The aim of this work is to assess the correlation between the
osteolysis around the
prosthesis and the presence of
cytokines favouring
inflammation in the tissues at the interface between loosened
prosthesis and bone. In this study, twenty-nine patients that underwent
revision surgery were examined. Bioptic samples were collected at the interface between bone and implant both at the stem and socket level. Semiquantitative immunohistochemistry was performed to detect
interleukin 1 alpha,
interleukin 1 beta,
interleukin 6 and tumour
necrosis factor,
cytokines that directly cause
bone resorption and indirectly induce synthesis of other bone resorbing
cytokines. Wear particles were identified and quantified by light microscopy. Radiographic evidence for
osteolysis was scored by the Engh and Bobyn score. In tissues collected at the interface, the percentage of cells positive to IL1,
IL6 and particularly to TNF increased in relation to the tissues collected at the interface with stable components. The cells occurring in the new
capsule do not secrete
cytokines in quantities that can be related to severity of wear. Cemented
prostheses showed higher incidence of severe
osteolysis, and higher levels of
cytokines. It can be concluded that TNF, and to a lesser extent IL1 and
IL6, are positively related to the severity of
osteolysis around the
prosthesis and therefore a pharmacological treatment can be hypothesized with anti-inflammatory or anti-
cytokine drugs in order to limit or to avoid
prosthesis loosening.