Cellular profile and cytokine production at prosthetic interfacesSTUDY OF TISSUES RETRIEVED FROM REVISED HIP AND KNEE REPLACEMENTSS. B. Goodman, MD, PhD, Associate Professor and Head1; P. Huie, MA, Senior Research Associate2; Y. Song, MD, Research Associate1; D. Schurman, MD, Professor1; W. Maloney, MD, Associate Professor1; S. Woolson, MD, Professor1; and R. Sibley, MD, Professor2
1 Division of Orthopaedic Surgery Correspondence should be sent to Dr S. B. Goodman. The tissues surrounding 65 cemented and 36 cementless total joint replacements undergoing revision were characterised for cell types by immunohistochemistry and for cytokine expression by in situ hybridisation.
We identified three distinct groups of revised implants: loose implants with ballooning radiological osteolysis, loose implants without osteolysis, and well-fixed implants. In the cemented series, osteolysis was associated with increased numbers of macrophages (p = 0.0006), T-lymphocyte subgroups (p = 0.03) and IL-1 (p = 0.02) and IL-6 (p = 0.0001) expression, and in the cementless series with increased numbers of T-lymphocyte subgroups (p = 0.005) and increased TNF Our findings suggest that there are different biological mechanisms of loosening and osteolysis for cemented and cementless implants. T-lymphocyte modulation of macrophage function may be an important interaction at prosthetic interfaces. This article has been cited by other articles:
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expression (p = 0.04). For cemented implants, the histological, histochemical and cytokine profiles of the interface correlated with the clinical and radiological grade of loosening and osteolysis. 
