Why the study?
Does prosthesis-associated pseudomembrane induce bone resorption in cemented hip implant failure?
Does prosthesis-associated pseudomembrane induce bone resorption in cemented hip implant failure?
Prosthesis-associated pseudomembranes produce inflammatory mediators and directly induce bone resorption, implicating them in the pathogenesis of aseptic loosening and prosthesis failure.
Animal findings link pseudomembrane media to bone resorption; hypothesis-generating for inflammatory targets in aseptic loosening.
A pseudomembranous structure invariably develops at the cement-bone interface of implanted prostheses in association with aseptic loosening. The tissue has histological characteristics of a foreign body reaction presumably initiated by repetitive microtrauma-associated release of methacrylate cement and polyethylene wear debris. Explant cultures of pseudomembrane and synovial tissue derived from osteoarthritic patients undergoing revision for cemented hip implant failure have been shown to produce interleukin-1, tumour necrosis factor and prostaglandin E2, recognized mediators of bone resorption. Further, the conditioned media obtained from pseudomembrane cultures could directly effect bone resorption by inducing 45Ca release from prelabelled limb bone rudiments. Results implicate the prosthesis-associated pseudomembrane in the pathogenesis of the bone resorptive process responsible for prosthesis failure.
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Appel et al. (1990) studied this question.
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