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Low IGF-I in synovial fluid and serum in patients with aseptic prosthesis loosening
Martin K Andersson1, André Stark, Lucas Anissian
1Department of Orthopaedic Surgery, Karolinska University Hospital Solna, Sweden.
Background:
We have previously shown that proliferation in primary cultures of human osteoblast-like cells is lower after exposure to synovial fluid from patients with aseptic prosthesis loosening than after exposure to synovial fluid from patients with osteoarthrosis.
Materials And Methods:
Insulin-like growth factors (IGF) I and II and IGF binding proteins (IGFBP) 3-6, were measured with radioimmunoassy in synovial fluid and in serum from patients with aseptic prosthesis loosening or osteoarthrosis. Proliferation in osteoblast-like MG-63 cells was studied with the CyQUANT assay.
Results:
IGF-I and IGFBP-4 concentrations were lower whereas the concentration of IGFBP-6 was higher in synovial fluids from patients with prosthesis loosening than in synovial fluid from patients with osteoarthrosis. IGF-I concentrations in serum from patients with prosthesis loosening were also lower than in the osteoarthrosis group, and were even below the normal range in most cases (72%). Synovial fluid from patients with aseptic loosening had a weaker stimulatory effect on MG63 osteoblast-like cell proliferation than synovial fluid from patients with osteoarthrosis, but there was no difference between the two groups when a human IGF-I antibody was added.
Interpretation:
Low levels of IGF-I in synovial fluid possibly result from low serum levels and may be a mechanism leading to aseptic prosthesis loosening.
