Osteolytic indicators found in total knee arthroplasty synovial fluid aspirates.

Interleukin-1beta and tartrate resistant acid phosphatase concentrations in synovial fluid aspirates were examined to determine if they could be used as indicators of increased synovial inflammation and an osteolytic reaction in patients having total knee arthroplasty. Synovial aspirates were obtained from seven patients with severely osteoarthritic knees that were scheduled for primary total knee arthroplasty and from 20 patients with knees scheduled for total knee arthroplasty revision. Eleven of the revision cases involved titanium alloy prostheses and nine involved cobalt chrome alloy prostheses. The interleukin-1beta and tartrate resistant acid phosphatase concentrations were obtained and compared between the group having primary total knee arthroplasty and the group having revision total knee arthroplasty. The knees having revision surgery had higher concentrations of interleukin-1beta and tartrate resistant acid phosphatase than did the knees having primary total knee arthroplasty. These results indicate a greater inflammatory and osteolytic response in knees having revision surgery. Although the osteoarthritic knees and the knees needing revision surgery in this study are considered to have an inflammatory state, it was only after total knee arthroplasty when particulate wear debris would be present that appreciable concentrations of interleukin-1beta and tartrate resistant acid phosphatase were produced.

A comparison of interleukin-1 beta in human synovial fluid of osteoarthritic and revision total knee arthroplasty.

Interleukin-1 beta levels from synovial aspirates were examined to determine if they can be used as indicators of increased synovial activity and an inflammatory reaction within total knee arthroplasty. Synovial aspirates were obtained from twelve osteoarthritic knees scheduled for total knee arthroplasty and twenty-one knees scheduled for total knee revision. Eleven of the revision cases involved titanium alloy prostheses and ten involved cobalt-chrome prostheses. Using a high sensitivity ELISA test kit, the interleukin-1 beta concentrations were compared. A significant difference in the interleukin-1 beta concentration was found between all three knee groups. The knees scheduled for revision surgery showed higher concentrations of interleukin-1 beta than osteoarthritic knees. While the knees implanted with a titanium prosthesis showed the greatest concentration of interleukin-1 beta, the osteoarthritic knees showed the lowest interleukin-1 beta concentration. Furthermore, significantly greater synovial aspirate volumes were obtained from the revision cases than from the osteoarthritic cases. This increased synovial activity is most likely attributed to the high concentration of the particulate wear debris produced from the prosthesis.