Santavirta S, Konttinen Y T, Hoikka V, Eskola A
Orthopaedic Hospital of the Invalid Foundation, Helsinki, Finland.
J Bone Joint Surg Br. 1991 Jan;73(1):38-42. doi: 10.1302/0301-620X.73B1.1991772.
The membranes surrounding seven loose cementless acetabular implants were shown to contain polyethylene particles, birefringent in polarised light. Three of these implants were made of titanium alloy and the membranes around these contained titanium particles as well. There was no metallosis around the four implants made of chromium-cobalt-steel alloy. Both titanium and polyethylene particles caused migration, adherence and phagocytosis of CD11b-positive, peroxidase-negative macrophages. There were no histological signs of activation of the specific immune response; neither interleukin-2 receptor-positive activated T cells nor PCA-1 plasmablasts/plasma cells were present in the tissues. In cases of simple loosening, resident mesenchymal fibroblast-like cells were active. In aggressive granulomatosis, there were many macrophages and multinucleated giant cells but little fibroblast reaction. The clinical relevance of the findings is that the use of cementless prostheses is not a guarantee against adverse tissue reactions.
围绕七个松动的非骨水泥髋臼植入物的包膜显示含有聚乙烯颗粒，在偏振光下呈双折射。其中三个植入物由钛合金制成，其周围的包膜也含有钛颗粒。由铬钴钢合金制成的四个植入物周围没有金属沉着病。钛颗粒和聚乙烯颗粒均可引起CD11b阳性、过氧化物酶阴性巨噬细胞的迁移、黏附和吞噬作用。组织中没有特异性免疫反应激活的组织学迹象；组织中既没有白细胞介素-2受体阳性的活化T细胞，也没有PCA-1成浆细胞/浆细胞。在单纯松动的病例中，常驻间充质成纤维细胞样细胞活跃。在侵袭性肉芽肿病中，有许多巨噬细胞和多核巨细胞，但成纤维细胞反应很少。这些发现的临床意义在于，使用非骨水泥假体并不能保证不会出现不良组织反应。
