Connective tissue disease after hip and knee implant surgery

Mellemkjær, Lene; Friis, Søren; McLaughlin, Joseph K.; Thomsen, B.; Kjøller, Kim; Høgsted, Charlotte; Winther, J. F.; Blot, W. J.; Olsen, Jørgen H.

doi:10.1080/03009740151095321

Cited by 4 publications

(3 citation statements)

References 3 publications

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“…mation of biofilm-induced 10-HOME molecule could serve as possible therapeutic strategy to relieve patient symptoms in BII. Additionally, in light of the reports of biofilm association with metal implants such as orthopedic arthroplasty, this study provides a possible explanation of similar immunological responses reported in individuals with those implants (19)(20)(21)(22)(23). The findings of this study suggest that management of biofilm can help to increase the safety and long-term use of surgical implants.…”

Section: R E S E a R C H A R T I C L Esupporting

confidence: 65%

“…However, studies have found silicone gel breast implants to be safe (18). Relevant to this apparent contradiction is the fact that these symptoms have been reported in people with other types of implants, such as orthopedic arthroplasty, which is typically comprised of titanium (14,(19)(20)(21)(22)(23). This suggests that the underlying cause of these conditions may be associated with factors other than the implant material.…”

Section: Introductionmentioning

confidence: 99%

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Biofilm-derived oxylipin 10-HOME–mediated immune response in women with breast implants

Khan,

Minto,

Kelley-Patteson

et al. 2023

Journal of Clinical Investigation

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This study investigates a mechanistic link of bacterial biofilm–mediated host-pathogen interaction leading to immunological complications associated with breast implant illness (BII). Over 10 million women worldwide have breast implants. In recent years, women have described a constellation of immunological symptoms believed to be related to their breast implants. We report that periprosthetic breast tissue of participants with symptoms associated with BII had increased abundance of biofilm and biofilm-derived oxylipin 10-HOME compared with participants with implants who are without symptoms (non-BII) and participants without implants. S. epidermidis biofilm was observed to be higher in the BII group compared with the non-BII group and the normal tissue group. Oxylipin 10-HOME was found to be immunogenically capable of polarizing naive CD4 + T cells with a resulting Th1 subtype in vitro and in vivo. Consistently, an abundance of CD4 + Th1 subtype was observed in the periprosthetic breast tissue and blood of people in the BII group. Mice injected with 10-HOME also had increased Th1 subtype in their blood, akin to patients with BII, and demonstrated fatigue-like symptoms. The identification of an oxylipin-mediated mechanism of immune activation induced by local bacterial biofilm provides insight into the possible pathogenesis of the implant-associated immune symptoms of BII.

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Section: R E S E a R C H A R T I C L Esupporting

confidence: 65%

Section: Introductionmentioning

confidence: 99%

Biofilm-derived oxylipin 10-HOME–mediated immune response in women with breast implants

Khan,

Minto,

Kelley-Patteson

et al. 2023

Journal of Clinical Investigation

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“…Another large retrospective study in Denmark stated that compared with osteoarthritis patients who did not undergo joint replacement, those who underwent hip replacement had significantly higher rates of hospitalization for dryness and systemic lupus erythematosus. Patients undergoing knee replacement surgery had a significantly increased risk of hospitalization for RA, CTD, and dryness 43 . A small-scale case-control study found a increase in the incidence of undifferentiated connective tissue disease (UCTD) after exposure to silicone-free artificial joints, with the risk greater than 5-fold observed.…”

Section: Discussionmentioning

confidence: 99%

Increased Risk of New-Onset Rheumatoid Arthritis Among Osteoarthritis Patients Received Total Knee Arthroplasty: a global federated health network analysis

Lin,

Chang,

et al. 2024

Int. J. Med. Sci.

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Background: Complications of total knee arthroplasty (TKA) had been widely discussed. However, whether TKA influence risk of rheumatoid arthritis (RA) in osteoarthritis patients remained uncertain. We intend to evaluate the risk of RA in osteoarthritis patients underwent TKA. Methods: In this retrospective cohort study, data was retrieved from the US collaborative networks in TriNetX research network. Within the study period between 2005 and 2017, osteoarthritis patients underwent TKA were enrolled as case cohort whereas osteoarthritis patients never underwent TKA were enrolled as control cohort. Covariates were matched via propensity score matching. Risk of RA in TKA patients were valuated under various follow-up time and sensitivity models. Results: Under 1-year, 3-year and 5-year of follow-up, TKA patients were associated with significantly elevated risk of RA, especially under 1-year follow-up (HR=1.74; 95% CI, 1.39-2.18). Subgroup analysis demonstrated a significant increase in the risk of RA following TKA in the female subgroup (HR=1.42; 95% CI, 1.24-1.63), the subgroup aged 18-64 years (HR=1.48; 95% CI, 1.11-1.97), and the subgroup aged greater than 65 years old (HR=1.38; 95% CI, 1.21-1.58) based on 5-year follow-up. Conclusion: Clinicians should be concerned about uncharted association between TKA and RA reported our current study. Additional prospective studies and in-depth mechanistic inquiries were warranted to determine the causation.

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Biofilm Derived Oxylipin Mediated Autoimmune Response in Breast Implant Subjects

Khan

Minto

Kelley-Patteson

et al. 2020

Preprint

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Over 10 million women worldwide have breast implants for breast cancer/prophylactic reconstruction or cosmetic augmentation. In recent years, a number of patients have described a constellation of symptoms that are believed to be related to their breast implants. This constellation of symptoms has been named Breast Implant Illness (BII). The symptoms described include chronic fatigue, joint pain, muscle pain and a host of other manifestations often associated with autoimmune illnesses. In this work, we report that bacterial biofilm is associated with BII. We postulate that the pathogenesis of BII is mediated via a host-pathogen interaction whereby the biofilm bacteria Staphylococcus epidermidis interacts with breast lipids to form the oxylipin 10-HOME. The oxylipin 10-HOME was found to activate CD4+ T cells to Th1 subtype. An increased abundance of CD4+Th1 was observed in the breast tissue of BII subjects. The identification of a mechanism of immune activation associated with BII via a biofilm enabled pathway provides insight into the pathogenesis for implant-associated autoimmune symptoms.

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Connective tissue disease after hip and knee implant surgery

Abstract: Since the materials used in hip and knee implants in Denmark are not substantially different, these results are unlikely to reflect an implant effect but rather the selection criteria of referral for implant surgery.

Cited by 4 publications

References 3 publications

Biofilm-derived oxylipin 10-HOME–mediated immune response in women with breast implants

Biofilm-derived oxylipin 10-HOME–mediated immune response in women with breast implants

Increased Risk of New-Onset Rheumatoid Arthritis Among Osteoarthritis Patients Received Total Knee Arthroplasty: a global federated health network analysis

Biofilm Derived Oxylipin Mediated Autoimmune Response in Breast Implant Subjects

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