Clinical Orthopaedics and Related Research®

, Volume 470, Issue 7, pp 1879–1884

Is Monocyte Chemotactic Protein 1 Elevated in Aseptic Loosening of TKA?: A Pilot Study

  • Vinod Dasa
  • Jill M. Kramer
  • Sarah L. Gaffen
  • Keith L. Kirkwood
  • William M. Mihalko
Symposium: Retrieval Studies

DOI: 10.1007/s11999-011-2191-5

Cite this article as:
Dasa, V., Kramer, J.M., Gaffen, S.L. et al. Clin Orthop Relat Res (2012) 470: 1879. doi:10.1007/s11999-011-2191-5

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.

Copyright information

© The Association of Bone and Joint Surgeons® 2011

Authors and Affiliations

  • Vinod Dasa
    • 1
  • Jill M. Kramer
    • 2
  • Sarah L. Gaffen
    • 4
  • Keith L. Kirkwood
    • 3
  • William M. Mihalko
    • 5
    • 6
  1. 1.Department of OrthopaedicsLouisiana State University Health Sciences CenterNew OrleansUSA
  2. 2.The Feinstein Institute for Medical ResearchNorth Shore-LIJ Health SystemManhassetUSA
  3. 3.Department of Craniofacial Biology and the Center for Oral Health ResearchMedical University of South CarolinaCharlestonUSA
  4. 4.Department of Medicine, Division of Rheumatology and Clinical ImmunologyUniversity of PittsburghPittsburghUSA
  5. 5.Campbell Clinic OrthopaedicsUniversity of TennesseeMemphisUSA
  6. 6.InMotion Orthopaedic Research LaboratoryMemphisUSA