The Journal of Bone and Joint Surgery, Vol 76, Issue 2 172-180, Copyright © 1994 by Journal of Bone and Joint Surgery, Inc
In vivo and in vitro analysis of membranes from hip prostheses inserted without cement
KJ Kim, J Chiba and HE Rubash
Ferguson Laboratory, Department of Orthopaedic Surgery, University of Pittsburgh, Pennsylvania.
Biochemical, histological, and immunohistochemical studies of interface
membranes surrounding failed hip prostheses that had been inserted without
cement were done to examine specific factors involved in the development of
aseptic loosening. Membranes from sixty-four femoral components were
obtained from sixty-three patients during revision arthroplasty.
Fifty-seven membranes were from implants that articulated with polyethylene
(thirty-two were made of cobalt-chromium alloy and twenty-five, titanium
alloy), and seven were from unipolar endoprostheses made of cobalt-chromium
alloy that did not articulate with polyethylene. The membranes from
implants with a polyethylene articulation produced significantly higher
levels of collagenase and interleukin-1 (p < 0.05). However, there was
no significant difference in the levels of prostaglandin E2 between the
three groups. Furthermore, membranes from implants with roentgenographic
evidence of focal osteolysis (endosteal erosion) released significantly
higher levels of interleukin-1 (p < 0.05) than did membranes from
implants without focal osteolysis. Although the membranes from the
titanium-alloy implants tended to contain more metal debris than those from
the cobalt-chromium-alloy implants, the biochemical findings were not
significantly different between these two groups. Many macrophages that
were filled with polyethylene and metal debris were present in the
membranes from both groups with a polyethylene articulation. Few T
lymphocytes or B lymphocytes were identified in the three groups.
CiteULike 
Connotea 
Del.icio.us 
Technorati What's this?
