The inflammatory response to XXXX in total hip arthroplasty.

@entity1 @entity738 @entity3356 @entity5744 @entity281 @entity6401 @entity1349
OBJECTIVE: To identify the cell types and patterns of cell distribution associated with @entity3356 in the membranes of @entity1 who undergo revision of hip arthroplasty. DESIGN: Case series. SETTING: Three university-affiliated hospitals. @entity1 : Twenty-nine @entity1 who underwent revision of a hip arthroplasty for reasons other than @entity281 . Eight @entity1 were excluded because loosening of the prosthesis was found to be associated with @entity281 , leaving 21 @entity1 , 18 with @entity1349 and 3 with recurrent dislocation. INTERVENTION: Retrieval of inflammatory membranes from loosened total hip prostheses. MAIN OUTCOME MEASURES: Results of aerobic and anaerobic tissue cultures, number of macrophages, T cells and B cells, and presence and histologic pattern of particulate debris in the membranes. RESULTS: None of the tissue cultures grew any organisms. All membranes contained T cells and macrophages, but B cells were present in only three @entity1 at a low level. Particulate debris, surrounded by macrophages and @entity5744 cells, was present in all membranes. Three histologic patterns were noted: type I--mostly fibrous tissue with cells and macrophages widely scattered through membrane (3 membranes); type II--fibrous membrane with a significant number of T cells, macrophages and @entity5744 cells and well-defined @entity6401 (7 membranes); type III--diffusely scattered T cells, ill-defined @entity738 , "foamy" macrophages and fewer @entity5744 cells than in type II (11 membranes). CONCLUSIONS: These findings document the key cellular elements involved in cell-mediated immunity in association with @entity3356 in aseptically loosened total hip arthroplasty membranes. T-cell amplification of the innate macrophage inflammatory reaction to particulate debris may play a role in the mechanism of particle clearance.
