Kim K J, Hijikata H, Itoh T, Kumegawa M
Department of Orthopaedic Surgery, Tokyo Women's Medical College, Japan.
J Biomed Mater Res. 1998 Fall;43(3):234-40. doi: 10.1002/(sici)1097-4636(199823)43:3<234::aid-jbm3>3.0.co;2-o.
Periprosthetic bone resorption has been implicated in the failure of total joint arthroplasty. Osteolysis is reported to be associated with bone resorption induced by bone-resorbing cytokines, which are released from macrophages and fibroblasts in periprosthetic tissues after stimulation by wear debris generated in the joint cavity. Recent reports have suggested the concept of the effective joint space, which includes all periprosthetic regions that are accessible to joint fluid and wear debris. In this study, we examined the levels of interleukin-6 (IL-6), soluble IL-6 receptor (sIL-6R), and tartrate-resistant acid phosphatase (TRAP) in joint fluid after failed total hip arthroplasty (THA) with osteolysis and investigated whether the joint fluid could activate osteoclastic bone resorption using unfractionated mouse bone cells cultured on dentin slices. Histochemical analysis showed the presence of more TRAP-positive cells in synovial capsules from failed THA patients when compared with osteoarthritis (OA) patients (controls). The levels of IL-6, sIL-6R, and TRAP in joint fluid from failed THA patients were significantly higher than in OA patients. Mouse osteoclasts cultured on dentin slices with joint fluid from failed THA patients with osteolysis produced a significant increase of pit area, whereas cells cultured with joint fluid from OA patients did not. Interestingly, osteoclastic bone resorption on dentin slices was significantly correlated with TRAP activity in joint fluid (p < 0.0001). These results suggest that joint fluid containing bone-resorbing cytokines is produced by synovial capsules in failed THA patients with osteolysis and may activate osteoclasts around the prosthesis in combination with those produced by interface tissues, thus contributing to periprosthetic bone resorption.
假体周围骨吸收被认为与全关节置换术失败有关。据报道，骨溶解与骨吸收细胞因子诱导的骨吸收有关，这些细胞因子在关节腔产生的磨损颗粒刺激后，从假体周围组织中的巨噬细胞和成纤维细胞释放出来。最近的报道提出了有效关节间隙的概念，其中包括所有可被关节液和磨损颗粒接触到的假体周围区域。在本研究中，我们检测了全髋关节置换术（THA）失败伴骨溶解患者关节液中白细胞介素-6（IL-6）、可溶性IL-6受体（sIL-6R）和抗酒石酸酸性磷酸酶（TRAP）的水平，并使用在牙本质切片上培养的未分级小鼠骨细胞研究了关节液是否能激活破骨细胞性骨吸收。组织化学分析显示，与骨关节炎（OA）患者（对照组）相比，THA失败患者滑膜囊中TRAP阳性细胞更多。THA失败患者关节液中IL-6、sIL-6R和TRAP的水平显著高于OA患者。用THA失败伴骨溶解患者的关节液在牙本质切片上培养的小鼠破骨细胞产生的凹坑面积显著增加，而用OA患者关节液培养的细胞则没有。有趣的是，牙本质切片上的破骨细胞性骨吸收与关节液中的TRAP活性显著相关（p < 0.0001）。这些结果表明，骨溶解的THA失败患者的滑膜囊产生了含有骨吸收细胞因子的关节液，并且可能与界面组织产生的细胞因子联合激活假体周围的破骨细胞，从而导致假体周围骨吸收。
