Periprosthetic osteolysis and its association with RANKL expression

Veigl, D; Niederlova, J; Kryštůfková, Olga

doi:10.33549/physiolres.930997

Cited by 21 publications

(5 citation statements)

References 19 publications

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“…These pro-inflammatory cytokines then result in osteolysis. In addition, wear-particle-mediated osteolysis can be regulated by not only pro-inflammatory cytokines (IL-1, IL-6, TNF-α, IL-8), induced by wear particles which act on the differentiation and activation of osteoclasts directly, but also osteoblast-released cytokines such as osteoprotegerin (OPG) and the 'receptor activator of NFk B' ligand (RANKL), stimulated by wear particles which control bone resorption and bone formation by means of molecules [1]. The RANKL/RANK/OPG system plays an important role in the process of wear-particles-induced periprosthetic aseptic loosening.…”

Section: Introductionmentioning

confidence: 99%

The inhibitory effect of strontium-doped calcium polyphosphate particles on cytokines from macrophages and osteoblasts leading to aseptic looseningin vitro

Huang¹,

Li²,

Yu³

et al. 2014

Biomed. Mater.

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Aseptic loosening is a common cause of joint implant failure in humans. In order to enhance implant stability, we need to develop a new material that not only promotes the wear resistance of components of an artificial joint, but also possesses the pharmaceutical efficacy of protecting patients against aseptic loosening. Strontium-doped calcium polyphosphate (SCPP) has been found to have this potential ability. The goal of this study is to respectively quantify the levels of TNF-α (for macrophages), receptor activator of NF-kB ligand (RANKL) and osteoprotegerin (OPG) (for osteoblasts) when osteoblasts and macrophages are challenged with various particles (including SCPP). In this study, the osteoblasts ROS 17/2.8 and macrophages RAW 264.7 were challenged with various wear particles (8% SCPP, the molar percentage of Sr in SCPP is 8%, UHMWPE, hydroxyapatite (HA) and CPP). The secretion of TNF-α (from RAW 264.7), OPG and RANKL protein (from ROS 17/2.8) was analyzed by ELISA. The OPG and RANKL mRNA from ROS 17/2.8 was detected by RT-PCR. The data of ELISA indicated that the amount of TNF-α challenged with 8% SCPP particles was more than three-fold lower than that of all other test groups. The ratio of OPG/RANKL in the 8% SCPP group was significantly increased compared to that of all other test groups. The results of OPG and RANKL mRNA expression showed the same tendency as the ELISA results. In general, this study showed that 8% SCPP particles can inhibit the expression of TNF-α and RANKL, promote the expression of OPG so that SCPP can inhibit bone resorption and promote bone formation, and then inhibit aseptic loosening. Thus SCPP could be a promising material for the construction of artificial joints.

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Section: Introductionmentioning

confidence: 99%

The inhibitory effect of strontium-doped calcium polyphosphate particles on cytokines from macrophages and osteoblasts leading to aseptic looseningin vitro

Huang¹,

Li²,

Yu³

et al. 2014

Biomed. Mater.

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“…nedostatečná protireakce OPG, se podílí na zvýšené diferenciaci a aktivaci osteoklastů, což vede k narušení rovnováhy v kostní multicelulární jednotce. Naru-šení vztahu mezi expresí RANKL a OPG molekul bylo pozorováno také v periprotetických tkáních (14,29). Naopak u artrotických kloubů bývají hladiny OPG vyšší než RANKL, což je rovněž ve shodě s naší studií, kde byl medián OPG u artrotických kloubů 12,651 pg/ml (tab.…”

Section: Původní Práce Original Paperunclassified

“…Dřívější studie referovaly asociaci mezi tkáňovou expresí cytokinů a periprotetickou osteolýzou (29). Avšak prací, které by korelovaly vztah mezi hladinami cytokinů ve výpotku a rozsahem kostního defektu, je…”

Section: Původní Práce Original Paperunclassified

Synovial Fluid from Aseptically Failed Total Hip or Knee Arthroplasty is Not Toxic to Osteoblasts

Gallo¹,

Zdařilová²,

Svobodová³

et al. 2010

ACHOT

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PURPOSE OF THE STUDYA failure of total hip or knee artroplasty is associated with an increased production of joint fluid. This contains wear particles and host cells and proteins, and is assumed to be involved in the pathogenesis of aseptic loosening and periprosthetic osteolysis. This study investigated the effect of synovial fluid from patients with aseptically failed joint prostheses on osteoblast cultures. MATERIAL AND METHODSSynovial fluid samples were obtained from patients with failed total joint prostheses (TJP; n=36) and from control patient groups (n=16) involving cases without TJP and osteoarthritis, without TJP but with osteoarthritis, and with stable TJP. The samples were treated in the standard manner and then cultured with the SaOS-2 cell line which shows the characteristics and behaviour of osteoblasts. Each fluid sample was also examined for the content of proteins, cells and selected cytokines (IL-1β, TNF-α, IL-6, RANKL and OPG detected by ELISA). We tested the hypothesis assuming that the fluids from failed joints would show higher cytotoxicity to osteoblast culture and we also expected higher levels of IL-1β, TNF-α, IL-6, and RANKL in patients with TJP failure and/ or with more severe bone loss. The statistical methods used included the Kruskal-Wallis ANOVA and Mann-Whitney U test. RESULTSThe fluids from failed TJPs showed the highest RANKL and the lowest OPG levels resulting in the highest RANKL/OPG ratio. However, there was no evidence suggesting that the joint fluids from failed TJPs would be more toxic to osteoblast culture than the fluids from control groups. In addition, no correlation was found between the fluid levels of molecules promoting inflammation and osteoclastic activity and the extent of bone loss in the hip (in terms of Saleh's classification) or the knee (AORI classification). In fact, the fluids from failed TJPs had higher protein levels in comparison with the controls, but the difference was not significant. DISCUSSIONThe finding of high RANKL levels and low OPG concentrations is in agreement with the theory of aseptic loosening and periprosthetic osteolysis. The other cytokines, particularly TNF-α and IL-1β, were found in low levels. This can be explained by the stage of particle disease at which the samples were taken for ELISA analysis. It is probable that the level of signal molecules reflects osteolytic process activity and is therefore not constant. The reason for no correlation found between cytokine levels and the extent of bone loss may also lie in the use of therapeutic classifications of bone defects that is apparently less sensitive to the biological activity of aseptic loosening and/or periprosthetic osteolysis. CONCLUSIONSSynovial fluids from failed total hip or knee joint prostheses are not toxic to osteoblast cultures. Cytotoxicity indicators and levels of pro-inflammatory and pro-osteoclastic cytokines (IL-1β, TNF-α, IL-6, RANKL and OPG) do not correlate well with the extent of periprosthetic bone loss.

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“…V posledním desetiletí se objevily snahy o využití keramiky v konstrukci kolenních náhrad také v USA (18) a dalších zemích (15) a byly většinou omezeny na komponentu femorální. Stejně tak ovlivnění biologické reakce na otěrové částice je obtížné, neboť mechanismus celého procesu na molekulární úrovni není zatím dostatečně prozkoumán (22,23). Také snahy o změnu struktury PE se zatím nesetkaly s úspěchem, neboť nové materiály sice vykazují snížený absolutní objem otěru, produkují však většinou menší a tím biologicky nebezpečnější částice.…”

Section: Diskuseunclassified

Clinical Evaluation of the Ceramic Femoral Component Used for Reconstruction of Total Knee Replacement

Vavřík¹,

Landor²,

Denk³

2008

ACHOT

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PURPOSE OF THE STUDYThe study evaluates mid-term results of total knee replacement with a zirconia ceramic (ZrO 2 ) femoral component. MATERIALThe evaluated group comprised 20 knees in 19 patients (4 men and 15 women). In one patient the replacement was performed bilaterally. Two patients had in the contralateral knee the same type of prosthesis with a femoral chrome-cobalt component.The mean age at the time of operation was 65.2 years (range, 38-81 years).The primary indication was 14times osteoarthritis and 5times rheumatoid arthritis. The average follow-up period was 6.5 years (range, 2.1-8.5 years). METHODSPatients included in the study regardless of age, body mass and the basic diagnosis, agreed with the use of the ceramic femoral component. The evaluation covered a range of motion, mechanical axis, joint stability, pain, swelling, ability to walk on level ground and on stairs, subjective satisfaction (EULAR Knee Chart). Radiograph were assessed at one year intervals in two projections to identify the incidence of radiolucency around the implant. The Kaplan-Meier survival curve was used and compared with the survival curve in identical chrome-cobalt implants. RESULTSAt he final follow-up, 14 knees were evaluated, because 3 patients died without any connection with the implant, in one case the tibial component migrated due to necrosis of the tibial condyle in a patient with RA and two implants had to be revised and replaced due to polyethylene wear. No infection or negative tissue reaction was recorded in the evaluated group. The average flexion range was 109 degrees. All knees were stable and without swelling, in two cases there occurred slight femoropatellar pain. Twelve patients were fully satisfied, 2 patients were satisfied with a certain reservation. The diferences in the course of the survival curves of chrome-cobalt and ceramic implants were statistically insignificant. DISCUSSIONAlthough the use of zirconia ceramics in vitro reduces the amount of polyethylene wear, the clinical outcomes of total knee replacements as compared to the hip are not convincing. One of the causes may be the substantially different and more complex biomechanics of the knee. Tribology improvement of the femoral ceramic component cannot compensate the deficiencies in the joint balancing in flexion and extension. The economically and technlogically demanding production of these implants may be justified in patients with allergies caused by chrome-cobalt components. CONCLUSIONSThe results of mid-term follow-up of the use of zirconia ceramic femoral components proved no impact on the improvement of the period of survival of the knee implant. No adverse response to the material or mechanical failure of the ceramic components was encountered.

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Periprosthetic osteolysis and its association with RANKL expression

Cited by 21 publications

References 19 publications

The inhibitory effect of strontium-doped calcium polyphosphate particles on cytokines from macrophages and osteoblasts leading to aseptic looseningin vitro

The inhibitory effect of strontium-doped calcium polyphosphate particles on cytokines from macrophages and osteoblasts leading to aseptic looseningin vitro

Synovial Fluid from Aseptically Failed Total Hip or Knee Arthroplasty is Not Toxic to Osteoblasts

Clinical Evaluation of the Ceramic Femoral Component Used for Reconstruction of Total Knee Replacement

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