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© 1996 British Society for Rheumatology

research-article

OSTEOLYTIC PROPERTIES OF THE SYNOVIAL-LIKE TISSUE FROM ASEPTICALLY FAILED JOINT PROSTHESES

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

Departments of Pathology Bristol BS8 1TD
*Orthopaedic Surgery, University of Bristol Bristol BS8 1TD
{dagger}Department of Orthopaedic Surgery, Bristol Royal Infirmary Bristol BS2 8HW

Correspondence to: Correspondence to: C. J. Elson, Department of Pathology & Microbiology, Bristol University, Bristol BS8 1TD

Relationships were found between the bone-resorbing ability of conditioned media (CMs) from cultures of peri-prosthetic tissues and their levels of bone-remodelling agents. Bone-resorbing activity was measured by 45Ca release from pre-labelled mouse calvaria and 23 of 40 CMs exhibited bone-resorbing activity. Cytokine and prostanoid levels in the CMs were measured by immunoassay, and the levels of interleukin (IL)-1ß, IL-6, tumour necrosis factor {alpha} (TNF{alpha}) and prostaglandin E2 (PGE2) correlated with each other, except for the latter two. Significantly higher levels of IL-6 were present in those CMs with bone-resorbing activity than in those without, and a similar pattern was observed for PGE2 and IL-1ß. However, some CMs with high levels of IL-1ß, IL-6, TNF{alpha} and PGE2 failed to induce resorption, whereas a few CMs with low levels of these agents induced resorption. Moreover, neither dialysis of CMs nor addition of neutralizing antisera to IL-1{alpha} and IL-1ß to CMs, either alone or in combination, reduced the bone-resorbing activity of the CMs. It is considered that these agents may act synergistically to mediate osteolysis around failed joint implants, but that other unidentified bone-resorbing agent(s) must be involved.

KEY WORDS: Implant failure, Pseudosynovial membrane, IL-1ß, IL-6, TNF{alpha}, TGFß1, Prostaglandins, Bone resorption, Leucocytes


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