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Clin Orthop Relat Res. 2012 Jul;470(7):1879-84. doi: 10.1007/s11999-011-2191-5.

Is monocyte chemotactic protein 1 elevated in aseptic loosening of TKA? A pilot study.

Author information

1
Department of Orthopaedics, Louisiana State University Health Sciences Center, 1542 Tulane Avenue, New Orleans, LA 70115, USA. vdasa@lsuhsc.edu

Abstract

BACKGROUND:

Failure of TKA from aseptic loosening is a growing concern, as TKA is performed with increasing frequency. Loosening is multifactorial and may be associated with elevated inflammatory cytokines in addition to biomechanical failure.

QUESTIONS/PURPOSES:

We asked whether proinflammatory cytokines and chemokines are elevated in synovial fluid from patients undergoing revision surgery as compared to those with osteoarthritis (OA) or rheumatoid arthritis (RA).

METHODS:

We obtained synovial fluid samples from 20 patients: six with aseptic loosening of TKA (all with bone loss), 10 with primary OA, and four with RA. A panel of cytokines/chemokines was screened using a SearchLight(®) Array (Pierce Biotechnology, Rockford, IL, USA) in one revision sample. Using these data, we assayed the synovial fluids for monocyte chemotactic protein 1 (MCP-1) by ELISA.

RESULTS:

We observed an increase in synovial MCP-1 levels in samples from patients planned for TKA revision compared to those with OA or RA. In patients undergoing revision arthroplasty, the mean (± SD) MCP-1 concentration was 21,233 ± 18,966 pg/mL (range, 1550-50,657 pg/mL; n = 6). In patients with OA, the mean MCP-1 level was 3012 ± 3321 pg/mL. In patients with RA, the mean MCP-1 concentration was 690 ± 561 pg/mL.

CONCLUSIONS:

All patients undergoing revision TKA showed elevated concentrations of MCP-1 compared to patients with OA and RA, suggesting MCP-1 may serve as a potential marker or predictor of bone loss in patients undergoing revision surgery.

CLINICAL RELEVANCE:

MCP-1 may be a novel biomarker in patients showing early symptoms of aseptic loosening of TKA.

PMID:
22131127
PMCID:
PMC3369079
DOI:
10.1007/s11999-011-2191-5
[Indexed for MEDLINE]
Free PMC Article
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