Platelet release of transforming growth factor- β and β-thromboglobulin after in vitro contact with acrylic bone cements

Abstract

Three methacrylate-based bone cements used for the fixation of joint prostheses were evaluated: Sulfix-60 ® (Sulzer Orthopedic Inc., Baar, Switzerland), CMW1 ® (DePuy International Ltd., England), and CMW2 ® (DePuy International Ltd., England). The cements after polymerization were put in contact in vitro with platelet-rich plasma. Plasma, in contact only with siliconized glass, was used as a negative control. After contact, platelet number, β-thromboglobulin ( β-TG), and transforming growth factor- β1 (TGF- β1) were determined. The Student's paired t test showed that the cements induced no significant modifications of platelet number. CMW1 ® and Sulfix-60 ® determined a significant increase in β-TG compared with the negative control. All cements determined a significant increase in TGF- β1. Significant differences were also seen in the levels of β-TG and TGF- β1 between cements with a content of benzoyl peroxide <1 (Sulfix-60 ®) and those with a content >1 (CMW1 ® and CMW2 ®). The cement with zirconium dioxide (Sulfix-60 ®) produced higher levels of β-TG and TGF- β1, compared to those with barium sulphate (CMW1 ® and CMW2 ®). In conclusion, all the cements induced the secretion of TGF- β1; CMW1 ® and Sulfix-60 ® determined also a significant release of β-TG. Platelet activation induced by the cements from one side could contribute to the pathogenesis of deep venous thrombosis, that often occurs after prosthetic implant and is caused also by other factors, including surgical trauma and venous stasis. From the other side, activated platelets can release growth factors favoring bone formation.