The Journal of Arthroplasty
Volume 23, Issue 8 , Pages 1212-1218, December 2008

Immune Responses in Patients With Metal-on-Metal Hip Articulations:

A Long-term Follow-up

  • Paul M. Whittingham-Jones, MRCS

      Affiliations

    • Royal National Orthopaedic Hospital, London, United Kingdom
    • Corresponding Author InformationReprint requests: Paul M. Whittingham-Jones, MRCS, 14 Raydean Road, Barnet, Herts EN5 1AN, United Kingdom.
  • ,
  • Edward Dunstan, FRCS (Orth)

      Affiliations

    • Royal National Orthopaedic Hospital, London, United Kingdom
  • ,
  • Huwaidha Altaf, MSc, BSc

      Affiliations

    • UCL Eastman Dental Institute, London, United Kingdom
  • ,
  • Stephen R. Cannon, FRCS

      Affiliations

    • Royal National Orthopaedic Hospital, London, United Kingdom
  • ,
  • Peter A. Revell, PhD, FRCPath

      Affiliations

    • Royal National Orthopaedic Hospital, London, United Kingdom
  • ,
  • Timothy W.R. Briggs, FRCS

      Affiliations

    • Royal National Orthopaedic Hospital, London, United Kingdom

Received 6 March 2007; accepted 14 October 2007. published online 17 April 2008.

Abstract 

Metal-on-metal (MoM) hip bearings are being inserted into ever-younger patients. The effects on the immune system of chronic exposure are unknown. We investigated the immune response of patients with MoM hip bearings. In patients with MoM implants, the expression of antigen-presenting cell (APC) surface molecules (CD86 and HLA-DR) was seen to be significantly higher (P < .05) than control group. High levels of APC surface molecules suggest an activated state and attempts to propagate an immune response. However, in the same group, the expression of T-cell markers (CD3 and CD28) was low, indicating a small T-cell population. This suggests, despite the activation of APCs, that T cells down-regulate immune responses in MoM articulations. Conversely, in metal-on-polyethylene articulations, expression of T-cell molecules was elevated and expression of APC molecules lowered.

Key words: immune responses, metal-on-metal, hip, metal-on-polyethylene

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 No benefits of funds were received in support of the study.

PII: S0883-5403(07)00610-9

doi:10.1016/j.arth.2007.10.015

The Journal of Arthroplasty
Volume 23, Issue 8 , Pages 1212-1218, December 2008