| Cellular response to prosthetic wear debris differs in rheumatoid versus non-rheumatoid arthritis patients. | |
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MedLine Citation:
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PMID: 22127818 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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OBJECTIVE: This study examined whether patients with rheumatoid arthritis (RA) demonstrate different patterns of prosthetic wear or cellular responses to implant wear debris compared to patients without inflammatory joint disease. METHODS: Thirty-eight patients who had a primary revision of a total elbow arthroplasty (TEA) for aseptic loosening between 1996 and 2008 were identified. Twenty-five had RA and 13 had no inflammatory arthritis. Clinical data, gross wear patterns of the removed prostheses, and histopathological analyses of peri-implant tissue were compared between RA and non-RA patients. RESULTS: Evaluation of the retrieved prostheses showed that conformational change of the humeral polyethylene bushing was associated with the generation of polyethylene and metal particles. The amount and type of wear debris in peri-prosthetic tissues was similar in RA and non-RA patients. RA patients not on anti-tumor necrosis factor (TNF) therapy exhibited a histologic pattern of interstitial and sheet-like lymphocytic infiltrates associated with a high plasma cell composition, which was different from the predominantly perivascular infiltrates with few plasma cells seen in non-RA patients (p-value = 0.04). RA patients on anti-TNF therapy fell in between these two groups. CONCLUSION: RA patients exhibit a distinct cellular response to implant wear debris compared with non-RA patients. This reaction was unrelated to differences in the type or amount of wear debris and was mitigated by anti-TNF therapy. These results suggest an intrinsic alteration in immunoregulation in RA and have implications for potential immunologic treatment of osteolysis in these patients. |
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Authors:
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Anant Vasudevan; Edward F Dicarlo; Timothy Wright; Dan Chen; Mark P Figgie; Steven R Goldring; Lisa A Mandl |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2011-11-29 |
Journal Detail:
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Title: Arthritis and rheumatism Volume: - ISSN: 1529-0131 ISO Abbreviation: - Publication Date: 2011 Nov |
Date Detail:
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Created Date: 2011-11-30 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0370605 Medline TA: Arthritis Rheum Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Copyright Information:
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Copyright © 2011 by the American College of Rheumatology. |
Affiliation:
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Yale University School of Medicine, New Haven, CT. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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