitation of the animal model used in this study [37].…”

Polyethylene wear in knee arthroplasty

“…However, particles of polymers and metals have been implicated in the etiology of loosening of joint protheses. When the membrane surrounding loose components is examined microscopically, plastic and metallic debris are found associated with a foreign body reaction with histiocytes, giant cells and lymphocytes embedded in a fibrous tissue stroma (Heilmann et al 1975, Vernon-Roberts and Freeman 1976, Willert and Semlitsch 1977, Mirra et al 1982, Goldring et al 1983, Linder et al 1983, Johanson et al 1987, Maguire et al 1987, Appel et al 1988, Schmalzried et al 1992. The adverse biological effects of polymethylmethacrylate (PMMA) in particulate form have been intensively investigated both in vitro and in vivo , Horowitz et al 1988, Davis et al 1989, Herman et al 1989, Davis et al 1990, Goodman and Chin 1990.…”

“…The loosening membrane has been shown to produce high levels of prostaglandin E2 and other substances that may stimulate bone resorption (Goldring et al 1983, Linder et al 1983, Kim et al 1988, Ayers et al 1989, Mather et al 1989. Whether the polyethylene particles alone are the major stimulus for these events, or whether cement and metallic particles are of equal importance is unknown.…”