Interleukin-6 in aseptic loosening of total hip replacement prostheses

Abstract

Objective: To investigate the level of interleukin-6 (IL-6) expression in the synovial-like interface membrane (SLIM) and in the pseudosynovial tissue surrounding the artificial hip joints, as well as in the pseudosynovial fluid from aseptically loosened total hip replacement (THR) prostheses.

Methods: A series of methods were used in this study including immunohistochemical staining, double immunofluorescence labeling, enzyme-linked immunosorbent assay (ELISA), and reverse transcriptase polymerase chain reaction (RT-PCR).

Results: IL-6 was found in all SLIM and the pseudosynovial tissue samples from aseptic loosening of THR. Semi-quantitative morphometry showed that IL-6 containing cells were more numerous in the SLIM (911 +/- 197; p < 0.01) and the pseudosynovial tissue samples (883 +/- 310; p < 0.01) than in the control synovial tissue (291 +/- 184). Double labeling confirmed that macrophages and fibroblasts were the predominant cell types expressing IL-6. These findings were confirmed by RT-PCR. ELISA revealed no difference in the IL-6 concentration between the pseudosynovial fluid and the control synovial fluid obtained from the patients undergoing hip arthroscopy.

Conclusions: IL-6 locally produced in SLIM may in a paracrine manner contribute to periprosthetic osteolysis of the nearby bone. In contrast, fluid phase IL-6 does not seem to contribute to this end.