Hospital for Special Surgery, New York, USA.
Department of Orthopaedic Surgery, Zealand University Hospital, Køge, Denmark.
Acta Orthop. 2020 Feb;91(1):115-120. doi: 10.1080/17453674.2019.1695351. Epub 2019 Nov 25.
Background and purpose - Insufficient initial fixation or early micromotion of an implant is associated with a thin layer of fibrous tissue at the peri-implant interface. It is unknown if bone loss is induced by the fibrous tissue interface acting as an active biological membrane, or as a membrane that will produce supraphysiologic fluid flow conditions during gait, which activates the mechanosensitive osteocytes to mediate osteoclast differentiation. We investigated whether mechanically induced osteolysis is dependent on the fibrous tissue interface as a biologically active scaffold, or if it merely acts as a conduit for fluid flow, affecting the mechanosensitive osteocytes in the peri-prosthetic bone.Methods - Using a rat model of mechanically instability-induced aseptic loosening, we assessed whether the induction of osteoclast differentiation was dependent on the presence of a peri-implant fibrous interface. We analyzed the amount of osteoclast differentiation, osteocyte apoptosis, pro-resorptive cytokine expression and bone loss using immunohistochemistry, mRNA expression and micro-CT.Results - Osteoclast differentiation and bone loss were induced by mechanical instability but were not affected by the presence of the fibrous tissue membrane or associated with osteocyte apoptosis. There was no increased mRNA expression of any of the cytokines in the fibrous tissue membrane compared with the peri-implant bone.Interpretation - Our data show that the fibrous tissue membrane in the interface plays a minor role in inducing bone loss. This indicates that the peri-implant bone adjacent to loose bone implants might play an important role for osteoclast differentiation.
背景与目的-植入物初始固定不足或早期微动与种植体周围界面的纤维组织层较薄有关。目前尚不清楚骨质流失是由纤维组织界面作为活性生物膜引起的,还是由在步态过程中产生超生理流体流动条件的膜引起的,该膜激活机械敏感成骨细胞来介导破骨细胞分化。我们研究了机械诱导的骨溶解是否依赖于纤维组织界面作为生物活性支架,还是仅仅作为流体流动的导管,影响假体周围骨中的机械敏感成骨细胞。
方法-使用机械不稳定诱导无菌性松动的大鼠模型,我们评估了成骨细胞分化的诱导是否依赖于种植体周围纤维界面的存在。我们使用免疫组织化学,mRNA 表达和 micro-CT 分析了破骨细胞分化,成骨细胞凋亡,促吸收细胞因子表达和骨丢失的程度。
结果-机械不稳定可诱导破骨细胞分化和骨丢失,但纤维组织膜的存在并不影响破骨细胞分化和骨丢失,也与成骨细胞凋亡无关。与种植体周围骨相比,纤维组织膜中没有任何细胞因子的 mRNA 表达增加。
结论-我们的数据表明,界面中的纤维组织膜在诱导骨丢失方面作用较小。这表明邻近松动骨植入物的种植体周围骨可能在破骨细胞分化中起重要作用。