beta 2-microglobulin amyloid deposition in hip revision arthroplasty tissues

Aims: Hip joint disease associated with progressive amyloid deposition in u raemic patients receiving chronic haemodialysis treatment often requires tr eatment by joint arthroplasty, The aim of this study was to determine wheth er beta 2-microglobulin amyloid deposition occurred in the periprosthetic t issues of arthroplasties that had undergone aseptic loosening and required a revision procedure. Methods and results: Sections of the pseudocapsule, acetabular and femoral pseudomembrane surrounding failed total hip replacements of five uraemic pa tients known to have beta 2-microglobulin amyloid deposits at the time of p rimary joint replacement were examined for the presence of beta 2-microglob ulin amyloid deposition by Congo red staining and immunohistochemical stain ing for pa-microglobulin and other amyloid proteins. Clinical and radiologi cal features of each case, including postoperative history and extent of os teolysis, were also noted. In all cases evidence of beta 2-microglobulin am yloid deposits were found in one or more of the above periprosthetic tissue s. In three of these cases amyloid deposition was extensive. Conclusions: This study shows that beta 2-microglobulin amyloid deposition occurs in revision arthroplasty tissues. Accelerated loosening of the prost hesis is known to occur in uraemic patients and it is possible that beta 2- microglobulin amyloid deposition may contribute to early arthroplasty failu re in uraemic patients who remain on haemodialysis treatment.