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The Journal of Bone and Joint Surgery, Vol 71, Issue 10 1530-1541, Copyright © 1989 by Journal of Bone and Joint Surgery, Inc
Polymethylmethacrylate-induced release of bone-resorbing factors
JH Herman, WG Sowder, D Anderson, AM Appel and CN Hopson
Department of Internal Medicine, University of Cincinnati College of Medicine, Ohio 45267.
A pseudomembranous structure that has the histological characteristics of a
foreign-body-like reaction invariably develops at the bone-cement interface
in the proximity of resorption of bone around aseptically loosened cemented
prostheses. This study was an attempt to implicate polymethylmethacrylate
in this resorptive process. Unfractionated peripheral-blood mononuclear
cells (consisting of lymphocytes and monocytes) and surface-adherent cells
(monocyte-enriched) were prepared from control subjects who did and did not
have clinical evidence of osteoarthrosis and from patients who had
osteoarthrosis and were having a revision for failure of a cemented hip or
knee implant. Cells were cultured for varying periods in the presence and
absence of nonpolymerized methacrylate (one to two-micrometer spherules),
pulverized polymerized material, or culture chambers that were pre-coated
with polymerized cement. Conditioned media that were derived from both
methacrylate-stimulated cell populations were shown to contain specific
bone-resorbing mediators (interleukin-1, tumor necrosis factor, or
prostaglandin E2) and to directly affect bone resorption in 45Ca-labeled
murine limb-bone assays.
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