The Journal of Bone and Joint Surgery, Vol 69, Issue 1 46-49, Copyright © 1987 by Journal of Bone and Joint Surgery, Inc
Anaphylatoxin release in association with methylmethacrylate fixation of hip prostheses
A Bengtson, M Larsson, W Gammer and M Heideman
In a prospective study, thirty patients in whom a Charnley hip prosthesis
was implanted with cement (methylmethacrylate) and fifteen who received a
prosthesis without cement were studied. The activation of complement, as
indicated by the release of anaphylatoxins (C3a and C5a), reduced activity
of whole complement, and decreased levels of C3, C4, and C5 in plasma, was
evaluated. Activation of complement was found when methylmethacrylate was
used. In patients in whom components were fixed without cement, no
formation of anaphylatoxins occurred, and only slightly reduced
whole-complement activity and concentrations of C3, C4, and C5 in plasma
were found. A dose-correlated release of the anaphylatoxins was found when
monomethylmethacrylate was incubated in fresh serum. One explanation for
the hemodynamic instability in these patients might be the biological
effects of anaphylatoxins that are released in association with fixation by
cement.