PT  - JOURNAL ARTICLE
AU  - Konttinen, Yrjö T
AU  - Li, Tian-Fang
AU  - Michelsson, Oliver
AU  - Xu, Jing-Wen
AU  - Sorsa, Timo
AU  - Santavirta, Seppo
AU  - Imai, Shinji
AU  - Virtanen, Ismo
TI  - Expression of tenascin-C in aseptic loosening of total hip replacement
AID  - 10.1136/ard.57.10.619
DP  - 1998 Oct 01
TA  - Annals of the Rheumatic Diseases
PG  - 619--623
VI  - 57
IP  - 10
4099  - http://ard.bmj.com/content/57/10/619.short
4100  - http://ard.bmj.com/content/57/10/619.full
SO  - Ann Rheum Dis1998 Oct 01; 57
AB  - OBJECTIVE To assess if the bonding interlayer between the implant and bone in aseptic loosening of total hip replacement (THR) is qualitatively deteriorated by excessive accumulation of anti-adhesive glycoprotein, tenascin-C. METHODS Alkaline phosphatase-anti-alkaline phosphatase (APAAP) method was used for immunohistochemical staining of tenascin-C in interface tissue and control synovial tissue. RESULTS Tenascin-C was found to be a major component of the extracellular matrix at a hitherto unrecognised site, namely the synovial membrane-like interface tissue between implant and bone in aseptic loosening of THR. The overall tenascin-C staining (median score 4.0) was greatly increased in aseptic loosening compared with synovial membrane (median score 2.0; p<0.001) and fibrous capsule (median score 2.0; p<0.001) from primary THR operations. Topological analysis disclosed that tenascin-C was also found at the critical implant-interface and interface-bone surfaces. CONCLUSION Local tenascin-C expression is increased as a result of a chronic foreign body type reaction associated with excessive cytokine production and tissue injury mediated by microtrauma and neutral endoproteinases. This qualitative and topological deterioration of the bonding interlayer by an increase of anti-adhesive tenascin-C expression may inadvertantly contribute to loosening.