Progression of Acetabular Periprosthetic Osteolytic Lesions Measured with Computed Tomography

Howie, Donald W.; Neale, S D; Stamenkov, Roumen; McGee, Margaret A.; Taylor, David J.; Findlay, David M.

doi:10.2106/jbjs.e.01305

Cited by 50 publications

(47 citation statements)

References 25 publications

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“…The above findings are consistent with other investigators who have shown that the biological activity of particulate wear debris is strongly dependent on adherent endotoxin, 18 that ex vivo responses of human PBMCs to particulate stimuli can be affected by the presence of indwelling metallic prostheses, 19 and that polyethylene wear rate modulates both the risk of osteolysis, and the severity of osteolytic lesions. 6 For these reasons polyethylene wear rate and clinical titanium exposure were included as covariates in our multivariate analysis model. The observed differences pattern of gene expression between the subject groups remained significant for all cytokines studied after correction for the effects of these covariates.…”

Section: Immune Response In Osteolysis-susceptible Patientsmentioning

confidence: 99%

“…5,6 Previous clinical studies have demonstrated elevated serum levels of proinflammatory cytokines in patients with active osteolysis after THA compared to healthy or osteoarthritis control subjects. 7,8 Peripheral blood mononuclear cells (PBMCs) taken from patients with active osteolysis show inducible cytokine responses in vitro that are greater than those from osteoarthritis subjects, 9 and the magnitude of these responses correlate with the severity of the associated clinical osteolytic lesion.…”

mentioning

confidence: 99%

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Individual susceptibility to periprosthetic osteolysis is associated with altered patterns of innate immune gene expression in response to pro‐inflammatory stimuli

Gordon

Greenfield

Eastell

et al. 2010

Journal Orthopaedic Research

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Susceptibility to osteolysis after total hip arthroplasty (THA) varies between individuals. We examined whether patients susceptible to osteolysis (group I, n ¼ 34 subjects) after cemented Charnley THA have quantitatively different innate immune responses to pro-inflammatory stimuli versus patients without this susceptibility (group II, n ¼ 28 subjects) at a mean of 14 years after primary surgery. Extracted peripheral blood mononuclear cells were stimulated for 3 h using endotoxin (lipopolysaccharide-LPS, 100 ng/mL), endotoxinstripped titanium particles (Ti) or endotoxin-stripped particles with adherent LPS added-back (TI þ LPS). Subjects returned 1 week later and the experimental protocol was repeated. Assays for mRNA induction for interleukin (IL)-1a, IL-1b, IL-1Ra, IL-6, IL-10, IL-18, and tumor necrosis factor (TNF) were made using quantitative real-time PCR. Although baseline levels of mRNA expression were slightly lower in group I, inducibility of mRNA expression was markedly greater in group I versus group II for all cytokines in response to LPS or Ti þ LPS, and for IL-1a in response to Ti (P < 0.05). LPS or Ti þ LPS stimulation also resulted in an increase in the IL-1/IL-1Ra mRNA ratio in group I versus group II (P < 0.05). mRNA induction was highly reproducible between subject visits (r > 0.7, P < 0.001). Osteolysis-susceptible patients show repeatable, quantitatively different patterns of innate cytokine gene expression in response to pro-inflammatory stimuli versus THA patients who do not display this susceptibility. These innate immune differences may contribute to the variation in osteolysis-susceptibility observed clinically between individuals. ß

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Section: Immune Response In Osteolysis-susceptible Patientsmentioning

confidence: 99%

mentioning

confidence: 99%

Individual susceptibility to periprosthetic osteolysis is associated with altered patterns of innate immune gene expression in response to pro‐inflammatory stimuli

Gordon

Greenfield

Eastell

et al. 2010

Journal Orthopaedic Research

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“…For example, increased wear of the UHMWPE acetabular cups correlates with an increased rate of osteolysis [44,55,111]. However, those studies also showed that other factors modulate the biologic response to wear particles.…”

Section: Introductionmentioning

confidence: 99%

Do Genetic Susceptibility, Toll-like Receptors, and Pathogen-associated Molecular Patterns Modulate the Effects of Wear?

Greenfield

2014

Clin Orthop Relat Res

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Background Overwhelming evidence supports the concept that wear particles are the primary initiator of aseptic loosening of orthopaedic implants. It is likely, however, that other factors modulate the biologic response to wear particles. This review focuses on three potential other factors: genetic susceptibility, Toll-like receptors (TLRs), and bacterial pathogen-associated molecular patterns (PAMPs). Where Are We Now? Considerable evidence is emerging that both genetic susceptibility and TLR activation are important factors that modulate the biologic response to wear particles, but it remains controversial whether bacterial PAMPs also do so. Where Do We Need to Go? Detailed understanding of the roles of these other factors may lead to identification of novel therapeutic targets for patients with aseptic loosening. How Do We Get There? Highest priority should be given to polymorphism replication studies with large numbers of patients and studies to replicate the reported correlation between bacterial biofilms and the severity of aseptic loosening.

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“…However, that study used plain radiographs to evaluate osteolysis and bone ingrowth. Multiple studies suggest radiographs underestimate the incidence and extent of osteolysis [10,14,19,27,28,34,38], and several authors state helical CT is the modality of choice to detect these lesions [19,26,32,34]. Thus, the true incidence of osteolysis with this implant is unclear.…”

Section: Introductionmentioning

confidence: 99%

A Monoblock Porous Tantalum Acetabular Cup Has No Osteolysis on CT at 10 Years

Moen

Ghate²,

Salaz

et al. 2011

Clinical Orthopaedics &Amp; Related Research

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Background Aseptic osteolysis has been the single most important factor limiting the longevity of a THA. A great deal of attention has been focused on the development of implants and materials that minimize the development of osteolysis. The monoblock porous tantalum acetabular cup was designed to minimize osteolysis, but whether it does so is unclear. Questions/purposes We evaluated the incidence of osteolytic lesions after THA using a monoblock porous tantalum acetabular component. Methods We retrospectively reviewed 51 patients who had a THA using a monoblock porous tantalum acetabular cup. At a minimum of 9.6 years postoperatively (average, 10.3 years; SD, 0.2 years; range, 9.6-10.8 years), a helical CT scan of the pelvis using a metal suppression protocol was obtained. This scan was evaluated for the presence of osteolysis.

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Progression of Acetabular Periprosthetic Osteolytic Lesions Measured with Computed Tomography

Cited by 50 publications

References 25 publications

Individual susceptibility to periprosthetic osteolysis is associated with altered patterns of innate immune gene expression in response to pro‐inflammatory stimuli

Individual susceptibility to periprosthetic osteolysis is associated with altered patterns of innate immune gene expression in response to pro‐inflammatory stimuli

Do Genetic Susceptibility, Toll-like Receptors, and Pathogen-associated Molecular Patterns Modulate the Effects of Wear?

A Monoblock Porous Tantalum Acetabular Cup Has No Osteolysis on CT at 10 Years

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