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The role of inflammatory cells in aseptic loosening and failure of cemented joint replacements is unclear. Inflammatory cells from the revision joint capsule of four failed hip arthroplasties were examined to determine their nature and resorptive capacity. The capsules contained numerous macrophages and abundant foreign-body macrophage polykaryons, distinguished from osteoclasts by their antigenic phenotype and lack of response to calcitonin. When cultured on cortical bone slices in vitro, both macrophages and macrophage polykaryons produced small resorption pits and were associated with areas of superficial resorption of the bone surface. These results indicate that foreign-body induced macrophages and macrophage polykaryons are capable of a type of low-grade bone resorption which may be of pathogenic significance in the loosening of cemented joint prosthetic components.

Type

Journal article

Journal

The journal of bone and joint surgery. british volume

Publication Date

01/1992

Volume

74

Pages

57 - 62

Addresses

Nuffield Department of Pathology, John Radcliffe Hospital, Oxford, England.

Keywords

Hip Joint, Synovial Membrane, Cells, Cultured, Humans, Bone Resorption, Postoperative Complications, Prosthesis Failure, Bone Cements, Calcitonin, Antibodies, Monoclonal, Antigens, Microscopy, Electron, Scanning, Reoperation, Immunohistochemistry, Hip Prosthesis, Phenotype