In vivo and in vitro analysis of membranes from hip prostheses inserted without cement.

Kim, Kang Jung; Chiba, Junji; Rubash, Harry E.

doi:10.2106/00004623-199402000-00002

Cited by 128 publications

(74 citation statements)

References 26 publications

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“…In agreement with prior immunohistochemical [3,5,12,28,36,40,41] or histologic [42,59] studies, the predominant cells in both cohorts were macrophages and T cells. The contribution of neutrophils was negligible, and even the largest neutrophil infiltration (8.6/mm 2 ; Table 2) represented only a fraction of what would be considered evidence of subclinical infection [4,7,17,56].…”

Section: Discussionsupporting

confidence: 89%

“…Our findings for the conventional cohort are similar to those reported in other immunohistochemical studies of periprosthetic tissues from uncemented, gamma air-sterilized UHMWPE liners [3,5,12,29,40,41]. In general, the colocalization of wear debris and macrophages/histiocytes is well-established [28,41], and several studies have identified the presence of T cells in periprosthetic tissues, with the incidence ranging from categorically absent to 30% [28,40,41].…”

Section: Discussionsupporting

confidence: 88%

“…In general, the colocalization of wear debris and macrophages/histiocytes is well-established [28,41], and several studies have identified the presence of T cells in periprosthetic tissues, with the incidence ranging from categorically absent to 30% [28,40,41]. However, in these studies, there was no attempt to correlate the presence of wear debris with immune cells, to separately evaluate the presence of macrophages and histiocytes using a size exclusion cutoff, or to determine macrophage and T cell number in the entire tissue section.…”

Section: Discussionmentioning

confidence: 99%

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Do Tissues From THA Revision of Highly Crosslinked UHMWPE Liners Contain Wear Debris and Associated Inflammation?

Baxter

Freeman

Kurtz

et al. 2011

Clinical Orthopaedics &Amp; Related Research

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Background Polyethylene wear debris is a major contributor to inflammation and the development of implant loosening, a leading cause of THA revisions. To reduce wear debris, highly crosslinked ultrahigh-molecular-weight polyethylene (UHMWPE) was introduced to improve wear properties of bearing surfaces. As highly crosslinked UHMWPE revision tissues are only now becoming available, it is possible to examine the presence and association of wear debris with inflammation in early implant loosening. Questions/purposes We asked: (1) Does the presence of UHMWPE wear debris in THA revision tissues correlate with innate and/or adaptive immune cell numbers? (2) Does the immune cell response differ between conventional and highly crosslinked UHMWPE cohorts?Methods We collected tissue samples from revision surgery of nine conventional and nine highly crosslinked UHMWPE liners. Polarized light microscopy was used to determine 0.5-to 2-lm UHMWPE particle number/mm 2 , and immunohistochemistry was performed to determine macrophage, T cell, and neutrophil number/mm 2 . Results For the conventional cohort, correlations were observed between wear debris and the magnitude of individual patient macrophage (q = 0.70) and T cell responses (q = 0.71) and between numbers of macrophages and T cells (q = 0.77) in periprosthetic tissues. In comparison, the highly crosslinked UHMWPE cohort showed a correlation between wear debris and the magnitude of macrophage responses (q = 0.57) and between macrophage and T cell numbers (q = 0.68). Although macrophages and T cells were present in both cohorts, the highly crosslinked UHMWPE cohort had lower numbers, which may be associated with shorter implantation times. Conclusions The presence of wear debris and inflammation in highly crosslinked UHMWPE revision tissues may contribute to early implant loosening.

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Section: Discussionsupporting

confidence: 89%

Section: Discussionsupporting

confidence: 88%

Section: Discussionmentioning

confidence: 99%

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Do Tissues From THA Revision of Highly Crosslinked UHMWPE Liners Contain Wear Debris and Associated Inflammation?

Baxter

Freeman

Kurtz

et al. 2011

Clinical Orthopaedics &Amp; Related Research

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“…[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.…”

mentioning

confidence: 99%

Cellular profile and cytokine production at prosthetic interfaces

Goodman¹,

Huie

Song³

et al. 1998

The Journal of Bone and Joint Surgery. British volume

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T he tissues surrounding 65 cemented and 36 cementless total joint replacements undergoing revision were characterised for cell types by immunohistochemistry and for cytokine expression by in situ hybridisation.We identified three distinct groups of revised implants: loose implants with ballooning radiological osteolysis, loose implants without osteolysis, and well-fixed implants. In the cemented series, osteolysis was associated with increased numbers of macrophages (

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“…The complex mechanism of aseptic loosening in THA is not yet fully understood [11,14]. In recent years attention has been more and more focused on the biological response to wear debris [14].…”

Section: Discussionmentioning

confidence: 99%

Serum levels of interleukin 6 (IL-6), granulocyte-macrophage colony-stimulating factor (GM-CSF) and elastase in aseptic prosthetic loosening

Streich

Breusch

Schneider

2003

International Orthopaedics

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In synovial-like membranes from failed total hip prostheses, an increased level of cytokines and cellular mediators has been identified. We compared two matched groups of patients with total hip arthroplasty (THA)-one with surgically proven component loosening and one without. We measured serum levels of interleukin 6 (IL-6), granulocyte-macrophage colony-stimulating factor (GM-CSF) and elastase. Soluble interleukin 2 receptor (sIL-2r) was also measured to exclude any hypersensitivity reaction. We found no significant difference in serum values between groups. Neither were there any differences with respect to implant material, mode of fixation, and periprosthetic osteolysis. In contrast to previous reports, our results suggest that serum levels of cytokines and cellular mediators may not be affected in aseptic loosening.Résumé Un niveau élevé de cytokines et de médiateurs cellulaires a été identifié au niveau des membranes synoviales des prothèses totales de hanche descellées. Nous avons comparé deux groupes de malades porteurs de PTH, un avec un composant descellé avec certitude l'autre sans descellement. Nous avons mesuré le taux sérique d'interleukine 6 (IL 6), du facteur de stimulation des granulocytes (GM-CSF) et d'élastase. Le récepteur d'interleukine 2 (sIL-2r) a aussi été mesuré pour exclure toute réaction d'hypersensibilité. Nous n'avons trouvé aucune différence des taux sériques entre les groupes. Il n'y avait pas non plus de différence au regard du matériel implanté, du mode de fixation et de l'ostéolyse péri-prothéthique. En contraste avec des rapports antérieurs nos résultats suggèrent que les taux de cytokines et de médiateurs cellulaires dans le sérum ne sont pas affectés dans les descellements aseptiques.

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In vivo and in vitro analysis of membranes from hip prostheses inserted without cement.

Cited by 128 publications

References 26 publications

Do Tissues From THA Revision of Highly Crosslinked UHMWPE Liners Contain Wear Debris and Associated Inflammation?

Do Tissues From THA Revision of Highly Crosslinked UHMWPE Liners Contain Wear Debris and Associated Inflammation?

Cellular profile and cytokine production at prosthetic interfaces

Serum levels of interleukin 6 (IL-6), granulocyte-macrophage colony-stimulating factor (GM-CSF) and elastase in aseptic prosthetic loosening

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