Histological Study of the Granulation Tissue around The Loosened Prosthesis

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Eighteen specimens obtained at the time of revision sungery of total joint replacement were studied histologically. Specimens of the granulation tissue were collected from the bone-cement interface. Most of the cells observed in this granulation tissue seemed to be macrophage-like cells which had relatively abundant cytoplasm with H2 E staining. Further study utilized anti-macrophage monoclonal antibody (63D3) showed that these cells were macrophage origin. With polarized light microscopy, abundant fragments of high density polyethylene were found in some of these cells. Finally, electronmicroscopic observation revealed that these cells had numerous vacuoles which included lysosomes in their cytoplasm suggesting that these cells produced orteolytic cytokine such as PGE1 and collagenese and played important role for the loosening of the prosthesis at bone-cement interface.