What causes periprosthetic osteolysis?

Periprosthetic osteolysis originates from chronic inflammatory responses triggered by implant-derived particulate debris, which cause recruitment of cells, including macrophages, fibroblasts, lymphocytes and osteoclasts.

What is periprosthetic osteolysis?

Abstract. Periprosthetic osteolysis is a serious complication of total hip replacement (THR) in the medium to long term. Although often asymptomatic, osteolysis can lead to prosthesis loosening and periprosthetic fracture. These complications cause significant morbidity and require complex revision surgery.

What is particle disease?

Particle disease is a rare lesion that results from an inflammatory response due to wear debris-induced osteolysis following arthroplasty. Particles resulting from the wear debris cause macrophage activation and phagocytosis. Particle disease often leads to joint loosening and implant failure.

What are the key features of periprosthetic osteolysis?

Several of the key features of this unique disease are presented focusing on the importance of periprosthetic osteolysis, comprehension of the general progressive nature of periprosthetic osteolysis, understanding of the diverse radiographic evidence of this disease, and the consequences that can occur from the disease.

When do you have osteolysis after a knee replacement?

In people who have had hip, knee or other joint replacements, a key sign of periprosthetic osteolysis is an aseptic loosening of the joint prosthesis (that is, a loosening of the implant without any indication of infection). This condition often causes no symptoms until very late, after there has been extensive bone loss.

How can PE wear particles cause osteolysis?

PE wear particles can cause osteolysis due to an inflammatory reaction. Existing publications proved that, additionally to the PE wear due to the main articulation, wear could be a consequence of the backside wear of the convex side of the PE liner [18].

Why is osteolysis the most common cause of hip loosening?

Osteolysis is important because it leads to implant loosening and/or periprosthetic fractures. While osteolysis is the primary cause of loosening, infection must be part of the differential diagnosis.