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International Orthopaedics
Published in: International Orthopaedics 6/2014

01-06-2014 | Original Paper

Infectious versus non-infectious loosening of implants: activation of T lymphocytes differentiates between the two entities

Authors: Ulrike Dapunt, Thomas Giese, Birgit Prior, Matthias M. Gaida, G. Maria Hänsch

Published in: International Orthopaedics | Issue 6/2014

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Abstract

Purpose

Loosening of implants occurs mainly for two reasons: bacterial infection of the implant or “aseptic loosening” presumably due to wear particles derived from the implant. To gain further insight into the pathomechanism, we analysed activation of the T cell response in these patients.

Methods

Activation of peripheral T lymphocytes was determined by cytofluorometry as down-regulation of CD28 and up-regulation of CD11b. In addition, tissue samples obtained during surgery were analysed by quantitative RT-PCR for gene expression of CD3, CD14 and cathepsin K, as markers for T cells, monocytes/macrophages or osteoclasts, respectively.

Results

Activated T lymphocytes were detected in patients with infection but not in patients with aseptic loosening. Gene expression of CD3 was significantly enhanced in tissues of patients with infection compared to those with aseptic loosening. Expression of CD14 and of cathepsin K did not differ between the two groups.

Conclusion

Implant-associated infection and aseptic loosening are associated with a local inflammatory response, which eventually results in osteoclastogenesis and bone resorption. Systemic T cell activation, in contrast, occurs only in patients with implant-associated infection, and hence analysis of T cell activation markers could serve as a diagnostic tool to differentiate between the two entities.
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Metadata
Title
Infectious versus non-infectious loosening of implants: activation of T lymphocytes differentiates between the two entities
Authors
Ulrike Dapunt
Thomas Giese
Birgit Prior
Matthias M. Gaida
G. Maria Hänsch
Publication date
01-06-2014
Publisher
Springer Berlin Heidelberg
Published in
International Orthopaedics / Issue 6/2014
Print ISSN: 0341-2695
Electronic ISSN: 1432-5195
DOI
https://doi.org/10.1007/s00264-014-2310-5

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