Elevation of circulating HLA DR(+) XXXX (+) T-cells and correlation with @entity3407 and @entity1953 concentrations 6 years after metal-on-metal hip arthroplasty.

@entity1 @entity691 @entity6437 @entity3407 @entity56 @entity1953 @entity405 @entity1349
BACKGROUND AND PURPOSE: Following metal-on-metal hip arthroplasty (THA), immunological reactions including changes in lymphocyte populations, @entity1349 , and @entity6437 occur. We hypothesized that changes in lymphocyte subpopulations would be associated with elevated metal ion concentrations. METHODS: A randomized trial involving 85 @entity1 matched for age and sex and randomized to receiving metal-on-metal (n = 41) or metal-on- @entity691 total hip arthroplasty (n = 44) was conducted. 36 @entity1 were eligible for follow-up after mean 7 (6-8) years. Concentrations of @entity3407 and @entity1953 were analyzed by high-resolution inductively coupled plasma mass spectrometry. Leukocyte subpopulations and immunoglobulins in @entity1 blood were measured using standard laboratory methods. RESULTS: @entity1 with a metal-on-metal hip had higher serum concentrations of @entity3407 (1.05 vs. 0.36  g/L; p < 0.001) and @entity1953 (0.86 vs. 0.24  g/L; p < 0.001) than those with metal-on- @entity691 . The percentage of HLA DR(+) @entity405 (+) T-cells was higher in the metal-on-metal group (10.6 vs. 6.7%; p = 0.03) and correlated positively with @entity3407 and @entity1953 concentrations in @entity1 blood (Pearson's correlation coefficient: 0.39, p = 0.02; 0.36, p = 0.03, respectively). The percentage of B-cells was lower in the metal-on-metal group (p = 0.01). The two groups were similar with respect to immunoglobulin concentrations and Harris hip scores, and there were no radiographic signs of loosening. INTERPRETATION: We conclude that immunological alterations appear to be associated with increased @entity1953 and @entity3407 concentrations. It is tempting to speculate that HLA DR(+) @entity405 (+) T-cells are involved in the pathogenesis of @entity56 , implant loosening, and @entity6437 .
