Document Detail


No difference in early cellular response of the pseudo-synovial membrane after total hip arthroplasty: comparison of 3 combinations of bearing materials.
MedLine Citation:
PMID:  16819678     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Wear-resistant bearing materials may hypothetically reduce chronic inflammation in the pseudosynovial membrane as compared to less wear-resistant bearing materials such as polyethylene. We assessed the foreign body response in the pseudosynovial membrane in vivo after total hip replacement. METHODS: 37 patients from a larger prospective randomized trial of 225 patients had biopsies taken arthroscopically from the artificial hip joint (i.e. the pseudosynovial membrane) 1 year after insertion of the implant. All patients had an identical hip prosthesis (Bimetric-RingLoc) except for the bearing materials, which consisted of polyethylene on zirconia, CoCr on CoCr, or alumina on alumina. Histological quantification was performed on 2-mum-thick semi-thin plastic sections or paraffin sections by point counting technique to compare the volume fraction of macrophages, granulomas and endothelial cells in biopsies of the pseudosynovial membrane. RESULTS: The median macrophage volume fractions for polyethylene-on-zirconia bearing material (n = 15), CoCr-on-CoCr (n = 9), and alumina-on-alumina (n = 11) were 0.02, 0.04, and 0.004, respectively. The median granuloma volume fractions for polyethylene-on-zirconia (n = 13), CoCr-on-CoCr (n = 9), and alumina-on-alumina (n = 13) were 0.02, 0.04, and 0.02, respectively. The median endothelial cell volume fractions for polyethylene-on-zirconia (n = 15), CoCr-on-CoCr (n = 9), and alumina-on-alumina (n = 11) were 0.03, 0.02, and 0.05, respectively. Statistical analysis showed no significant differences between the three groups with the different bearings with respect to volume fraction of macrophages, granulomas and endothelial cells. INTERPRETATION: Our study demonstrated that a granulomatous inflammation is a common finding in non-loose implants as early as 1 year after the operation not demonstrating a difference in macrophages and granuloma formation with the various bearing materials. Thus a high volume fraction of macrophages was found in the osteoarthritis control group compared to the operated group.
Authors:
Marianne Nygaard; Folmer Elling; Lone Bastholm; Kjeld Søballe; Arne Borgwardt
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Publication Detail:
Type:  Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Acta orthopaedica     Volume:  77     ISSN:  1745-3674     ISO Abbreviation:  Acta Orthop     Publication Date:  2006 Jun 
Date Detail:
Created Date:  2006-07-04     Completed Date:  2006-08-04     Revised Date:  2009-12-11    
Medline Journal Info:
Nlm Unique ID:  101231512     Medline TA:  Acta Orthop     Country:  Sweden    
Other Details:
Languages:  eng     Pagination:  402-12     Citation Subset:  IM    
Affiliation:
Department of Orthopaedic Surgery, Frederiksberg University Hospital, Frederiksberg, Denmark. many@dadlnet.dk
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Arthroplasty, Replacement, Hip* / adverse effects,  methods
Biopsy / methods
Female
Femur Head Necrosis / surgery
Follow-Up Studies
Foreign-Body Reaction / etiology,  immunology,  pathology*
Granuloma, Foreign-Body / pathology
Hip Prosthesis / adverse effects*
Humans
Male
Materials Testing
Middle Aged
Osteoarthritis, Hip / pathology*,  surgery
Prospective Studies
Prosthesis Design
Prosthesis Failure
Synovial Membrane / pathology

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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