We analysed data from 155 revisions of identical cementless hip prostheses to determine the influence of patient-, implant- and surgery-related factors on the polyethylene wear rate and size of periprosthetic osteolysis (OL). This was calculated by logistic regression analysis. Factors associated with an increased/decreased wear rate included position of the cup relative to Kohler's line, increase in abduction angle of the cup, traumatic and inflammatory arthritis as a primary diagnosis, and patient height. Severe acetabular bone defects were predicted by an increased wear rate (odds ratio, OR = 5.782 for wear rate above 200 mm(3)/y), and increased height of the patient (OR = 0.905 per each centimetre). Predictors of severe bone defects in the femur were the increased wear rate (OR = 3.479 for wear rate above 200 mm(3)/y) and placement of the cup outside of the true acetabulum (OR = 3.292). Variables related to surgical technique were the most predictive of polyethylene wear rate.

Nous avons analysé les données de 155 révisions d’une prothèse totale de hanche sans ciment de façon à déterminer les facteurs relatifs aux patients et à l’implant concernant l’utilisation du polyéthylène et l’importance de l’ostéolyse (OL). Les 155 modèles de prothèses étaient identiques. Il s’agit d’une analyse informatique. L’augmentation ou la diminution du taux d’usure était associée à la position de la cupule par rapport à la ligne de Kohler, une cupule verticalisée entraînant plus d’usure. De même en ce qui concerne les arthroses d’origine traumatique ou inflammatoire et le poids des patients. On pouvait prévoir d’importantes lésions d’ostéolyse acétabulaire du fait d’une importante augmentation de l’usure du polyéthylène (OR = 5,782 taux d’usure 707, 200 mm3/an) et l’augmentation du poids des patients (OR = 0,905) pour chaque cm. L’augmentation du taux prédictif d’usure avec des lésions osseuses sévères au niveau du fémur l’étaient également (OR = 3,479 d’usure et 200 mm3/an) de même que le positionnement de la cupule en dehors de l’arrière fond acétabulaire (OR = 3,292). Les facteurs d’usure les plus importants sont surtout d’origine technique et secondaires aux problèmes de technique chirurgicale.

• MeSH
• acetabulum patologie   chirurgie   MeSH
• dospělí MeSH
• hlavice femuru patologie   chirurgie   MeSH
• kyčelní kloub patofyziologie   chirurgie   MeSH
• kyčelní protézy MeSH
• lidé středního věku MeSH
• lidé MeSH
• logistické modely MeSH
• mechanický stres MeSH
• náhrada kyčelního kloubu škodlivé účinky   MeSH
• odds ratio MeSH
• osteolýza epidemiologie   etiologie   patologie   MeSH
• polyethylen MeSH
• protézy - design MeSH
• reoperace MeSH
• rizikové faktory MeSH
• selhání protézy MeSH
• senioři MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Názvy látek
• polyethylen MeSH

BACKGROUND: The differences in total hip arthroplasty (THA) survivorship may be influenced by individual susceptibility to periprosthetic osteolysis. This may be driven by functional polymorphisms in the genes for cytokines and cytokine receptors involved in the development of osteolysis in THA, thereby having an effect on the individual's phenotype. METHODS: We performed a study on 22 single-nucleotide polymorphisms (SNPs) for 11 cytokines and two cytokine receptor candidate genes for association with severity of acetabular osteolysis and risk to failure in THA. Samples from 205 unrelated Caucasian patients with cementless type THA (ABG 1) were investigated. Distribution of investigated SNP variants between the groups of mild and severe acetabular osteolysis was determined by univariate and multivariate analysis. Time-dependent output variables were analyzed by the Cox hazards model. RESULTS: Univariate analysis showed: 1) TNF-238*A allele was associated with severe osteolysis (odds ratio, OR = 6.59, p = 0.005, population attributable risk, PAR 5.2%); 2) carriers of the IL6-174*G allele were 2.5 times more prone to develop severe osteolysis than non-carriers (OR = 2.51, p = 0.007, PAR = 31.5%); 3) the carriage of IL2-330*G allele was associated with protection from severe osteolysis (OR = 0.55, p = 0.043). Based on logistic regression, the alleles TNF-238*A and IL6-174*G were independent predictors for the development of severe acetabular osteolysis. Carriers of TNF-238*A had increased cumulative hazard of THA failure according to Cox model (p = 0.024). In contrast, IL2-330*G allele predicted lower cumulative hazard of THA failure (p = 0.019). CONCLUSION: Genetic variants of proinflammatory cytokines TNF-alpha and IL-6 confer susceptibility to severe OL. In this way, presence of the minor TNF allele could increase the cumulative risk of THA failure. Conversely, SNP in the IL2 gene may protect carriers from the above THA complications.

• MeSH
• alely MeSH
• cytokiny genetika   MeSH
• dospělí MeSH
• genetické asociační studie * MeSH
• interleukin-2 genetika   MeSH
• interleukin-6 genetika   MeSH
• jednonukleotidový polymorfismus MeSH
• lidé středního věku MeSH
• lidé MeSH
• náhrada kyčelního kloubu škodlivé účinky   MeSH
• odds ratio MeSH
• osteolýza etiologie   genetika   MeSH
• proporcionální rizikové modely MeSH
• receptory cytokinové genetika   MeSH
• rizikové faktory MeSH
• selhání protézy * MeSH
• senioři MeSH
• stupeň závažnosti nemoci MeSH
• TNF-alfa genetika   MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• srovnávací studie MeSH
• Názvy látek
• cytokiny MeSH
• interleukin-2 MeSH
• interleukin-6 MeSH
• receptory cytokinové MeSH
• TNF-alfa MeSH