The Expression of the Adhesion Molecules on Interfacial Membrane from the Aseptically Loosened Failed Femoral Stems in Revisional Hip Arthroplasty

Soo-Ho Lee; Ji-Hyo Hwang; Dong-Wook Kim; Byung-Kwan Kim; Ho-Wook Jeong

doi:10.4055/jkoa.2007.42.4.490

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Lee, Hwang, Kim, Kim, and Jeong: The Expression of the Adhesion Molecules on Interfacial Membrane from the Aseptically Loosened Failed Femoral Stems in Revisional Hip Arthroplasty

Original Article

Journal of the Korean Orthopaedic Association

Journal of the Korean Orthopaedic Association 2007; 42(4): 490-497.

Published online: 31 August 2007

DOI: https://doi.org/10.4055/jkoa.2007.42.4.490

The Expression of the Adhesion Molecules on Interfacial Membrane from the Aseptically Loosened Failed Femoral Stems in Revisional Hip Arthroplasty

Soo-Ho Lee, M.D., Ji-Hyo Hwang, M.D.^*, Dong-Wook Kim, M.D., Byung-Kwan Kim, M.D., Ho-Wook Jeong, M.D.

Department of Orthopedic Surgery, Asan Medical Center, Ulsan University College of Medicine, Seoul, Korea.

^*Department of Orthopedic Surgery, Hallym University College of Medicine, Kangnam Sacred Heart Hospital, Seoul, Korea.

Address reprint requests to Soo-Ho Lee, M.D. Department of Orthopedic Surgery, Asan Medical Center, Ulsan University College of Medicine, 388-1, Pungnap 2-dong, Songpa-gu, Seoul 138-736, Korea. TEL: +82.2-3010-3530, Fax: +82.2-488-7877, shlee2@amc.seoul.kr

Abstract

Purpose

To clarify the relationship between aseptic loosening of hip arthroplasty and adhesion molecules on interfacial membrane from revisional hip arthroplasty.

Materials and Methods

We studied 26 revisional total hip arthroplasties between May 2004 and July 2006, and 15 synovial tissues from hip fractures were selected as the control group. We analyzed the degree of femoral osteolysis by Paprosky's classification. We examined the expression of soluble endothelial leukocyte adhesion molecule-1 (E-selectin), vascular adhesion molecule-1 (VCAM-1) and intercellular adhesion molecule-1 (ICAM-1) by immunohistochemical staining technique. We compared and analyzed radiologic evaluation and expression of adhesion molecules.

Results

Expression of E-selectin was observed in 100%, VCAM-1 in 42.3% and ICAM-1 in 34.6%. Expression of adhesion molecules were increased compared to the control group (p<0.05). The higher the expression of E-selectin, the higher the degree of osteolysis (p=0.023).

Conclusion

These results showed that adhesion molecules are involved in aseptic loosening of hip arthroplasties, and we proposed that E-selectin may strongly engage in the cascade of aseptic loosening in hip arthroplasty.

Keywords: Interfacial membrane, Adhesion molecule, Aseptic loosening, Revisional hip arthroplasty

Figures and Tables

Fig. 1

A microscopic image demonstrating vessels stained with antibody to E-selectin (arrow). (A) Negative for staining. (B) 1st grade of intensity and 1st grade of proportion. (C) 1st grade of intensity and 2nd grade of proportion (×100).

Table 1

Detailed Clinical Data of the Revision Patients

^*HHS, Harris hip score; ^†THA, Total hip arthroplasty; ^‡BPHA, Bipolar hemiarthroplasty.

Table 2

Histologic Findings of Revision Patients (H&E Stain)

0, absent; 1, mild; 2, extensive.

Table 3

Comparison between Cemented Cases and Uncemented Cases in Patient Group

Table 4

Comparison between Patients and Control Group in Stainability of Adhesion Molecules

Table 5

Paprosky's Classification of the Patient Group

Table 6

Correlation between Modified Paprosky Classification and Stainability of Adhesion Molecule

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