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© 1995 British Society for Rheumatology

research-article

ANALYSIS OF CELL TYPES AND MEDIATOR PRODUCTION FROM TISSUES AROUND LOOSENING JOINT IMPLANTS

M. J. PERRY*,, F. Y. MORTUZA*, F. M. PONSFORD*, C. J. ELSON* and R. M. ATKINS{dagger}

*Departments of Pathology, University of Bristol Bristol BS8 1TD
{dagger}Departments of Orthopaedic Surgery, University of Bristol Bristol BS8 1TD

Correspondence to: Correspondence to: M. J. Perry, Department of Pathology, Medical School, University Walk, University of Bristol, Bristol BS8 1TD.

Quantitative immunophenotypic analysis of cell types present in peri-prosthetic tissue [pseudosynovial membrane (PSM)] from aseptically loose joint implants revealed considerable heterogeneity between tissues from different individuals. The monocyte/macrophage was the commonest leucocyte type; however, its proportion varied widely. T cells normally accounted for ~ 5% of cells, but in a few cases formed > 20% of cells. In all cases, there was a high ratio of CD4 to CD8 cells. PSM leucocytes were activated in most PSMs as judged by surface expression of CD23, CD25 and CD71. Analysis of the proportions of cell types in PSM, OA synovium and RA synovium revealed similarities between the different tissue types. The levels of IL-1, IL-6 and prostaglandin E produced by the PSM were correlated, but only IL-1 and IL-6 levels correlated with markers of the monocyte/macrophage lineage. This result suggests that prostaglandin E is produced in vivo by many PSM cell types.

KEY WORDS: Implant failure, Pseudosynovial membrane, Flow cytometry, Immunophenotyping, Leucocytes, Prostaglandin E, Interleukin-1, Interleukin-6


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