| Abstract: | Objective To analyze the cause of prosthesis loosening by observing the interface membranes harvested during the hip restoration operation. Methods A total of 28 specimens of interface membrane around the loose prosthesis were harvested from 28 patients undergoing the restoration of total hip replacement. All the specimens underwent the observation of appearance, light microscopy and scanning electronic microscopy(SEM). Results All the gaps around the loose prosthesis were filled with interface membrane of different thickness. The color of the most interface membrane was madder red, and the other one third of membrane was black. The comparatively thicker membrane was similar to scar connective tissue while the thinner was similar to fiber membrane. A large number of wear debris, macrophages and foreign-body giant cells were found under light microscope. With SEM observation a large number of different diameter collagen fibra structures that looked like scar tissues were arranged disorderly in a great mass, foreign particles and bone debris of different size were distributed unevenly, and the fibroblast was distributed in the collagen fiber. Conclusion Wear debris is related to inflammatory cell response around the interface membrane of the loose prosthesis. The wear debris engulfed by macrophage stimulates the interface membrane to release bone resorption factors (such as TNF) which lead to osteolysis, and this is one of the most important causes of the prosthesis loosening. |
