Journal List > J Korean Orthop Assoc > v.38(3) > 1012109

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Kim, Ihn, Sohn, Kim, Shin, and Koo: Apoptosis of Cells of Interfacial Tissue of Aseptic Loosening and Osteolysis after Hip rthroplasty
Original Article

Journal of the Korean Orthopaedic Association 2003; 38(3): 245-251.

Published online: 3 January 2018

DOI: https://doi.org/10.4055/jkoa.2003.38.3.245

Apoptosis of Cells of Interfacial Tissue of Aseptic Loosening and Osteolysis after Hip rthroplasty

Shin Yoon Kim, Joo Chul Ihn, Yoon Kyung Sohn, Jung Wan Kim, Hong Ihn Shin, Kyung Hoi Koo

Department of Orthopedic Surgery, School of Medicine, Kyungpook National University, Daegu, Korea.

Department of Pathology, School of Medicine, Kyungpook National University, Daegu, Korea.

Department of Microbiology, School of Dental Medicine, Kyungpook National University, Daegu, Korea.

Department of Pathology, School of Dental Medicine, Kyungpook National University, Daegu, Korea.

Department of Orthopedic Surgery, School of Medicine, Seoul National University, Seoul, Korea.

syukim@knu.ac.kr

Copyright © 2003 The Korean Orthopaedic Association

Abstract

Purpose

To evaluate the relationships between the apoptosis induced by nitric oxide (NO), aseptic loosening and osteolysis, which are the most serious causes of failure after total hip arthroplasty.

Materials and Methods

Apoptosis of the inflammatory cells of interface tissues from 18 patients who underwent revision hip arthroplasty was identified by Terminal Deoxyribonucleotidyl Transferase-Mediated dUTP Nick End Labeling (TUNEL). The reaction to immunostaining of inducible nitric oxide synthase (iNOS), p53, Bax, Bcl2, and Ki-67 were evaluated. Six joint capsules obtained from six patients of femoral neck fracture were studied as controls.

Results

Sixteen (89%) of 18 interface tissues were positive for iNOS, p53, and Bax monoclonal antibody and twelve (67%) for Bcl2 and Ki-67 monoclonal antibody. All tissues were positive for TUNEL. In the control group of six joint capsules, only one (17%) was positive for iNOS and Bax, and three (50%) were positive for TUNEL. The incidences of apoptotic signals at the interfacial tissue of aseptic loosening and osteolysis were significantly greater than those of the control.

Conclusion

The current study suggested that the apoptosis of inflammatory cells, due to oxidative stress by NO, might be involved in the development of implant loosening and osteolysis after total hip arthroplasty. This information might be crucial for the treatment and prevention of periprosthetic osteolysis and subsequent loosening.

Keywords: Hip arthroplasty, Aseptic loosening, Osteolysis, Apoptosis

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