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Synovial tissue may be immunomodulated by PMMA-spacers in two-stage revision TJA
PRAGUE — According to data presented at the 16th EFORT Congress, synovial tissue in patients undergoing two-stage revision total joint arthroplasty may be immunomodulated by polymethyl acrylate spacers.
Nicole Deutloff, MD, and colleagues evaluated 35 patients with a mean age of 67 years, of whom, nine underwent two-stage total hip arthroplasty (THA) revision and 25 underwent two-stage revision of total knee arthroplasty (TKA). Periprosthetic tissue samples were analyzed during the course of a 6-week period to determine the presence of polymethyl acrylate (PMMA) particles via Fourier transform infrared spectroscopy and microscopy, and a histological analysis was performed via Sudan Red and Haematoxylin and eosin staining. The relationship between immunophenotype and inflammatory cells was determined from CD68, CD20, CD11(c), CD3 and IL-17 antibodies, and modified Willert scores were assigned to all slides by two independent reviewers.
Tissue samples from all patients were confirmed to have PMMA particles. Significant differences were observed in perivascular and diffuse scores in CD3, CD20, CD11(c) and IL- 17. Additionally, a shift in the dendritic cell expression pattern toward the perivascular arrangement and near PMMA particles was observed upon reimplantation, according to the researchers.
“What we [did not expect was] that CD11(c) did not differ between exit and reimplantation, but we see a shift in significant difference between perivascular and diffuse expression,” Deutloff said during her presentation. – by Christian Ingram
Reference:
Deutloff, et al. Paper #3352. Presented at: 16th EFORT Congress; May 27-29, 2015; Prague.
Disclosure: Deutloff reports no relevant financial disclosures.