Wear particulate species and bone loss in failed total joint arthroplasties
Wear particulate species and bone loss in failed total joint arthroplasties
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DOI：
10.1097/00003086-199707000-00016
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发表时间：
1997-07-01
影响因子：
4.2
通讯作者：
Freeman, MAR
中科院分区：
文献类型：
--
作者：
Kadoya, Y;Revell, PA;Freeman, MAR
本研究旨在评价聚乙烯、金属和聚甲基丙烯酸甲酯（骨水泥）颗粒对无菌性松动中总体骨丢失的相对贡献。在17例翻修型全关节置换术（11例髋关节和6例膝关节）中获得了24个与相邻骨的界面组织。破骨细胞和巨噬细胞在骨表面上被化学鉴定。测量与这些细胞类型接触的骨表面的长度，并参考纤维界面内存在的颗粒物质进行分析。大量聚乙烯颗粒的存在显著增加了与巨噬细胞接触的骨表面的比例，但对破骨细胞的比例没有显著影响。在金属颗粒的存在下，骨吸收明显更广泛。相反，骨水泥颗粒的存在对骨表面的巨噬细胞或破骨细胞覆盖没有显著影响。这些结果突出了聚乙烯颗粒在巨噬细胞募集和随后的骨质溶解中的重要性，并表明与金属相关的骨丢失的不同机制，即通过骨吸收活性进行调解。水泥颗粒的相对贡献可以忽略不计，需要根据其他人提供的证据重新评估。
The aim of this study was to evaluate the relative contribution of polyethylene, metal, and polymethylmethacrylate (cement) particles to the overall bone loss in aseptic loosening. Twenty-four interface tissues with adjacent bone were obtained during 17 revision total joint arthroplasties (11 hips and six knees). Osteoclasts and macrophages were identified immunohistochemically on the bone surface. The length of the bone surface in contact with these cell types was measured and analyzed with reference to the particulate species present within the fibrous interface. The presence of abundant polyethylene particles significantly increased the proportion of the bone surface in contact with macrophages but did not have a significant influence on that of osteoclasts. Osteoclastic bone resorption was significantly more extensive in the presence of metal particles. In contrast, the presence of cement particles did not have a significant influence on macrophage or osteoclast coverage of the bone surface. These results highlight the significance of polyethylene particles in macrophage recruitment and subsequent osteolysis and suggest a different mechanism of bone loss related to metal, namely mediation through osteoclastic activities. The relative contribution of cement particles was negligible and needs reevaluation in light of evidence provided by others.