The characterization of cytokines in the interface tissue obtained from failed cementless total hip arthroplasty with and without femoral osteolysis.

Abstract

The histologic, biochemical, and immunohistologic characteristics of the interface membranes surrounding the femoral component of failed cementless total hip arthroplasty (THA) in patients with (Group I) and without (Group II) radiographic evidence of focal endosteal erosion (osteolysis) were studied. Group I membranes had more macrophages and small particles of polyethylene debris in the membrane, but both groups had similar amounts of metal particles. A greater activity level of interleukin-1 (IL-1), tumor necrosis factor (TNF), and interleukin-6 (IL-6) was seen in the culture supernatant of the membranes from Group I than in that of Group II. Group I membranes also had more cells (macrophages, fibroblasts, and endothelial cells) that stained positively with anti-IL-6 antibody. These results suggest that IL-6, IL-1, and TNF play a role in the focal femoral osteolysis observed in patients with failed cementless hip prostheses.