Extended report
Expression of epidermal growth factor and transforming growth
factor 
in interfacial membranes retrieved at revision total hip
arthroplasty
Jing-Wen Xua b d, Jian Maa, Tian-Fang Lia, Eero Warisa, Anne Albertyb, Seppo Santavirtab, Yrjö T Konttinena c
a Institute of
Biomedicine, Department of Anatomy, University of Helsinki, Finland, b Department of Orthopaedics and
Traumatology, Helsinki University Central Hospital, Helsinki, Finland, c Department of Oral Medicine, Helsinki University
Central Hospital, d Division
of Rheumatology, Long Island Jewish Medical Center, New Hyde Park, NY,
USA
Correspondence to: Professor Yrjö T Konttinen, Department of Oral Medicine, Surgical Hospital, Kasarmikatu 11-13, FIN-00029, Helsinki University Central Hospital, Helsinki, Finland Email: yrjo.konttinen{at}helsinki.fi
Accepted for publication 17 February 2000
BACKGROUND
The
interfacial membrane between bone and implant has been shown to be a
key tissue in the process of aseptic loosening of total hip
arthroplasty. The cells within the interfacial membrane produce
numerous inflammatory mediators which, through complex mechanisms,
cause periprosthetic osteolysis and aseptic loosening. Both epidermal
growth factor (EGF) and transforming growth factor 
(TGF) have
similar biological functions. They have been found to stimulate bone resorption.
OBJECTIVETo
investigate the presence, cellular localisation, and extent of
expression of EGF and TGF in interfacial membrane retrieved from
revision total hip arthroplasty and compare it with that in synovial
membrane from primary total hip arthroplasty.
METHODSTen
interfacial membranes and 10 synovial membranes were stained with
avidin-biotin-peroxidase complex for EGF and TGF. The staining
process was done using the Lab Vision Autostainer. The results were
measured by a semiautomatic VIDAS image analysis system.
RESULTSImmunoreactivity
for both EGF and TGF was found in the endothelial cells of blood
vessels, macrophages, and fibroblasts, both in interfacial membranes
and synovial membranes. However, the number of EGF (980 (370)) and
TGF (1070 (360)) positive cells per mm2 was greater in
interfacial membranes than in the synovial membranes (220 (200), 270 (100); p<0.01).
CONCLUSIONIt
is suggested that owing to their increased expression in interfacial
membrane, EGF and TGF may have an important pathogenetic role in
stimulating periprosthetic bone resorption in aseptic loosening of
total hip arthroplasty.
© 2000 by Annals of the Rheumatic Diseases
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