RT Journal Article
SR Electronic
T1 Expression of tenascin-C in aseptic loosening of total hip replacement
JF Annals of the Rheumatic Diseases
JO Ann Rheum Dis
FD BMJ Publishing Group Ltd and European League Against Rheumatism
SP 619
OP 623
DO 10.1136/ard.57.10.619
VO 57
IS 10
A1 Konttinen, Yrjö T
A1 Li, Tian-Fang
A1 Michelsson, Oliver
A1 Xu, Jing-Wen
A1 Sorsa, Timo
A1 Santavirta, Seppo
A1 Imai, Shinji
A1 Virtanen, Ismo
YR 1998
UL http://ard.bmj.com/content/57/10/619.abstract
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.