alpha-Smooth muscle actin-expressing cells and lubricin in periprosthetic tissue.

The objective of the study was to evaluate the distributions of (1) cells expressing the contractile actin isoform, alpha-smooth muscle actin (alpha-SMA) and (2) a lubricating and antiadhesion glycoprotein, lubricin, in the tissue around loose joint replacement prostheses in human subjects. Periprostehtic tissue resected at revision arthroplasty of noncemented glenoid components of total shoulder arthroplasties was obtained from 10 patients. Samples of periprosthetic tissue were stained with monoclonal antibodies to alpha-SMA and lubricin. alpha-SMA was found in cells, principally of fibroblast morphology, in many of the fields of view (FOVs) in samples from all patients. Moderate correlations were observed between the percentage of FOVs containing alpha-SMA-expressing cells and the percentages of FOVs containing polyethylene (R(2) = 0.79) and metallic (R(2) = 0.75) particles. Lubricin was identified (1) as a discrete layer on the surface, (2) within the extracellular matrix, and (3) intracellularly. These lubricin-positive features were found in samples from all patients. Strong correlations were noted between the percentages of FOVs with matrix and intracellular lubricin staining (R(2) = 0.97) and between the percentages of FOVs with surface and matrix staining for lubricin (R(2) = 0.96). Having established the presence of alpha-SMA and lubricin in periprosthetic tissue, hypotheses regarding their role in the development and persistence of periprosthetic tissue can be synthesized for future study: for example, alpha-SMA-enabled contracture of the fibrous periprosthetic tissue results in its densification, and lubricin-coated surfaces interfere with integrative repair processes necessary for resorption and remodeling.