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Related Analysis between the Interface Membrane and Loosening Prosthesis of Hip
Objective: To analyze the reason of loosening prosthesis by observing the interface membranes harvested during the hip revision operation. Methods: 28 specimens of interface membrane around the loosening prosthesis were harvested from 28 patients who underwent the revision of total hip replacement. All the specimens were observed by appearance, light microscope and scanning electronic microscope (SEM). Results: All the gap around the loosening prothesis were filled with different thickness of interface membranes. The color of the most interface membranes was madder red, and other one third of membranes was black. The thicker membrane was similar to scar connective tissue, the thinner was similar to fiber membrane. A large number of wear debris, macrophage and foreign-body giant cells were found under light microscope. With SEM observation, a large number of different diameter collagen fibra structures looked like scar tissue arranged disorderly in a great mass, different size of foreign particles and bone debris distributed unevenly, and the fibroblast distributed in the collagen fiber. Conclusion: Wear debris is relevant to inflammatory cells response around the interface membrane of the loosening prosthesis. The wear debris engulfed by macrophage stimulated the interface membrane to release bone resorption factors (such as TNF) which lead to osteolysis, and this was one of the most importment reasons of the prosthesis loosening.
