Suture wear particles cause a significant inflammatory response in a murine synovial airpouch model

Lovric, Vedran, Goldberg, Michael J., Heuberer, Philipp R., Oliver, Rema A., Stone, Dana, Laky, Brenda, Page, Richard S. and Walsh, William R. 2018, Suture wear particles cause a significant inflammatory response in a murine synovial airpouch model, Journal of orthorpaedic surgery and research, vol. 13, pp. 1-8, doi: 10.1186/s13018-018-1026-4.

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Title Suture wear particles cause a significant inflammatory response in a murine synovial airpouch model
Author(s) Lovric, Vedran
Goldberg, Michael J.
Heuberer, Philipp R.
Oliver, Rema A.
Stone, Dana
Laky, Brenda
Page, Richard S.ORCID iD for Page, Richard S.
Walsh, William R.
Journal name Journal of orthorpaedic surgery and research
Volume number 13
Article ID 311
Start page 1
End page 8
Total pages 8
Publisher BMC
Place of publication London, Eng.
Publication date 2018-12
ISSN 1749-799X
Keyword(s) Foreign body reaction
Inflammatory response
Matrix metalloproteinase
Post-arthroscopic glenohumeral chondrolysis
Suture wear particles
Science & Technology
Life Sciences & Biomedicine
Summary BACKGROUND: Commonly used contemporary orthopaedic sutures have been identified as a potential causative factor in the development of post-arthroscopic glenohumeral chondrolysis. Currently, little is known about the body's immune response to these materials. The aim of this study was to examine the biological response of synovial tissue to three commonly used orthopaedic sutures, using a murine airpouch model. METHODS: Fifty rats were used in this study (ten per group). An airpouch was created in each rat, and test materials were implanted. Test materials consisted of an intact polyethylene terephthalate suture with a polybutilate coating (suture A), an intact polyethylene suture braided around a central polydiaxannone core (suture B), an intact polyethylene/polyester cobraid suture with a silicone coating (suture C), and particles of suture C (particles C). Rats were sacrificed at 1 or 4 weeks following implantation. Histological (multinucleated giant cell count) and immunohistochemical (expression of matrix metalloproteinases MMP-1,-2,-3,-9,-13) markers of inflammation were examined. RESULTS: Multinucleated giant cells were present in all specimens containing suture material but not in the control specimens. No significant differences were found in the number of giant cells between the intact suture groups at either time point. Significantly higher numbers of giant cells were noted in the particles C group compared to the intact suture C group at both time points (p = 0.021 at 1 week, p = 0.003 at 4 weeks). Quantitative analysis of immunohistochemical staining expression at 4 weeks showed that significantly more MMP (-1,-2,-9,-13) was expressed in the particles C group than the intact suture C group (p = 0.024, p = 0.009, p = 0.002, and p = 0.007 for MMP-1, MMP-2, MMP-9, and MMP-13, respectively). No significant difference was seen in the expression of MMP-3 (p = 0.058). CONCLUSIONS: There were no differences observed between the biological reactivity of commonly used intact orthopaedic sutures A, B, and C. However, wear particles of suture C elicited a significantly greater inflammatory response than intact suture alone. This was confirmed by increased numbers of multinucleated giant cells as well as MMP ( -1,-2,-9,-13) expression. Further studies are needed to determine whether this inflammatory response may play a role in the development of post-arthroscopic glenohumeral chondrolysis or interfere with biological healing. These findings have important clinical implications relating to surgical technique and surgical implant design.
Language eng
DOI 10.1186/s13018-018-1026-4
Field of Research 1103 Clinical Sciences
HERDC Research category C1 Refereed article in a scholarly journal
Copyright notice ©2018, The Author(s)
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