Aseptic Implant Loosening

Desy, Nicholas M.; Abdel, Matthew P.

doi:10.1007/978-3-319-54913-2_18

Cited by 3 publications

(5 citation statements)

References 61 publications

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“…At present, the use of screws with an enlarged diameter, traditional antiosteoporosis drugs, and bone cement injection are the main treatment methods in clinic [11][12][13]. Among these methods, systemic antiosteoporosis drugs, such as bisphosphonates, denosumab, raloxifene, and teriparatide, are used to strengthen the strength of osteoporotic bone internal fixation [14,15].…”

Section: Introductionmentioning

confidence: 99%

Sustained Release of Melatonin from GelMA Liposomes Reduced Osteoblast Apoptosis and Improved Implant Osseointegration in Osteoporosis

Xiao

Lin

Chen

et al. 2020

Oxidative Medicine and Cellular Longevity

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A reduction in bone mass around an implant is the main cause of implant loosening, especially in postmenopausal osteoporosis patients. In osteoporosis, excessive oxidative stress, resulting in osteoblast apoptosis, largely contributes to abnormal bone remodeling. Melatonin (MT) synthesized by the pineal gland promotes osteoblast differentiation and bone formation and has been effectively used to combat oxidative stress. Therefore, we hypothesized that MT attenuates osteoblast apoptosis induced by oxidative stress, promotes osteogenesis in osteoporosis, and improves bone mass around prostheses. Moreover, considering the distribution and metabolism of MT, its systemic administration would require a large amount of MT, increasing the probability of drug side effects, so the local administration of MT is more effective than its systemic administration. In this study, we constructed a composite adhesive hydrogel system (GelMA-DOPA@MT) to bring about sustained MT release in a local area. Additionally, MT-reduced apoptosis caused by hydrogen peroxide- (H2O2-) induced oxidative stress and restored the osteogenic potential of MC3T3-E1 cells. Furthermore, apoptosis in osteoblasts around the implant was significantly attenuated, and increased bone mass around the implant was observed in ovariectomized (OVX) rats treated with this composite system. In conclusion, our results show that GelMA-DOPA@MT can inhibit osteoblast apoptosis caused by oxidative stress, thereby promoting osteogenesis and improving bone quality around a prosthesis. Therefore, this system of local, sustained MT release is a suitable candidate to address implant loosening in patients with osteoporosis.

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Section: Introductionmentioning

confidence: 99%

Sustained Release of Melatonin from GelMA Liposomes Reduced Osteoblast Apoptosis and Improved Implant Osseointegration in Osteoporosis

Xiao

Lin

Chen

et al. 2020

Oxidative Medicine and Cellular Longevity

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confidence: 99%

“…Aseptic loosening continues to be one of the most common reasons for revision of hip arthroplasties . Risk factors for aseptic loosening following THA include patient, component, and surgical technique factors . Two potential patient factors which have been identified are activity level and obesity, however, research to date has not firmly established a relationship between these factors and the risk of aseptic loosening.…”

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confidence: 99%

“…Risk factors for aseptic loosening following THA include patient, component, and surgical technique factors . Two potential patient factors which have been identified are activity level and obesity, however, research to date has not firmly established a relationship between these factors and the risk of aseptic loosening. Flugsrud et al found that patients with upper‐quartile body weight were at increased risk of revision for aseptic loosening of the femoral component.…”

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confidence: 99%

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Effect of Femoral Head Size, Subject Weight, and Activity Level on Acetabular Cement Mantle Stress Following Total Hip Arthroplasty

Del‐Valle‐Mojica

Alonso-Rasgado

Jimenez-Cruz

et al. 2019

Journal Orthopaedic Research

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In cases where cemented components are used in total hip arthroplasty, damage, or disruption of the cement mantle can lead to aseptic loosening and joint failure. Currently, the relationship between subject activity level, obesity, and prosthetic femoral head size and the risk of aseptic loosening of the acetabular component in cemented total hip arthroplasty is not well understood. This study aims to provide an insight into this. Finite element models, validated with experimental data, were developed to investigate stresses in the acetabular cement mantle and pelvic bone resulting from the use of three prosthetic femoral head sizes, during a variety of daily activities and one high impact activity (stumbling) for a range of subject body weights. We found that stresses in the superior quadrants of the cortical bone-cement interface increased with prosthetic head size, patient weight, and activity level. In stumbling, average von Mises stresses (22.4 MPa) exceeded the bone cement yield strength for an obese subject (143 kg) indicating that the cement mantle would fail. Our results support the view that obesity and activity level are potential risk factors for aseptic loosening of the acetabular component and provide insight into the increased risk of joint failure associated with larger prosthetic femoral heads.

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“…Implant loosening is one of the main complications following THR. Its nature is determined by patient factors (obesity, bone quality, activity level, patient genetics), surgical technique factors and implant factors (primarily the type of friction pair, method of fixation and the ability of the implant to osseointegrate) [47][48][49][50]; • Cup-liner dissociation-a relatively rare complication of THR associated with misplacement of the component and/or impingement. To a greater extent, it is determined by the design of the implant [51][52][53]; • Implant fracture-a complication after THK resulting from the loss of strength of the implant, i.e., to the greatest extent determined directly by the design of the implant [54,55].…”

mentioning

confidence: 99%

Is It Possible to Create an “Ideal Endoprosthesis” for an “Ideal Total Hip Replacement”?

Popov,

Poliakov,

Pakhaliuk

2023

Prosthesis

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Since the end of the 19th and the beginning of the 20th centuries, technological equipment, implant designs (endoprosthesis) and the surgical technique of total hip replacement (THR) have been constantly improved and reached a high level of functionality and quality. Therefore, at present, THR is one of the most high-tech, reliable and popular surgical operations that allow a large number of people suffering from osteoarthritis and other serious diseases of the hip joint to return to an active lifestyle. At the same time, it is known that even operations at this level do not always guarantee the achievement of the desired result and can lead to various complications. The question arises: are there potential opportunities for creating an “ideal endoprosthesis” that allows one to perform an “ideal THR”? In this paper, based on a critical analysis of modern endoprosthesis designs for THR, technologies for their implantation and systemic postoperative complications, the most probable, according to the authors, ways of their development are formulated, which allow asymptotically approaching the “ideal”.

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Aseptic Implant Loosening

Cited by 3 publications

References 61 publications

Sustained Release of Melatonin from GelMA Liposomes Reduced Osteoblast Apoptosis and Improved Implant Osseointegration in Osteoporosis

Sustained Release of Melatonin from GelMA Liposomes Reduced Osteoblast Apoptosis and Improved Implant Osseointegration in Osteoporosis

Effect of Femoral Head Size, Subject Weight, and Activity Level on Acetabular Cement Mantle Stress Following Total Hip Arthroplasty

Is It Possible to Create an “Ideal Endoprosthesis” for an “Ideal Total Hip Replacement”?

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