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Ann Rheum Dis 2000;59:822-827 doi:10.1136/ard.59.10.822
  • Extended report

Expression of epidermal growth factor and transforming growth factor α in interfacial membranes retrieved at revision total hip arthroplasty

  1. Jing-Wen Xua,b,d,
  2. Jian Maa,
  3. Tian-Fang Lia,
  4. Eero Warisa,
  5. Anne Albertyb,
  6. Seppo Santavirtab,
  7. Yrjö T Konttinena,c
  1. aInstitute of Biomedicine, Department of Anatomy, University of Helsinki, Finland, bDepartment of Orthopaedics and Traumatology, Helsinki University Central Hospital, Helsinki, Finland, cDepartment of Oral Medicine, Helsinki University Central Hospital, dDivision of Rheumatology, Long Island Jewish Medical Center, New Hyde Park, NY, USA
  1. 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 17 February 2000

Abstract

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 α (TGFα) have similar biological functions. They have been found to stimulate bone resorption.

OBJECTIVE To investigate the presence, cellular localisation, and extent of expression of EGF and TGFα in interfacial membrane retrieved from revision total hip arthroplasty and compare it with that in synovial membrane from primary total hip arthroplasty.

METHODS Ten interfacial membranes and 10 synovial membranes were stained with avidin-biotin-peroxidase complex for EGF and TGFα. The staining process was done using the Lab Vision Autostainer. The results were measured by a semiautomatic VIDAS image analysis system.

RESULTS Immunoreactivity for both EGF and TGFα 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 TGFα (1070 (360)) positive cells per mm2 was greater in interfacial membranes than in the synovial membranes (220 (200), 270 (100); p<0.01).

CONCLUSION It is suggested that owing to their increased expression in interfacial membrane, EGF and TGFα may have an important pathogenetic role in stimulating periprosthetic bone resorption in aseptic loosening of total hip arthroplasty.

Footnotes

  • Supported in part by grants from the Academy of Finland, Helsinki University Central Hospital, the Foundation for Orthopaedic and Traumatological Research in Finland.

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