Acrylic resin bone cement composite as a bone substitute for subchondral bone induces knee joint osteoarthritis

Jiang Hua; Yan Yu; Ma Hong-bing; Xu Bing; Wang Jun-rui; Jiang Dian-ming

doi:10.3969/j.issn.2095-4344.2015.25.006

Abstract：BACKGROUND:The hardened acrylic resin bone cement composite after implantation into human body can resist an intensity of 78-93 MPa. But a large amount of heat energy is released by bone cement during the process of solidification and it wil kil normal cel s, leading to peripheral tissue necrosis. OBJECTIVE:To investigate the characteristics of induced knee joint osteoarthritis after application of acrylic resin bone cement composite as a bone substitute for subchondral bone. METHODS:Thirty male Japanese big ear rabbits were randomly and equal y divided into four experimental groups (A, B, C, D) and a blank control group. After removal of subchondral bone on the right medial tibial plateau, polymethyl methacrylate powder/hydroxyapatite composite materials were implanted in rabbits in the experimental groups A, B, C, and D. Rabbits in the blank control group were only subjected to exposure of periosteum on the left medial tibial plateau. At 3, 6, 9 and 12 weeks after removal of subchondral bone, rabbits in the experimental groups A, B, C and D were sacrificed, and subchondral bone specimens were taken for hematoxylin-eosin staining and matrix metal oproteinase expression analysis. At the same time, interleukin-1βand tumor necrosis factor-ɑ levels in the synovial fluid were determined. RESULTS AND CONCLUSION:Mankin score in the experimental group C was significantly higher than in the blank control group and experimental group A (P<0.05). Mankin score in the experimental group D was significantly higher than in the experimental group B (P<0.05). The gray scale of matrix metal oproteinase-1 was highest in the blank control group, fol owed by experimental groups A, B, C, and the last in the experimental group D (P<0.05). Interleukin-1β and tumor necrosis factor-ɑ levels in the synovial fluid were highest in the experimental group D, fol owed by experimental groups C, B, A and the last in the blank control group (P<0.05). These findings suggest that acrylic resin bone cement composite as a bone substitute for subchondral bone induces knee joint osteoarthritis and leads to increases in matrix metal oproteinase-1 and tumor necrosis factor-ɑ levels in the synovial fluid.