CD3+ lymphocytosis in the peri-implant membrane of 222 loosened joint endoprostheses depends on the tribological pairing.
Background and purpose -- The most frequent cause of arthroplasty failure is aseptic loosening--often induced by particles. Abrasion material triggers inflammatory reactions with lymphocytic infiltration and the formation of synovial-like interface membranes (SLIM) in the bone-implant interface. We...
| Publicado en: | Acta Orthopaedica Vol. 88; no. 6; pp. 642 - 649 |
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| Autores principales: | , , , , , , , , |
| Formato: | pictorial research tables/charts Journal Article |
| Publicado: |
Medical Journals Sweden AB
Dec2017
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=126129129&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 126129129 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 17453674 1BVL jtl: Acta Orthopaedica issn: 17453674 maglogo: N pubinfo: dt: Dec2017 vid: 88 iid: 6 pid: 59195 pub: Medical Journals Sweden AB artinfo: ui: 126129129 126129129 126129129 10.1080/17453674.2017.1362774 126129129 ppf: 642 ppct: 7 formats: fmt: – @attributes: type: T – @attributes: type: P tig: atl: CD3+ lymphocytosis in the peri-implant membrane of 222 loosened joint endoprostheses depends on the tribological pairing. aug: au: Hopf, Felix Thomas, Peter Sesselmann, Stefan Thomsen, Marc N Hopf, Maximilian Hopf, Johannes Krukemeyer, Manfred G Resch, Herbert Krenn, Veit affil: Center for Histopathology and Molecular Pathology, Trier, Germany sug: subj: Antigens, Surface Analysis Leukocyte Disorders Synovial Membrane Biocompatible Materials Adverse Effects Joint Prosthesis Human Immunohistochemistry Predictive Value of Tests Sensitivity and Specificity Reoperation Prosthesis Failure Arthroplasty, Replacement, Hip Methods Arthroplasty, Replacement, Knee Methods Metals Polyethylenes Hypersensitivity Inflammation ab: Background and purpose -- The most frequent cause of arthroplasty failure is aseptic loosening--often induced by particles. Abrasion material triggers inflammatory reactions with lymphocytic infiltration and the formation of synovial-like interface membranes (SLIM) in the bone-implant interface. We analyzed CD3 quantities in SLIM depending on articulating materials and possible influences of proven material allergies on CD3 quantities. Patients and methods -- 222 SLIM probes were obtained from revision surgeries of loosened hip and knee arthroplasties. SLIM cases were categorized according to the SLIM-consensus classification and to the particle algorithm. The CD3 quantities were analyzed immunohistochemically, quantified, and correlated to the particle types. Results -- Metal-metal pairings showed the highest CD3 quantities (mean 1,367 counted cells). CD3 quantities of metal-polyethylene (mean 243), ceramic-polyethylene (mean 182), and ceramic-ceramic pairings (mean 124) were significantly smaller. Patients with contact allergy to implant materials had high but not statistically significantly higher CD3 quantities than patients without allergies. For objective assessment of the CD3 response as result of a pronounced inflammatory reaction with high lymphocytosis (adverse reaction), a defined CD3 quantity per high power field was established, the "CD3 focus score" (447 cells/0.3 mm², sensitivity 0.92; specificity 0.90; positive predictive value 0.71; negative predictive value 0.98). Interpretation -- The high CD3 quantities for metal-metal pairings may be interpreted as substrate for previously described adverse reactions that cause severe peri-implant tissue destruction and SLIM formation. It remains unclear whether the low CD3 quantities with only slight differences in the various non-metal-metal pairings and documented contact allergies to implant materials have a direct pathogenetic relevance. pubtype: Academic Journal doctype: pictorial research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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