Debris-Mediated Osteolysis—A Cascade Phenomenon Involving Motion, Wear, Particulates, Macrophage Induction, and Bone Lysis

Clarke, IC; Campbell, Priscilla A.; Kossovsky, Nir

doi:10.1520/stp14848s

Cited by 42 publications

(22 citation statements)

References 88 publications

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“…The micromotions then activate an osteoclastic response (Stadelmann et al, 2008), which results in periprosthetic osteolysis and later implant migration and wear (Karrholm et al, 1994). Both particulate formation from implant wear and implant migration have been shown to be associated with increased implant failure rate (Clarke et al, 1992;Horikoshi et al, 1994). In the case of osteoporotic patients, this early phase is particularly delicate as the bone is already weak at the time of surgery.…”

Section: Introductionmentioning

confidence: 99%

Implants delivering bisphosphonate locally increase periprosthetic bone density in an osteoporotic sheep model. A pilot study

Stadelmann¹,

Gauthier²,

Terrier³

et al. 2008

eCM

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It is a clinical challenge to obtain a sufficient orthopaedic implant fixation in weak osteoporotic bone. When the primary implant fixation is poor, micromotions occur at the bone-implant interface, activating osteoclasts, which leads to implant loosening. Bisphosphonate can be used to prevent the osteoclastic response, but when administered systemically its bioavailability is low and the time it takes for the drug to reach the periprosthetic bone may be a limiting factor. Recent data has shown that delivering bisphosphonate locally from the implant surface could be an interesting solution. Local bisphosphonate delivery increased periprosthetic bone density, which leads to a stronger implant fixation, as demonstrated in rats by the increased implant pullout force. The aim of the present study was to verify the positive effect on periprosthetic bone remodelling of local bisphosphonate delivery in an osteoporotic sheep model. Four implants coated with zoledronate and two control implants were inserted in the femoral condyle of ovariectomized sheep for 4 weeks. The bone at the implant surface was 50% higher in the zoledronate-group compared to control group. This effect was significant up to a distance of 400μm from the implant surface. The presented results are similar to what was observed in the osteoporotic rat model, which suggest that the concept of releasing zoledronate locally from the implant to increase the implant fixation is not species specific. The results of this trial study support the claim that local zoledronate could increase the fixation of an implant in weak bone.

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Section: Introductionmentioning

confidence: 99%

Implants delivering bisphosphonate locally increase periprosthetic bone density in an osteoporotic sheep model. A pilot study

Stadelmann¹,

Gauthier²,

Terrier³

et al. 2008

eCM

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“…Two factors have been identified in the creation of this fibrous tissue, the presence of wear particles and the generation of micromotions at the bone-implant interface (Clarke et al, 1992;Goodman, 1994). The precise role of or correlation between these two factors in the tissue differentiation process remains to be determined (Aspenberg and Herbertsson, 1996).…”

Section: Introductionmentioning

confidence: 99%

Effect of micromechanical stimulations on osteoblasts: development of a device simulating the mechanical situation at the bone–implant interface

Pioletti

Müller²,

Rakotomanana

et al. 2003

Journal of Biomechanics

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Many experimental models have been developed to investigate the effects of mechanical stimulation of cells, but none of the existing devices can simulate micromotions at the cellular-mechanical interface with varying amplitudes and loads. Osteoblasts are sensitive to mechanical stimuli, so to study the bone-implant interface it would be important to quantify their reaction in a situation mimicking the mechanical situation arising at that interface. In this study, we present the development of a new device allowing the application of micromotions and load on cells in vitro. The new device allowed the cells to be stimulated with sinusoidal motions of amplitudes comprised between 75 and 750 mm; frequencies between 0.5 and 2 Hz; and loads between 50 and 1000 Pa: The device, with a total length of 20 cm; was designed to work in an incubator at 371C and 100% humidity. Expression of various bone important genes was monitored by real-time RT-PCR. Micromotions and load were shown to affect the behavior of osteoblasts by down-regulating the expression of genes necessary for the creation of organic extracellular matrix (collagen type I) as well as for genes involved in the mineralization process (osteocalcin, osteonectin). The developed device could then be used to simulate different mechanical situations at the bone-implant interface. r

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“…The accumulation of billions of micron-sized UHMWPE wear particles cause wear tissue reaction, leading to bone loss and failure of the prosthesis. [3][4][5][6][7][8] The biologic mechanisms of tissue reaction to wear particles is not yet well known, but it is likely that number, size, shape, and morphology of UHMWPE wear particles each plays a significant role in producing osteolysis and subsequent prosthesis failure. [9][10][11][12] In Figure 1 the theoretical calculation of the number of wear particles is plotted against particle diameter for annual UHMWPE wear amounts totaling 10 mm 3 and 100 mm 3 , assuming spherical shape and equal diameter of all particles.…”

Section: Introductionmentioning

confidence: 99%

Enhanced wear performance of highly crosslinked UHMWPE for artificial joints

Chiesa

Tanzi

Alfonsi

et al. 2000

J. Biomed. Mater. Res.

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It is well known that osteolysis induced by polyethylene wear debris is the main cause of long-term failure of hip and knee prostheses. We developed a treatment of medical-grade ultra-high molecular-weight polyethylene (UHMWPE) in order to improve its tribologic properties and reduce its wear. Medical-grade UHMWPE was irradiated with a 200 kGy dose of radiation, thermally stabilized at a temperature close to the melting point, and then sterilized with ethylene oxide. The irradiation treatment was performed to crosslink the UHMWPE. The thermal stabilization treatment, contributing to the reaction between the free radicals generated by the irradiation process, was chosen to enhance crosslinking and to prevent oxidation and the shortening of chains. The non-invasive sterilization process with ethylene oxide was chosen to prevent the re-formation of free radicals. The wear performance of this material was compared to UHMWPE, untreated or treated with different sterilization techniques, using gamma and beta irradiation. Insoluble crosslinked constituents were measured with an extraction method. Wear was evaluated using a flat-on-ring wear test machine. While small differences were found among the different sterilization processes, 200 kGy-irradiated UHMWPE followed by thermal treatment and sterilization with ethylene oxide had the least wear and the greatest amount of crosslinking.

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Debris-Mediated Osteolysis—A Cascade Phenomenon Involving Motion, Wear, Particulates, Macrophage Induction, and Bone Lysis

Cited by 42 publications

References 88 publications

Implants delivering bisphosphonate locally increase periprosthetic bone density in an osteoporotic sheep model. A pilot study

Implants delivering bisphosphonate locally increase periprosthetic bone density in an osteoporotic sheep model. A pilot study

Effect of micromechanical stimulations on osteoblasts: development of a device simulating the mechanical situation at the bone–implant interface

Enhanced wear performance of highly crosslinked UHMWPE for artificial joints

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