Aseptic Loosening of Total Hip Arthroplasty as a Result of Local Failure of Tissue Homeostasis

Gallo, Jiří; Konttinen, Yrjö T.; Goodman, Stuart B.; Thyssen, Jacob P.; Gibon, Emmanuel; Pajarinen, Jukka; Takakubo, Yuya; Schalock, Peter C.; Mackiewicz, Z; Jämsen, Eemeli; Petřek, Martin; Trebše, Rihard; Coer, A.; Takagi, Michiaki

doi:10.5772/25817

Cited by 16 publications

(20 citation statements)

References 165 publications

(169 reference statements)

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“…The way in which they are used varies between countries, but there is growing evidence to support the idea that younger patients should receive uncemented components, for example a titanium alloy, meaning that the implant does not have to be embedded in the bone with polymethyl methacrylate (25). Titanium is very biocompatible, and rarely induces hypersensitivity reactions, but evidence suggests that TiO 2 and titanium ions form haptens that can, indeed, induce hypersensitivity and create a proinflammatory cellular response (26). As expected, we did not find any release of cobalt, chromium or nickel from the titanium alloys.…”

Section: Discussionmentioning

confidence: 99%

Failure of total hip implants: metals and metal release in 52 cases

et al. 2014

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Section: Discussionmentioning

confidence: 99%

Failure of total hip implants: metals and metal release in 52 cases

et al. 2014

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“…Both mechanical and biological theories have been proposed to participate in the development of osteolysis around total joint replacements, while the exact mechanism of aseptic loosening is complex and likely multifactorial. [18][19][20] Mechanical theories highlight cyclic implant loading affecting the bone-implant interface ultimately leading to the loss of implant fixation. First, micromotion between the implant and the surrounding bone has been suggested to result in remodeling of bone trabeculae and migration of fibroblasts into the empty spaces between implant surface and bone.…”

Section: Overview Of the Mechanisms Of Peri-prosthetic Osteolysismentioning

confidence: 99%

Mesenchymal stem cells in the aseptic loosening of total joint replacements

Pajarinen

Lin

Nabeshima

et al. 2017

J Biomedical Materials Res

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Peri-prosthetic osteolysis remains as the main long-term complication of total joint replacement surgery. Research over four decades has established implant wear as the main culprit for chronic inflammation in the peri-implant tissues and macrophages as the key cells mediating the host reaction to implant-derived wear particles. Wear debris activated macrophages secrete inflammatory mediators that stimulate bone resorbing osteoclasts; thus bone loss in the peri-implant tissues is increased. However, the balance of bone turnover is not only dictated by osteoclast-mediated bone resorption but also by the formation of new bone by osteoblasts; under physiological conditions these two processes are tightly coupled. Increasing interest has been placed on the effects of wear debris on the cells of the bone-forming lineage. These cells are derived primarily from multipotent mesenchymal stem cells (MSCs) residing in bone marrow and the walls of the microvasculature. Accumulating evidence indicates that wear debris significantly impairs MSC-to-osteoblast differentiation and subsequent bone formation. In this review, we summarize the current understanding of the effects of biomaterial implant wear debris on MSCs. Emerging treatment options to improve initial implant integration and treat developing osteolytic lesions by utilizing or targeting MSCs are also discussed.

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“…Over the past 50 years significant advancements in implant design and biomaterials have occurred, including the development of coatings and composites containing bioactive constituents such as calcium phosphates (CaP), synthetic hydroxyapatite (HAp), and bioglasses . Yet, despite these valued efforts, aseptic loosening remains as the leading cause for revision surgery, requiring the removal of poorly fixated implants . Clearly, there is a continued need for new and novel materials to improve the osseointegration of biomedical devices.…”

Section: Introductionmentioning

confidence: 99%

Development of a SiYAlON glaze for improved osteoconductivity of implantable medical devices

et al. 2017

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The application of bioactive coatings onto orthopaedic appliances is commonly performed to compensate for the otherwise bioinert nature of medical devices and to improve their osseointegration. Calcium phosphates, hydroxyapatite (HAp), and bioglasses are commercially available for this purpose. Until recently, few other inorganic compounds have been identified with similar biofunctionality. However, silicon nitride (Si N ) has emerged as a new orthopaedic material whose unique surface chemistry also enhances osteoconductivity. Recent research has confirmed that its minority intergranular phase, consisting of silicon yttrium aluminum oxynitride (SiYAlON), is principally responsible for this improvement. As a result, it was hypothesized that SiYAlON itself might serve as an effective osteoconductive coating or glaze for medical devices. To test this hypothesis, a process inspired by traditional ceramic whiteware glazing was developed. A slurry containing ingredients similar to the intergranular SiYAlON composition was applied to a Si N surface, which was then subjected to a heat treatment to form a glaze. Various analytical tools were employed to assess its chemistry and morphology. It was found that the glaze was comprised predominately of Y Si O N, a compound commonly referred to as N-apatite, which is isostructural to native HAp. Subsequent exposure of the glazed surface to acellular simulated body fluid led to increased deposition of biomimetic HAp-like crystals, while exposure to Saos-2 osteosarcoma cells in vitro resulted in greater HAp deposition relative to control samples. The observation that SiYAlON exhibits enhanced osteoconductivity portends its potential as a therapeutic aid in bone and tissue repair. © 2017 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 106B: 1084-1096, 2018.

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Aseptic Loosening of Total Hip Arthroplasty as a Result of Local Failure of Tissue Homeostasis

Cited by 16 publications

References 165 publications

Failure of total hip implants: metals and metal release in 52 cases

Failure of total hip implants: metals and metal release in 52 cases

Mesenchymal stem cells in the aseptic loosening of total joint replacements

Development of a SiYAlON glaze for improved osteoconductivity of implantable medical devices

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