Diagnosis and management of implant debris-associated inflammation.

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Abstract

[Indexed for MEDLINE] Conflict of interest statement: Declaration of interest The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties. 4. Inflammopharmacology. 2013 Dec;21(6):389-96. doi: 10.1007/s10787-013-0192-6. Epub 2013 Oct 15. Periprosthetic osteolysis after total hip replacement: molecular pathology and clinical management. Howie DW(1), Neale SD, Haynes DR, Holubowycz OT, McGee MA, Solomon LB, Callary SA, Atkins GJ, Findlay DM. Author information: (1)Department of Orthopaedics and Trauma, Royal Adelaide Hospital, Adelaide, Australia. 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. Here, we review advances in our understanding of the cell and tissue response to particles produced by wear of the articular and non-articular surfaces of prostheses. We discuss the molecular and cellular regulators of osteoclast formation and bone resorptive activity, a better understanding of which may lead to pharmacological treatments for periprosthetic osteolysis. We describe the development of imaging techniques for the detection and measurement of osteolysis around THR prostheses, which enable improved clinical management of patients, provide a means of evaluating outcomes of non-surgical treatments for periprosthetic osteolysis, and assist in pre-operative planning for revision surgery. Finally, there have been advances in the materials used for bearing surfaces to minimise wear, and we review the literature regarding the performance of these new materials to date. DOI: 10.1007/s10787-013-0192-6