Aim: The most important long-term complication in total joint replacements is aseptic osteolysis. Our aim was to use immunohistological methods to study samples taken during total hip arthroplasty revision surgery. And to compare these results with the preoperative radiological findings.

Methods: Between 1996 and 2003, 103 revision of total hip arthroplasty have been performed because of aseptic loosening at our Department. Out of these 103 cases 83 histological examination was performed. The samples taken during surgery are stored in paraffin-embedded tissue sections at the University’s Department of Pathology. Aseptic loosening of prosthetic components after total hip replacement is characterized by the formation of a synovial membrane-like tissue. Particle induced osteolysis is a primary cause of aseptic loosening through cytokine production in response to phagocytosis of implant wear particle. To study the local immun (macrophage) reaction, we applied labelling of sections by immunohistochemistry using the macrophage marker anti-CD68, anti-TNF-α marker and Crosmon staining. Osteolysis on the AP and lateral radiographs was detected by the periprosthetic radiolucent zones. Classification was performed by the Paprosky and DeLee-Charnley methods. The results of the radiological analysis was compered statisticaly to the immunohistological findings.

Results: Increased macrophage activity showed an elevation in the immun-markers in the samples. In the radiologicaly more severe cases an increase in the immun response was detected.