Local and Systemic Activation of the Mononuclear Phagocyte System in Aseptic Loosening of Total Hip Arthroplasty

Flécher, Xavier; Rolland, Christelle; Rixrath, Emmanuel; Argenson, Jean-Noël; Robert, P.; Bongrand, Pierre; Wendling, Sylvie; Vitte, Joana

doi:10.1007/s10875-009-9305-9

Cited by 13 publications

(8 citation statements)

References 28 publications

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“…The titanium samples mimick the real state occurring in the periprosthetic region, which was derived from the implants in vivo. 48 The figure shows that similar levels of osteoclasts were reached when cultured in the extracts of Ti, TiO 2 , and AT-TiO 2 . Fig.…”

Section: Osteoclast Activitymentioning

confidence: 76%

Strontium delivery on topographical titanium to enhance bioactivity and osseointegration in osteoporotic rats

Wen

Pan

et al. 2015

J. Mater. Chem. B

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Strontium delivery on topographical titanium to enhance bioactivity and osseointegration in osteoporotic ratsThis work completed by Wen Jin, Li Jinhua et al. indicated that a topographical titanium surface with substituted strontium could promote osteogenic diff erentiation, inhibit osteoclast formation in vitro and have a good osseointegration eff ect in osteoporotic rats. 4790 | J. Mater. Chem. B, 2015, 3, 4790--4804 This journal is Osseointegration remains a major clinical challenge in osteoporotic patients. Strontium (Sr) has been shown to be a significant therapy to favor bone growth by both increasing new bone formation and reducing bone resorption. In this study, we attempt to chemically functionalize Ti implants by micro-arc oxidation, alkali treatment and ion exchange. This functionalized Ti surface possessed a hierarchical topography with Sr incorporation, which can release Sr ions at a slow rate. To our knowledge, this work is the first to use this type of Sr-doped Ti surface to address osteoporotic bone mesenchymal stem cells (BMSCs) in the dual directions of bone regeneration, bone formation and bone resorption. The modified surface was demonstrated to remarkably enhance the adhesion, spreading, and osteogenic differentiation of BMSCs in vitro. The effect of the wash-out solution from various groups on osteoporotic BMSCs was also investigated. The Sr-doped group can improve the ALP activity and osteogenic gene expression.Moreover, the Sr-doped group and the wash-out solution show the most inhibition in osteoclast formation and maturation. Furthermore, the increased bioactivity of the hierarchical structure was also confirmed with the ovariectomized rat femur model in vivo. The outcome of fluorescence labeling, histology and histomorphometric analysis demonstrated a significant promotion of osseointegration in ovariectomized rats. Altogether, the experimental data indicate that the fabrication of a Sr-doped hierarchical Ti surface is a meaningful attempt to incorporate the Sr nutrient element into Ti-based implants, and it is expected to be exploited in developing better osseointegration for osteoporotic patients.

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Section: Osteoclast Activitymentioning

confidence: 76%

Strontium delivery on topographical titanium to enhance bioactivity and osseointegration in osteoporotic rats

Wen

Pan

et al. 2015

J. Mater. Chem. B

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“…Activation of the monocyte-macrophage-system leads to a local inflammatory reaction and is a relevant promoter for prosthetic loosening [6]. …”

Section: Introductionmentioning

confidence: 99%

The development of whole blood titanium levels after instrumented spinal fusion – Is there a correlation between the number of fused segments and titanium levels?

Ipach¹,

Schäfer²,

Mittag³

et al. 2012

BMC Musculoskelet Disord

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BackgroundMost modern spinal implants contain titanium and remain in the patient’s body permanently. Local and systemic effects such as tissue necrosis, osteolysis and malignant cell transformation caused by implants have been described. Increasing tissue concentration and whole blood levels of ions are necessary before a disease caused by a contaminant develops. The aim of the present study was the measurement of whole blood titanium levels and the evaluation of a possible correlation between these changes and the number of fused segments.MethodsA prospective study was designed to determine changes in whole blood titanium levels after spinal fusion and to analyze the correlation to the number of pedicle screws, cross connectors and interbody devices implanted.Blood samples were taken preoperatively in group I (n = 15), on the first, second and 10th day postoperatively, as well as 3 and 12 months after surgery.Group II (n = 16) served as a control group of volunteers who did not have any metal implants in the body. Blood samples were taken once in this group.The number of screw-rod-connections and the length of the spinal fusion were determined using radiographic pictures. This study was checked and approved by the ethical committee of the University of Tuebingen.ResultsThe mean age in group I was 47 ± 22 years (range 16 - 85 years). There were three male (20%) and twelve female (80%) patients. The median number of fused segments was 5 (range 1 to 11 segments).No statistically significant increase in the titanium level was seen 12 months after surgery (mean difference: -7.2 μg/l, 95% CI: -26.9 to 12.5 μg/l, p = 0.446). By observing the individual titanium levels, 4 out of 15 patients demonstrated an increase in titanium levels 12 months after surgery.No statistically significant correlation between fused segments (r = -0.188, p = 0.503) length of instrumentation (r = -0.329, p = 0.231), number of interbody devices (r = -0.202, p = 0.291) and increase of titanium levels over the observation period was seen.ConclusionsInstrumented spinal fusion does not lead to a statistically significant increase in whole blood titanium levels. There seems to be no correlation between the number of pedicle screws, cross connectors and interbody devices implanted and the increase of serum titanium levels.

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“…Previous studies have suggested that localized peri-implant bone loss might be reflected at the systemic level 29,30 . Synovial fluid analyses have provided information on biochemical changes in the joint 31 . However, the usefulness of joint aspirate as a matrix for biomarkers is a matter of debate 32 .…”

Section: Discussionmentioning

confidence: 99%

Wear of hip prostheses increases serum IGFBP-1 levels in patients with aseptic loosening

Vallés

García-Rey

Saldaña

et al. 2021

Sci Rep

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The biological mechanisms involved in aseptic loosening include inflammation-associated and bone resorption-associated processes. Coordinated cellular actions result in biochemical imbalances with devastating consequences for the joint. Given that this condition is not known for showing systemic signs, we investigated whether circulating levels of inflammation-related proteins are altered in patients with aseptic loosening. Our study included 37 patients who underwent revision surgery due to hip osteolysis and aseptic loosening and 31 patients who underwent primary total hip arthroplasty. Using antibody arrays, we evaluated the serum levels of 320 proteins in four patients from each group. The results showed differences in insulin-like growth factor-binding protein 1 (IGFBP-1) concentrations, which we then quantified using enzyme-linked immunosorbent assay tests in all study patients. The results confirmed that serum IGFBP-1 concentrations were higher in the revision surgery patients than in the hip arthroplasty patients. In vitro studies showed that exposure of human osteoblasts to titanium particles induced an IGFBP-1 release that further increased when exposure to particles was performed in media conditioned by human M1 macrophages. These findings suggest that elevated serum IGFBP-1 levels in patients with aseptic loosening can arise from increased local IGFBP-1 production in the inflammatory environment of the periprosthetic bed.

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Local and Systemic Activation of the Mononuclear Phagocyte System in Aseptic Loosening of Total Hip Arthroplasty

Abstract: Taken together, our results demonstrate the integrated activation of the MPS and suggest the possible use of cytokines in the laboratory workup of prosthesis aseptic loosening.

Cited by 13 publications

References 28 publications

Strontium delivery on topographical titanium to enhance bioactivity and osseointegration in osteoporotic rats

Strontium delivery on topographical titanium to enhance bioactivity and osseointegration in osteoporotic rats

The development of whole blood titanium levels after instrumented spinal fusion – Is there a correlation between the number of fused segments and titanium levels?

Wear of hip prostheses increases serum IGFBP-1 levels in patients with aseptic loosening

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