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Periprosthetic osteolysis: a narrative review.

A Marmotti^1,2, D Messina¹, A Cykowska¹

¹Department of Orthopaedics and Traumatology, University of Turin, Torino, Italy.

Journal of Biological Regulators and Homeostatic Agents

|December 2, 2020

Summary

Periprosthetic osteolysis, a silent disease, limits prosthetic joint lifespan. This review details mechanical and biological factors causing implant failure and explores potential treatments.

Keywords:

RANK-RANKL growth factors osteoimmunology periprosthetic osteolysis

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Area of Science:

Biomaterials Science
Immunology
Orthopedic Surgery

Background:

Periprosthetic osteolysis is a major cause of prosthetic joint failure.
It involves mechanical and biological factors leading to implant loosening.
Wear debris and cell-particle interactions are key elements in the periprosthetic microenvironment.

Purpose of the Study:

To review recent studies on the pathogenesis of periprosthetic osteolysis.
To summarize biological and mechanical factors contributing to osteolysis.
To explore current pharmacological treatments for failing implants.

Main Methods:

Narrative review of existing literature.
Analysis of studies on wear debris and cell-particle interactions.
Examination of factors like micromotion, implant position, and joint fluid pressure.

Main Results:

Osteolysis pathogenesis is driven by a complex interplay of factors.
Immune response in periprosthetic tissue is a critical component.
Wear debris and cellular interactions significantly contribute to aseptic loosening.

Conclusions:

Understanding the multifactorial nature of osteolysis is crucial for improving prosthetic joint longevity.
Pharmacological interventions show promise in managing or reversing osteolysis.
Further research is needed to develop effective strategies to "rescue" failing implants.