Journal
JOURNAL OF ORTHOPAEDIC RESEARCH
Volume 28, Issue 2, Pages 184-190Publisher
WILEY
DOI: 10.1002/jor.20979
Keywords
hip prosthesis; prosthesis failure; foreign-body reaction; Toll-like receptors; lipopolysaccharide
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Funding
- Finnish Research Foundation of Orthopaedics
- and Traumatology
- Clinical EVO research
- Sigrid Juselius Foundation
- Finska Lakareskapet
- Finnish PhD Graduate School in Musculoskeletal Diseases and Biomaterials
- Orion Foundation
- MNT ERA Net New generation titania
- Danish Council for Strategic Research
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Bacterial remnants and subclinical biofilms residing on prosthesis surfaces have been speculated to play a role in hip implant loosening by opsonizing otherwise relatively inert wear particles. The innate immune system recognizes these microbial pathogen-associated molecular patterns (PAMPs) using Toll-like receptors (TLRs). Our objective was to evaluate the possible presence of TLRs in aseptic synovial membrane-like interface tissue. Bacterial culture-negative, aseptic (n = 4) periprosthetic synovial membrane-like tissue was compared to osteoarthritis synovial membrane (it = 5) for the presence of cells positive for all known human functional TLRs, stained using specific antibodies by immunohistochemistry, and evaluated using morphometry. In comparison to osteoarthtritic synovium, the number of TLR-positive cells was found to be increased in the aseptic setting, reflecting the considerable macrophage infiltration to the tissues investigated. Thus aseptic periprosthetic tissue seems to be very reactive to PAMPs. It has been recently recognized that TLR do not only respond to traditional PAMPs, but also to endogenous alarmings or danger signals released from necrotic and activated cells. Alarming-TLR interaction in the periprosthetic tissue might be a novel mechanism of aseptic loosening of endoprosthesis. (C) 2009 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 28:184-190, 2010
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