假体周围骨保护素表达与磨损微粒分布的关系

The relation between the concertration of OPG and wear debris accumulation

目的 :观察骨保护素 (osteoprotegerin ,OPG)在假体周围各区的浓度变化 ,研究各区OPG表达与磨损微粒聚积之间的关系。 方法 :临床选取 4例人工全髋关节翻修术病例 ,于术中按照Delee Charnley髋臼分区法和Gruen Amstutz股骨分区法 ,采取松动假体周围各区的反应界膜组织 ,采用羊抗人OPG多克隆抗体对界膜进行免疫标记 ,比较OPG在各个分区中的浓度 ,并以电镜观察统计界膜各个分区中磨损微粒聚积的数目。 结果 :髋臼分区中OPG阳性细胞数目三区显著高于一区和二区 (P <0 .0 5 ) ,股骨分区中OPG的阳性细胞数目一区、六区和七区显著高于其余各区 (P <0 .0 5 )。髋臼分区中三区磨损微粒聚积数明显高于一区和二区 (P <0 .0 5 ) ,股骨分区中一区、七区中黑色磨损微粒均匀弥漫存在 ,明显高于其余各区 (P <0 .0 5 )。 结论 :假体周围OPG的表达具有一定规律性 ,并与磨损微粒的局部聚积密切相关。

Objective:To observe the concentration of osteoprotegerin (OPG) around the prostheses, and study the relationship between the concentration of OPG and the accumulation of wear debris. Methods:Interface tissues were obtained at three Delee-Charnley acetabular sections and seven Gruen-Amstutz femur sections in four revision total hip arthroplasty surgery. The tissues were prepared for immunohistochemical assays with goat-anti-human OPG antibodies for evaluatingt the concentration of OPG in each section.Data of wear debris accumulated in the tissue were compared among all sections to determine periprosthetic distribution characteristics of abrasive wear debris with electronic microscope. Results:Data showed that the 3 rd section of acetabulum having much higher accumulating level of wear debris than that of the 1 st and 2 nd sections, and black metal wear debris distributed extensively at sections 1 and 7 of femur sections, with a accumulating level significantly higher than of the other femur sections (P<0.05). Immmunohistochemical results suggested far more positive cells at the section 3 of acetabulum than those at sections 1 and 2, and even more in sections 1,6 and 7 of femur than those at the others (P<0.05). Conclusion:The concertration of OPG found and deposition of wear debris can affect the local content of OPG Ligand and OPG.