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Osteoclastic differentiation by mononuclear phagocytes containing biomaterial particles
A Sabokbar1, R Pandey, J M Quinn
1University of Oxford, Nuffield Department of Orthopaedic Surgery, Nuffield Orthopaedic Centre, UK.
Archives of Orthopaedic and Trauma Surgery
|April 1, 1998
Summary
Biomaterial wear particles from joint replacements cause macrophages to become bone-resorbing osteoclasts. This process contributes to aseptic loosening, a common complication in prosthetic joint surgery.
Area of Science:
- Biomaterials Science
- Immunology
- Orthopedic Surgery
Background:
- Aseptic loosening is a frequent complication of prosthetic joint replacements.
- Wear particles from implant biomaterials are found in macrophages near loose components.
- Periprosthetic bone resorption is a key factor in aseptic loosening.
Purpose of the Study:
- To investigate if macrophages containing biomaterial particles contribute to periprosthetic bone resorption.
- To understand the role of the foreign-body response in aseptic loosening pathogenesis.
Main Methods:
- Murine monocytes were cultured with particles of polymethylmethacrylate (PMMA), polyethylene (PE), titanium, and chromium-cobalt.
- Cells were cultured on bone slices and with osteoblast-like cells in the presence of 1,25-dihydroxy-vitamin D3.
- Osteoclast differentiation and bone resorption activity were assessed.
Main Results:
- All particle-containing macrophages differentiated into osteoclastic cells.
- These multinucleated cells exhibited tartrate-resistant acid phosphatase (TRAP) positivity.
- Extensive lacunar bone resorption was observed in the presence of particle-laden macrophages.
Conclusions:
- Macrophage phagocytosis of biomaterial wear particles does not prevent osteoclast differentiation.
- The foreign-body macrophage response to wear particles is crucial in the development of aseptic loosening.
- Findings highlight a key mechanism in the failure of prosthetic joint implants.