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Intra-surgical Protein Layer on Titanium Arthroplasty Explants: From the Big Twelve To The Implant Proteome.

PURPOSE: Aseptic loosening in total joint replacement due to insufficient osteointegration is an unsolved problem in orthopaedics. The purpose of our study was to obtain a picture of the initial protein adsorption layer on femoral endoprosthetic surfaces as the key to the initiation of osseointegration.

EXPERIMENTAL DESIGN: This paper describes the first study of femoral stem explants from patients for proteome analysis of the primary protein layer. After 2 min. in situ the stems were explanted and frozen in liquid nitrogen. Proteins were eluted under reducing conditions and analyzed by LC-MS/MS.

RESULTS: After exclusion of proteins identified by a single peptide the implant proteome was found to consist of 2,802 unique proteins. Of these 77% were of intracellular origin, 9% were derived from the plasma proteome, 8% from the bone proteome and 4 proteins with highest specificity score could be assigned to the bone marrow proteome (Transcriptome). The most abundant protein in the adsorbed total protein layer was haemoglobin (8-11%) followed by serum albumin (3.6-6%).

CONCLUSIONS: A detailed knowledge of the initial protein film deposited onto the implants, as demonstrated here for the first time, may help to understand and predict the response of the osseous microenvironment to implant surfaces. This article is protected by copyright. All rights reserved.

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