Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2012 Jul;470(7):1879-84.
doi: 10.1007/s11999-011-2191-5.

Is monocyte chemotactic protein 1 elevated in aseptic loosening of TKA? A pilot study

Vinod Dasa  1 , Jill M Kramer, Sarah L Gaffen, Keith L Kirkwood, William M Mihalko
Affiliations

Is monocyte chemotactic protein 1 elevated in aseptic loosening of TKA? A pilot study

Vinod Dasa et al. Clin Orthop Relat Res. 2012 Jul.

Abstract

Background: Failure of TKA from aseptic loosening is a growing concern, as TKA is performed with increasing frequency. Loosening is multifactorial and may be associated with elevated inflammatory cytokines in addition to biomechanical failure.

Questions/purposes: We asked whether proinflammatory cytokines and chemokines are elevated in synovial fluid from patients undergoing revision surgery as compared to those with osteoarthritis (OA) or rheumatoid arthritis (RA).

Methods: We obtained synovial fluid samples from 20 patients: six with aseptic loosening of TKA (all with bone loss), 10 with primary OA, and four with RA. A panel of cytokines/chemokines was screened using a SearchLight(®) Array (Pierce Biotechnology, Rockford, IL, USA) in one revision sample. Using these data, we assayed the synovial fluids for monocyte chemotactic protein 1 (MCP-1) by ELISA.

Results: We observed an increase in synovial MCP-1 levels in samples from patients planned for TKA revision compared to those with OA or RA. In patients undergoing revision arthroplasty, the mean (± SD) MCP-1 concentration was 21,233 ± 18,966 pg/mL (range, 1550-50,657 pg/mL; n = 6). In patients with OA, the mean MCP-1 level was 3012 ± 3321 pg/mL. In patients with RA, the mean MCP-1 concentration was 690 ± 561 pg/mL.

Conclusions: All patients undergoing revision TKA showed elevated concentrations of MCP-1 compared to patients with OA and RA, suggesting MCP-1 may serve as a potential marker or predictor of bone loss in patients undergoing revision surgery.

Clinical relevance: MCP-1 may be a novel biomarker in patients showing early symptoms of aseptic loosening of TKA.

PubMed Disclaimer

Figures

Fig. 1A–D
Fig. 1A–D
Elevated levels of MCP-1 occurred in patients undergoing revision surgery and some patients with OA. Graphs show the MCP-1 concentrations in synovial fluid of (A) patients undergoing revision surgery for aseptic loosening of TKA (n = 6), (B) patients with OA undergoing primary TKA (n = 10), and (C) patients with RA undergoing primary TKA (n = 4). All samples were analyzed in triplicate, and SDs are shown. (D) A compilation of MCP-1 data shows elevated MCP-1 in patients undergoing revision TKA for aseptic loosening (n = 6) as compared to patients with OA (n = 10) or RA (n = 4) undergoing primary TKA.
Fig. 2
Fig. 2
Screening of a large panel of cytokines and chemokines identifies high levels of MCP-1 in synovial fluid from a patient undergoing revision surgery for aseptic loosening of TKA. A SearchLight® Array (Pierce Biotechnology) was performed using 50 μL of synovial fluid from one patient undergoing revision (Patient 1). Concentrations of the indicated cytokines or chemokines are indicated. IFN-γ = interferon γ; IP-10 = 10-kDa IFN-γ-induced protein; MIP-1α = macrophage inflammatory protein 1α.
See this image and copyright information in PMC

References

    1. Andersson MK, Anissian L, Stark A, Bucht E, Felländer-Tsai L, Tsai JA. Synovial fluid from loose hip arthroplasties inhibits human osteoblasts. Clin Orthop Relat Res. 2000;378:148–154. doi: 10.1097/00003086-200009000-00024. - DOI - PubMed
    1. Beraudi A, Stea S, Cremonini S, Visentin M, Toni A. Assessment of five interleukins in human synovial fluid as possible markers for aseptic loosening of hip arthroplasty. Artif Organs. 2009;33:538–543. doi: 10.1111/j.1525-1594.2009.00736.x. - DOI - PubMed
    1. Choy EH, Panayi GS. Cytokine pathways and joint inflammation in rheumatoid arthritis. N Engl J Med. 2001;344:907–916. doi: 10.1056/NEJM200103223441207. - DOI - PubMed
    1. Clarke SA, Brooks RA, Hobby JL, Wimhurst JA, Myer BJ, Rushton N. Correlation of synovial fluid cytokine levels with histological and clinical parameters of primary and revision total hip and total knee replacements. Acta Orthop Scand. 2001;72:491–498. doi: 10.1080/000164701753532835. - DOI - PubMed
    1. Engh GA, Ammeen DJ. Bone loss with revision total knee arthroplasty: defect classification and alternatives for reconstruction. Instr Course Lect. 1999;48:167–175. - PubMed

MeSH terms