Experimental Research On The Histology Manifestation And Physical Properties Of The Interface Membrane Nearby The Lower Limb And Lumbar Vertebrae' Metallic Orthopaedic Implants And Interface Membrane's Apoptosis

Objective :The interface membrane around the the lower limb and lumbar vertebrae'metallic orthopaedic implants were studied by SEM(scanning electron microscopy) , TUNEL staining and Analysis of X-ray Diffraction. Mental concentrations in the serum were studied by inductively coupled plasma spectrometry Mass Spectrometers (ICP-MS) and the role of cytokines in the interface membrane tissue was studied by immunohistochemistry.Methods:The subjects were divided into 3 groups.Group A:20 patients undergoing spinal instrumentation and having their instrument removed. Group B: 20 patients undergoing lower limb instrumentation and having their instrument removed. Group C ( control group):20 normal tissue specimens.1.SEM observation:The specimens were observed and examined under scanning electron microscope,spectral analysis was used in some areaes of the interface membrane. 2.X-ray diffraction analysis: The specimens were investigated by using X-ray diffraction after prepared. 3.TUNEL staining:The specimens were observed under optical microscope after HE staining and TUNEL staining. 4.TNF-a : The specimens were analysed by immunohistochemically for the presence of TNF-a. 5.Analysis of the serum of the inductively coupled plasma spectrometryMass Spectrometers (ICP-MS) : All the blood were centrifuged to get serum.Then the serum was analyzed by the ICP-MS.Result:(1) SEM observation:Many kinds of globe and the anomalous shape particulate matter in the tissue could be found by SEM assuming the dispersed distribution, their diameters range from 0.5um to 10um. The elements of K,Na,Mg, Al,Ti,V could been seen by spectrum analysis in group A and the element of K,Na,Mg,Fe could be seen in group B and the element K,Na,Mg in group C.A conclusion could be made that Fe,Al,Ti,V are characteristic elements of interface membrance and they could not been found in normal tissue.2.Diffraction analysis of X-ray: Diffractogram of group C were not picture pattern of unit cell,and crystal particles cound not be found obviously.The diffractograms of group A and B are the picture pattern of unit cell,and their diffracted wave were of the same as that of Fe and Ti.This finding could demontrate that mental particle existed in the interface membrance. 3.TUNEL staining: Many brown apoptosis cells presenting the colony distribution coud be found by TUNEL staining in group A and B. A few brown apoptosis cells could be seen in group C.Moreover, the comparison of the index of apoptosis among groups was B>A>C.There was a statistical significant difference in the control group and the two experimental groups(P<0.05).4.TNF-a :TNF-a positively expressing cells were presented in 10 specimens of group A and 15 specimens of group B. No positively expressing cells were detected in the group C. 5.ICP-MS: No significant differences in three groups were showed (P>0.05).Conclusion:The corresponding partical elements of metallic orthopaedic implants could be found in interface membrane around the lower limb and lumbar vertebrae,the expression of TNF-a and the index of apoptosis in the interface membrane were increased .These were harmful to the recovery of the tissue.