Absence of lymphatics at the bone-implant interface - Implications for periprosthetic osteolysis
Absence of lymphatics at the bone-implant interface - Implications for periprosthetic osteolysis
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DOI：
10.1080/17453670710015175
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发表时间：
2008-01-01
影响因子：
3.7
通讯作者：
Athanasou, Nicholas Anthony
中科院分区：
文献类型：
--
作者：
Edwards, James;Schulze, Eva;Athanasou, Nicholas Anthony
在松动假体周围的骨-植入物界面发现的磨损颗粒通常被巨噬细胞吞噬。在引流关节成形术组织的局部淋巴结中也发现了磨损颗粒和含磨损颗粒的巨噬细胞。磨损颗粒从关节成形术组织运输到淋巴结的方法是不确定的，因为在假体周围组织中淋巴管的存在或不存在还没有建立。方法我们确定LYVE-I和podoplanin的免疫表型表达，这两种高度特异性的淋巴内皮细胞标记物，结果LYVE-1+/podoplanin+在假膜中未发现淋巴管，但在假包膜中发现了淋巴管。正常骨不含lymphatic vessels.Interpretation我们的研究结果表明，在骨植入物界面脱落的磨损颗粒不直接从伪膜运输到引流淋巴结，而是通过伪包膜。缺乏淋巴清除机制可能导致磨损颗粒在骨-植入物界面处积聚，并通过刺激破骨细胞形成和活性促进假体周围骨溶解。
Background Wear particles, found at the bone-implant interface surrounding a loose prosthesis, are commonly phagocytosed by macrophages. Wear particles and wear particle-containing macrophages are also found in regional lymph nodes draining arthroplasty tissues. The means by which wear particles are transported from arthroplasty tissues to lymph nodes is uncertain, as the presence or absence of lymphatic vessels in periprosthetic tissues has not been established.Methods We determined immunophenotypic expression of LYVE-I and podoplanin, two highly specific lymphatic endothelial cell markers, in the hip arthroplasty pseudocapsule surrounding the false joint and the bone-implant interface of the femoral and acetabular pseudomembrane.Results LYVE-1+/podoplanin+ lymphatic vessels were not identified in the pseudomembrane but were found in the pseudocapsule. Normal bone did not contain lymphatic vessels.Interpretation Our findings suggest that the wear particles shed at the bone-implant interface are not transported to draining lymph nodes by lymphatics directly from the pseudomembrane, but via the pseudocapsule. The absence of a lymphatic clearance mechanism may contribute to accumulation of wear particles at the bone-implant interface and promote periprosthetic osteolysis through stimulation of osteoclast formation and activity.