To detect the expression of interleukin-1receptor-associated kinase-M (IRAK-M) in periprosthetic tissues, and explore the effect and discrepancy of IRAK-M in different interface membranes.

A total of 45 osteoarthritis(OA) patients for total hip arthroplasty(THA) were selected in the joint surgery, First Affiliated Hospital of Sun Yat-sen University. All the patients were diagnosed clearly before operation, excluding immunological disorders, immunodeficiency diseases and connective tissue diseases. Intraoperative samples collection: the synovial membrane samples were obtained at primary total hip arthroplasty, and for aseptic and septic loosening, the interface membrane samples from two sites of each patient, stem and cup, were obtained during revision operation. According to conventional immunohisto-chemical rules, the slices were stained . IRAK-M was detectd by microscope. Multigroups were compared by Kruskal-Wallis H test, and the two independent samples by t test. The positive expression percentage between the two groups was measured by Mann-Whitney U test. A value of P<0.05 was regarded as statistically significant.

The results showed that the interface membranes of septically and aseptically loosened prosthesis express more IRAK-M protein than control membranes from osteoarthritic patients, and indeed, in particular macrophages and multinucleated giant cells express IRAK-M. There is no significant difference between the two types of loosening (P>0.05). However, the IRAK-M staining was quite scarce in OA synovial membranes, compared with interface membranes from aseptically and septically loosened hip joints.

The highly expression of IRAK-M in periprosthetic tissues may be involved in the immune tolerance, lead to the lower local anti-infection after arthroplasty.