Journal List > J Korean Orthop Assoc > v.42(4) > 1012685

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

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.

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).
jkoa-42-490-g001
Table 1
Detailed Clinical Data of the Revision Patients
jkoa-42-490-i001

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

Table 2
Histologic Findings of Revision Patients (H&E Stain)
jkoa-42-490-i002

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

Table 3
Comparison between Cemented Cases and Uncemented Cases in Patient Group
jkoa-42-490-i003
Table 4
Comparison between Patients and Control Group in Stainability of Adhesion Molecules
jkoa-42-490-i004
Table 5
Paprosky's Classification of the Patient Group
jkoa-42-490-i005
Table 6
Correlation between Modified Paprosky Classification and Stainability of Adhesion Molecule
jkoa-42-490-i006

References

1. Al-Saffar N, Mah JT, Kadoya Y, Revell PA. Neovascularisation and the induction of cell adhesion molecules in response to degradation products from orthopaedic implants. Ann Rheum Dis. 1995. 54:201–208.
crossref
2. Amstutz HC, Campbell P, Kossovsky N, Clarke IC. Mechanism and clinical significance of wear debris-induced osteolysis. Clin Orthop Relat Res. 1992. 276:7–18.
crossref
3. Betts F, Wright T, Salvati EA, Boskey A, Bansal M. Cobalt-alloy metal debris in periarticular tissues from total hip revision arthroplasties. Metal contents and associated histologic findings. Clin Orthop Relat Res. 1992. 276:75–82.
4. Chiba J, Rubash HE, Kim KJ, Iwaki Y. The characterization of cytokines in the interface tissue obtained from failed cementless total hip arthroplasty with and without femoral osteolysis. Clin Orthop Relat Res. 1994. 300:304–312.
crossref
5. Cicuttini FM, Martin M, Boyd AW. Cytokine induction of adhesion molecules on synovial type B cells. J Rheumatol. 1994. 21:406–412.
6. Cila E, Alpaslan AM, Melli M, Tokgözoğlu AM. Prostaglandin E2 activity in the synovial-like membrane. J Arthroplasty. 1994. 9:67–71.
crossref
7. Fairburn K, Kunaver M, Wilkinson LS, Cambridge G, Haskard D, Edwards JC. Intercellular adhesion molecules in normal synovium. Br J Rheumatol. 1993. 32:302–306.
crossref
8. Fassbender K, Kaptur S, Becker P, Groschl J, Hennerici M. Adhesion molecules in tissue injury: kinetics of expression and shedding and association with cytokine release in humans. Clin Immunol Immunopathol. 1998. 89:54–60.
crossref
9. Freeman MA, Bradley GW, Revell PA. Observations upon the interface between bone and polymethylmethacrylate cement. J Bone Joint Surg Br. 1982. 64:489–493.
crossref
10. Griffiths CE, Barker JN, Kunkel S, Nickoloff BJ. Modulation of leucocyte adhesion molecules, a T-cell chemotaxin (IL-8) and a regulatory cytokine (TNF-alpha) in allergic contact dermatitis (rhus dermatitis). Br J Dermatol. 1991. 124:519–526.
11. Hale LP, Martin ME, McCollum DE, et al. Immunohistologic analysis of the distribution of cell adhesion molecules within the inflammatory synovial microenvironment. Arthritis Rheum. 1989. 32:22–30.
crossref
12. Harris WH, Schiller AL, Scholler JM, Freiberg RA, Scott R. Extensive localized bone resorption in the femur following total hip replacement. J Bone Joint Surg Am. 1976. 58:612–618.
crossref
13. Jasty MJ, Floyd WE 3rd, Schiller AL, Goldring SR, Harris WH. Localized osteolysis in stable, non-septic total hip replacement. J Bone Joint Surg Am. 1986. 68:912–919.
crossref
14. Jiranek WA, Machado M, Jasty M, et al. Production of cytokines around loosened cemented acetabular components. Analysis with immunohistochemical techniques and in situ hybridization. J Bone Joint Surg Am. 1993. 75:863–879.
crossref
15. Johanson NA, Bullough PG, Wilson PD Jr, Salvati EA, Ranawat CS. The microscopic anatomy of the bone-cement interface in failed total hip arthroplasties. Clin Orthop Relat Res. 1987. 218:123–135.
crossref
16. Jones LC, Frondoza C, Hungerford DS. Immunohistochemical evaluation of interface membranes from failed cemented and uncemented acetabular components. J Biomed Mater Res. 1999. 48:889–898.
crossref
17. Koch AE, Burrows JC, Haines GK, Carlos TM, Harlan JM, Leibovich SJ. Immunolocalization of endothelial and leukocyte adhesion molecules in human rheumatoid and osteoarthritic synovial tissues. Lab Invest. 1991. 64:313–320.
18. Norris P, Poston RN, Thomas DS, Thornhill M, Hawk J, Haskard DO. The expression of endothelial leukocyte adhesion molecule-1 (ELAM-1), intercellular adhesion molecule-1 (ICAM-1), and vascular cell adhesion molecule-1 (VCAM-1) in experimental cutaneous inflammation: a comparison of ultraviolet B erythema and delayed hypersensitivity. J Invest Dermatol. 1991. 96:763–770.
crossref
19. Paprosky WG, Perona PG, Lawrence JM. Acetabular defect classification and surgical reconstruction in revision arthroplasty. A 6-year follow-up evaluation. J Arthroplasty. 1994. 9:33–44.
20. Sabokbar A, Fujikawa Y, Neale S, Murray DW, Athanasou NA. Human arthroplasty derived macrophages differentiate into osteoclastic bone resorbing cells. Ann Rheum Dis. 1997. 56:414–420.
crossref
21. Shimada H, Eguchi K, Ueki Y, et al. Interleukin 4 increases human synovial cell expression of VCAM-1 and T cell binding. Ann Rheum Dis. 1994. 53:601–607.
crossref
22. van Dinther-Janssen AC, Kraal G, van Soesbergen RM, Scheper RJ, Meijer CJ. Immunohistological and functional analysis of adhesion molecule expression in the rheumatoid synovial lining layer. Implications for synovial lining cell destruction. J Rheumatol. 1994. 21:1998–2004.
23. Wilkinson LS, Edwards JC, Poston RN, Haskard DO. Expression of vascular cell adhesion molecule-1 in normal and inflamed synovium. Lab Invest. 1993. 68:82–88.
TOOLS
Similar articles