Immunological changes in patients with primary osteoarthritis of the hip after total joint replacement

Donatella Granchi, Lucia Savarino, Gabriela Ciapetti, Elisabetta Cenni, Roberto Rotini, Michele Mieti, Nicola Baldini, Armando Giunti

Research output: Contribution to journalArticlepeer-review


We aimed to assess whether the immunological abnormalities which have been observed in patients with loose total hip replacements (THRs) are present in patients with a well-fixed prosthesis. We examined blood samples from 39 healthy donors, 22 patients before THR and 41 with well-fixed THRs of different types (15 metal-on-metal, 13 metal-on-polyethylene, 13 ceramic-on-ceramic). Before THR, the patients showed a decrease in leukocytes and myeloid cells in comparison with healthy donors, and a prevalence of type-1 T lymphocytes, which was confirmed by the increase in ratio of interferon-γ to interleukin 4. Moreover, patients with metal-on-metal or metal-on-polyethylene implants showed a significant decrease in the number of T lymphocytes and a significant increase in the serum level of chromium and cobalt, although no significant correlation was observed with the immunological changes. In the ceramic-on-ceramic group, leukocytes and lymphocyte subsets were not significantly changed, but a significant increase in type-2 cytokines restored the ratio of interferon-γ to interleukin 4 to normal values. We conclude that abnormalities of the cell-mediated immune response may be present in patients with a well-fixed THR, and that the immunological changes are more evident in those who have at least one metal component in the articular coupling.

Original languageEnglish
Pages (from-to)758-764
Number of pages7
JournalJournal of Bone and Joint Surgery - Series B
Issue number5
Publication statusPublished - Jul 2003

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine
  • Surgery


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