Matrix metalloproteinases (MMPs) and tissue inhibitors of metalloproteinase (TIMPs) play an important role in tissue destruction and remodeling. Nine samples of cement interface tissues from nine patients who had failed cemented total hip arthroplasty (THA) were obtained for revision of THA and analyzed on mRNA expression of MMPs and TIMPs. The preoperative serial radiographic examinations revealed an apparent clear zone around all implants. We excluded septic loosening as one of the factors affecting THA. Three samples were obtained from three different sites of the acetabular interface tissue in each patient. After extraction of total RNA from 27 samples, we used the reverse-transcriptional polymerase chain reaction (RT-PCR). mRNA of MMP-1, -2, -3, -9, and TIMP-1 and -2 was detected in the interface tissue. MMP-10 mRNA was not detected, yet MMP-1 and MMP-3 mRNA were commonly observed. TIMP-2 mRNA was also strongly expressed compared to TIMP-1. It was thus demonstrated that MMPs and TIMPs were produced locally in the cemented tissue of THA loosening. These findings may suggest that MMPs and TIMPs expressed around the implants play a critical role in the progression of aseptic loosening of THA.
The purpose of this study was to determine whether depletion of circulating neutrophils, using an antineutrophil monoclonal antibody (RP3), would attenuate ischemia/reperfusion injury in rat skeletal muscle. A 3- and 5-hr period of ischemia was induced unilaterally into the hindlimbs of rats; the isolated limbs were then reperfused for 24 hr after ischemia. The gastrocnemius muscle was then removed, and blood was taken simultaneously. The hematologic parameters were measured, muscle neutrophil sequestration was assessed by myeloperoxidase (MPO) activity, free radical production was evaluated by the tissue lipid peroxides (LPO) levels, muscle viability was assessed by tissue levels of adenosine triphosphate (ATP) and creatine phosphate (PCr) levels, and muscle wet/dry weights were determined. Treatment with RP3 selectively and sufficiently depleted the circulating neutrophil population, markedly reduced MPO, and significantly attenuated LPO and the tissue water content after both 3- and 5-hr of ischemia. After 3 hr of ischemia, ATP and PCr levels were significantly increased by neutrophil depletion; however, after 5 hr of ischemia, the same effect was not demonstrated. These results suggest that neutrophil depletion after 3 hr of ischemia restrains free radical production and edema formation, and also attenuates skeletal muscle ischemia reperfusion injury; however, after 5 hr of ischemia, ischemic damage was so severe, that neutrophil depletion did not reduce ischemia reperfusion injury.
A haemophilic pseudotumour is a rare complication of haemophilia occurring in 1-2% of patients with a factor VIII or IX deficiency. This report presents three surgical cases of pseudotumours involved in a pathological fracture in the extremities. All cases showed a favourable post-operative course. If the preoperative management is appropriately designed, a limb salvage operation for a pathological fracture due to a pseudotumour could be carried out successfully. Before choosing amputation of a limb, the surgeon should consider the possibility of limb salvage.
Rapid degeneration of the anterior cruciate ligament (ACL) may occur after ligament rupture, making primary repair of the anterior cruciate ligament difficult. Nine completely ruptured anterior cruciate ligaments were collected by arthroscopic surgery performed within 6 months of injury. The authors studied the localization of matrix metalloproteinases and tissue inhibitors of matrix metalloproteinases in ruptured anterior cruciate ligament using immunohistochemistry, and measured messenger ribonucleic acid expression using the reverse transcriptase polymerase chain reaction. Cells in residual ligament tissue seemed to contain matrix metalloproteinases 1 and 3 and tissue inhibitors of matrix metalloproteinases 1 and 2. Promatrix metalloproteinase-9 positive cells were observed in the perivascular area. Promatrix metalloproteinase-2 positive cells frequently were seen between irregular collagen bundles in stumps of ruptured ligaments. Tissue inhibitors of matrix metalloproteinase-2 positive cells commonly were observed in ruptured ligaments. Matrix metalloproteinase-1 and matrix metalloproteinase-3 messenger ribonucleic acid were highly expressed compared with matrix metalloproteinase-2 messenger ribonucleic acid. Tissue inhibitor of matrix metalloproteinase-2 messenger ribonucleic acid was highly expressed compared with tissue inhibitor of matrix metalloproteinase 1. The authors could not identify whether these intrinsic reactions mediated by anterior cruciate ligament cells were the causes of rapid degradation or the results of the degradation process. Various amounts of matrix metalloproteinase and inhibitor production of intrinsic ligament cells were observed in the ruptured anterior cruciate ligament. The biological reaction reported in this study may suggest that pronounced metabolism is undertaken in ruptured ACL cells, and provide N. Ishiguro ( ) · T. Shimizu · T. Ito · T.
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