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Journal of Bone and Joint Surgery - British Volume, Vol 84-B, Issue 5, 753-757.
doi: 10.1302/0301-620X.84B5.12314  
Copyright © 2002 by British Editorial Society of Bone and Joint Surgery
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The role of inducible nitric oxide synthase in aseptic loosening after total hip arthroplasty

K. T. Suh, MD, Professor; and J. W. Chang, MD, Fellow

Department of Orthopaedic Surgery

J. S. Jung, MD, Associate Professor

Department of Physiology, College of Medicine, Pusan National University, 1-10 Ami-dong, Seo-gu, Pusan 602-739, Korea.

Correspondence should be sent to Professor K. T. Suh.

We collected 16 samples of the membrane which surrounds loose hip prostheses from patients undergoing revision operations for aseptic loosening. To serve as the control group, samples of the synovial tissue and the fibrous capsular tissue were collected from 11 patients undergoing primary hip arthroplasties. Analyses of the expression levels of inducible nitric oxide synthase (iNOS), tumour necrosis factor-{alpha} (TNF-{alpha}), and cytosolic phospholipase A2 (cPLA2) mRNAs were performed by a reverse transcription polymerase chain reaction, and the content of nitrite was measured by the Griess reaction using sodium nitrite as the standard.

The expression levels of iNOS, TNF-{alpha}, and cPLA2 mRNAs in the membranes were significantly higher than those in the control samples (p < 0.05). The expression levels of iNOS mRNA and the nitrite content in the membranes significantly correlated with those of TNF-{alpha} and cPLA2 mRNAs, respectively. In addition, the expression levels of iNOS, TNF-{alpha}, and cPLA2 mRNAs were significantly higher in membranes from cementless than in those from cemented implants (p < 0.05).

Our results suggest that the expression levels of iNOS, TNF-{alpha}, and cPLA2 mRNAs in the membranes are regulated by closely-related mechanisms and that these have a significant role in aseptic loosening.






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Hip, Knee, Trauma, Upper limb, Foot & Ankle, Paediatrics, Oncology, Spine, Arthroplasty, General