Archives of Orthopaedic and Trauma Surgery

, Volume 113, Issue 3, pp 159–163 | Cite as

Local immune inflammatory response to infected total hip and knee replacements

  • D. Nordström
  • S. Santavirta
  • I. Antti-Poika
  • Y. T. Konttinen
Clinical and Experimental Forum


We studied the tissue response for periprosthetic pseudosynovial tissue in seven patients with a purulent endoprosthetic infection and six patients with common prosthesis loosening, using specific monoclonal antibodies in avidin-biotin-peroxidase complex staining. In infected cases, proline 4-hydroxylase positive fibroblasts dominated the stroma of the vascularized periprosthetic connective tissue, whereas ;diffuse local infiltrations of mononuclear cells characterized the cellular histological overview. Local cellular response consisted of CD11b and MHC locus II antigen-positive immunoreactive monocytes/macrophages and of T lymphocytes, mostly of the CD4 subset. Only a few CD25-positive cells could be detected. The local cellular response in six patients with prosthesis loosening of nonbacterial origin was mild, showing a sparse perivascular infiltration of CD11b- and Ia-positive monocytes/macrophages and CD4/CD8-positive T lymphocytes in a proportion of 2:1. Only occasional CD15- or lactoferrin-positive neutrophils and CD25-positive lymphocytes could be detected. Our results from chronically infected joint replacements suggest that neutrophils, being virtually absent in the tissue compartment, do not contribute to pathological events in the “pseudojoint” cavity, whereas local tissue response consists of a mononuclear inflammatory cell reaction of a macrophage-dependent foreign-body type.


Knee Replacement Tissue Response Specific Monoclonal Antibody Infected Case Mononuclear Inflammatory Cell 
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Copyright information

© Springer-Verlag 1994

Authors and Affiliations

  • D. Nordström
    • 1
  • S. Santavirta
    • 2
  • I. Antti-Poika
    • 3
  • Y. T. Konttinen
    • 4
    • 5
  1. 1.Fourth Department of MedicineHelsinki University Central HospitalHelsinkiFinland
  2. 2.Orthopaedic Hospital of the Invalid FoundationHelsinkiFinland
  3. 3.Peijas-Rekola HospitalVantaaFinland
  4. 4.Hospital for Joint DiseasesOrthopaedic InstituteNew YorkUSA
  5. 5.Department of AnatomyUniversity of HelsinkiHelsinkiFinland

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