PMID- 8978959
OWN - NLM
STAT- MEDLINE
DCOM- 19970314
LR  - 20170112
IS  - 0392-856X (Print)
IS  - 0392-856X (Linking)
VI  - 14
IP  - 6
DP  - 1996 Nov-Dec
TI  - Tumor necrosis factor-alpha (TNF-alpha) in loosening of total hip replacement 
      (THR).
PG  - 643-8
AB  - OBJECTIVE: The initially well-fixed implants of total hip replacement (THR) are 
      in the long-term subject to aseptic loosening. Many cytokines can contribute to 
      osteolysis due to osteoclast recruitment and/or activation. However, in this 
      respect tumor necrosis factor-alpha (TNF-alpha) plays a pivotal role, because it 
      upregulates interleukin-1 and 6 and granulocyte-macrophage colony stimulating 
      factor. The aim of this study was to assess the eventual presence, cellular 
      localization and extent of expression of TNF-alpha in the synovial-like membrane 
      at the implant or at the cement to bone interface compared to control synovial 
      membrane. METHODS: Twenty samples from the synovial-like membrane of the 
      periprosthetic tissues were compared to control samples. TNF-alpha containing 
      cells were visualized using an avidin-biotin-peroxidase complex (ABC) method and 
      analyzed by light microscopy, double labelling and image analysis. RESULTS: 
      TNF-alpha was found in the periprosthetic tissues in fibroblasts and vascular 
      endothelial cells, but mainly in the macrophages was it found to coincide with 
      areas containing implant-derived debris. TNF-alpha containing cells were more 
      numerous in the synovial-like membrane in the interface tissue from the proximal 
      stem area (2816 +/- 318 cells) than in the control synovial membrane (565 +/- 93 
      cells, p < 0.01). Interestingly, similarly high TNF-alpha expression (3452 +/- 
      582 cells) was also seen in the synovial-like membrane of the pseudocapsule. 
      CONCLUSION: These findings suggest that the foreign body-type host reaction 
      caused by THR is characterized by the high expression of TNF-alpha. Because such 
      expression occurred in the interface tissue between the implant and surrounding 
      bone, TNF-alpha, due to its pivotal direct and indirect role in the activation 
      and recruitment of osteoclasts, may contribute to periprosthetic osteolysis and 
      to the loosening of THR.
FAU - Xu, J W
AU  - Xu JW
AD  - Research Unit of the Orthopaedic Hospital, Invalid Foundation, Helsinki, Finland.
FAU - Konttinen, Y T
AU  - Konttinen YT
FAU - Lassus, J
AU  - Lassus J
FAU - Natah, S
AU  - Natah S
FAU - Ceponis, A
AU  - Ceponis A
FAU - Solovieva, S
AU  - Solovieva S
FAU - Aspenberg, P
AU  - Aspenberg P
FAU - Santavirta, S
AU  - Santavirta S
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - Italy
TA  - Clin Exp Rheumatol
JT  - Clinical and experimental rheumatology
JID - 8308521
RN  - 0 (Tumor Necrosis Factor-alpha)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Endothelium, Vascular/metabolism
MH  - Female
MH  - Fibroblasts/metabolism
MH  - *Hip Prosthesis
MH  - Humans
MH  - Immunohistochemistry
MH  - Macrophages/metabolism
MH  - Male
MH  - Middle Aged
MH  - Osteolysis/*metabolism/pathology/surgery
MH  - *Prosthesis Failure
MH  - Reoperation
MH  - Synovial Membrane/metabolism/pathology
MH  - Tumor Necrosis Factor-alpha/*metabolism
EDAT- 1996/11/01 00:00
MHDA- 1996/11/01 00:01
CRDT- 1996/11/01 00:00
PHST- 1996/11/01 00:00 [pubmed]
PHST- 1996/11/01 00:01 [medline]
PHST- 1996/11/01 00:00 [entrez]
PST - ppublish
SO  - Clin Exp Rheumatol. 1996 Nov-Dec;14(6):643-8.