Long-term survival of total joint arthroplasty by drug inhibition of autophagy

• Project/Area Number: 26462306
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Research Field: Orthopaedic surgery
• Research Institution: Kagoshima University
• Principal Investigator: Komiya Setsuro 鹿児島大学, 医歯学域医学系, 教授 (30178371)
• Co-Investigator(Kenkyū-buntansha): 瀬戸口 啓夫 鹿児島大学, 医歯学総合研究科, 特任准教授 (40423727)
• Research Collaborator: SAITOH YOSHINOBU
• Project Period (FY): 2014-04-01 – 2017-03-31
• Project Status: Completed (Fiscal Year 2016)
• Budget Amount: ¥4,940,000 (Direct Cost: ¥3,800,000、Indirect Cost: ¥1,140,000); Fiscal Year 2016: ¥1,430,000 (Direct Cost: ¥1,100,000、Indirect Cost: ¥330,000); Fiscal Year 2015: ¥1,950,000 (Direct Cost: ¥1,500,000、Indirect Cost: ¥450,000); Fiscal Year 2014: ¥1,560,000 (Direct Cost: ¥1,200,000、Indirect Cost: ¥360,000)
• Keywords: 人工関節ルーズニング / オートファジー / 感染 / 人工関節周囲感染 / 好中球 / ポリエチレン摩耗 / 骨融解

Outline of Final Research Achievements

Polyethylene particle promoted the expression of inflammatory cytokines in macrophage cell lines. But inhibition of cytokine signals could not inhibit the autophagy. Aseptic and septic loosening prevent the long term survival of total joint arthroplasty. We evaluated the accumulation of polymorphonuclear leukocytes (PMNs) in periprosthetic tissues during second-stage revision surgery. There was no statistical relationship between PMNs-positivity and relapse of infection. Intraoperative evaluation of PMNs during second-stage revision surgery promote overdiagnosis of persistent infection. We retrospectively reviewed 18 patients with bipolar hip hemiarthroplasty (BHA) that necessitated revision. Pathological findings showed that several patients with early BHA migration were PMNs-positive, which was indicative of infection. Our findings suggest that some portion of rapid BHA prosthesis migration is caused by mild infection.

Research Products

• [Journal Article] Cut-off values of latent infection in patients with rapid migration following bipolar hip hemiarthroplasty. (2016)
  • Author(s): Setoguchi T, Kawakami H, Ishidou Y, Kawamura H, Nishi J, Yoshioka T, Kakoi H, Nagano S, Yokouchi M, Tanimoto A, Komiya S.
  • Journal Title: BMC Musculoskelet Disord. Volume: 17 Issue: 1 Pages: 37-37
  • DOI: 10.1186/s12891-016-0876-3
  • Peer Reviewed / Open Access
• [Journal Article] Enrichment of bacteria samples by centrifugation improves the diagnosis of orthopaedics-related infections via real-time PCR amplification of the bacterial methicillin-resistance gene. (2015)
  • Author(s): Tsuru A, Setoguchi T, Kawabata N, Hirotsu M, Yamamoto T, Nagano S, Yokouchi M, Kakoi H, Kawamura H, Ishidou Y, Tanimoto A, Komiya S.
  • Journal Title: BMC Res Notes. Volume: 8 Issue: 1 Pages: 288-288
  • DOI: 10.1186/s13104-015-1180-2
  • Peer Reviewed / Open Access
• [Presentation] 人工関節周囲感染に対する再置換術時の病理診断の評価 (2017)
  • Author(s): 瀬戸口啓夫
  • Organizer: 第90回日本整形外科学会学術総会
  • Place of Presentation: 仙台国際センター(宮城県仙台市)
  • Year and Date: 2017-05-19
• [Presentation] 人工関節周囲感染で抗生剤含有セメント設置後二期的再置換時の術中病理診断は有用か？ (2017)
  • Author(s): 瀬戸口啓夫
  • Organizer: 第47回日本人工関節学会
  • Place of Presentation: 沖縄コンベンションセンター(沖縄県宜野湾市)
  • Year and Date: 2017-02-24