Properties of tissue from around cemented joint implants with erosive and/or linear osteolysis

Levels of bone remodeling agents were measured in conditioned media from cultures of periprosthetic pseudosynovial membranes and related to the radiographic features of the failed joint implants. Radiographs of both cemented hip (n = 28) and cemented knee (n = 11) implants were examined and the pattern of radiolucency was classified as erosive, linear, or mixed. Similar levels of interleukin-1-beta (IL-1β), interleukin-6, tumor necrosis factor alpha (TNF-α), transforming growth factor beta-1, and prostaglandin E 2 (PGE 2) were found in pseudosynovial membrane conditioned media from all 3 groups of hips and the knee group (all linear). Significant correlations were evident only between PGE 2 and TNF-α levels in the linear hip group and PGE 2 and IL-1β levels in the knee group. A close correlation was found between IL-1β and TNF-α in both linear and erosive hips. It is suggested that coregulation of these bone remodeling agents differs with the radiographic appearance of the failed joint implants. As all the implants were cemented and the results contrast with those of others obtained with pseudosynovial membrane conditioned media from cementless implants, it is considered that cement critically influences the process of implant failure.