Osteolysis Propensity Among Bilateral Total Hip Arthroplasty Patients

Engh, Charles A.; Ho, Henry; Powers, Cara C.; Huynh, Cathy; Beykirch, Sarah E.; Hopper, Robert H.

doi:10.1016/j.arth.2010.05.014

Cited by 9 publications

(4 citation statements)

References 24 publications

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“…A high variability in the survivorship of THA implants, and the incidence of aseptic loosening and size of the periprosthetic osteolytic lesions has been observed between individuals with similar UHMWPE wear rates even with the identical implant . Engh et al estimated that both volumetric wear and patient propensity to osteolysis might account for 53% of the variance in the total area of osteolysis. How does one explain such a high degree of inter‐patient variability?…”

Section: Recent Developmentsmentioning

confidence: 99%

Macrophages—Key cells in the response to wear debris from joint replacements

Nich

Takakubo

Pajarinen³

et al. 2013

J Biomedical Materials Res

218

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The generation of wear debris is an inevitable result of normal usage of joint replacements. Wear debris particles stimulate local and systemic biological reactions resulting in chronic inflammation, periprosthetic bone destruction, and eventually, implant loosening and revision surgery. The latter may be indicated in up to 15% patients in the decade following the arthroplasty using conventional polyethylene. Macrophages play multiple roles in both inflammation and in maintaining tissue homeostasis. As sentinels of the innate immune system, they are central to the initiation of this inflammatory cascade, characterized by the release of pro-inflammatory and proosteoclastic factors. Similar to the response to pathogens, wear particles elicit a macrophage response, based on the unique properties of the cells belonging to this lineage, including sensing, chemotaxis, phagocytosis, and adaptive stimulation. The biological processes involved are complex, redundant, both local and systemic, and highly adaptive. Cells of the monocyte/ macrophage lineage are implicated in this phenomenon, ultimately resulting in differentiation and activation of bone resorbing osteoclasts. Simultaneously, other distinct macrophage populations inhibit inflammation and protect the bone-implant interface from osteolysis. Here, the current knowledge about the physiology of monocyte/macrophage lineage cells is reviewed. In addition, the pattern and consequences of their interaction with wear debris and the recent developments in this field are presented.

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Section: Recent Developmentsmentioning

confidence: 99%

Macrophages—Key cells in the response to wear debris from joint replacements

Nich

Takakubo

Pajarinen³

et al. 2013

J Biomedical Materials Res

218

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“…However, we found that differences between the AL and PR groups were more significant in the patients with bone loss in the femur and acetabulum (p = 0.0001) than in those with involvement of only one area (p = 0.0045), which suggests a relationship between the extent of periprosthetic bone loss and IGFBP-1 levels. We found no correlation between the longevity or service time of the implant and IGFBP-1 levels, which could be explained www.nature.com/scientificreports/ by differences in the wear rate in terms of prosthetic and patient-related factors that affect the host response and thus the implant success 41,42 . Circulating IGFBP-1, a member of the IGFBP family, binds IGFs I and II, prolonging their half-lives and altering their interaction with cell surface receptors, thereby regulating the endocrine and local actions of IGFs 43,44 .…”

Section: Discussionmentioning

confidence: 71%

Wear of hip prostheses increases serum IGFBP-1 levels in patients with aseptic loosening

Vallés

García-Rey

Saldaña

et al. 2021

Sci Rep

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The biological mechanisms involved in aseptic loosening include inflammation-associated and bone resorption-associated processes. Coordinated cellular actions result in biochemical imbalances with devastating consequences for the joint. Given that this condition is not known for showing systemic signs, we investigated whether circulating levels of inflammation-related proteins are altered in patients with aseptic loosening. Our study included 37 patients who underwent revision surgery due to hip osteolysis and aseptic loosening and 31 patients who underwent primary total hip arthroplasty. Using antibody arrays, we evaluated the serum levels of 320 proteins in four patients from each group. The results showed differences in insulin-like growth factor-binding protein 1 (IGFBP-1) concentrations, which we then quantified using enzyme-linked immunosorbent assay tests in all study patients. The results confirmed that serum IGFBP-1 concentrations were higher in the revision surgery patients than in the hip arthroplasty patients. In vitro studies showed that exposure of human osteoblasts to titanium particles induced an IGFBP-1 release that further increased when exposure to particles was performed in media conditioned by human M1 macrophages. These findings suggest that elevated serum IGFBP-1 levels in patients with aseptic loosening can arise from increased local IGFBP-1 production in the inflammatory environment of the periprosthetic bed.

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“…стабильность бесцементной ножки определяли по критериям c.a. engh с соавторами, которые включали отсутствие рентгенопрозрачных линий, сформировавшегося пьедестала у кончика бедренного компонента, перестройки калькара и признаков миграции ножки [13]. критерии стабильности цементной ножки включали отсутствие признаков миграции бедренного компонента и рентгенопрозрачных линий на границе имплантат-цемент (от 50 до 100% зоны имплантат-цемент).…”

Section: таблицаunclassified

Outcome of Periprosthetic Femoral Fractures in Hip Arthroplasty

Корыткин

moudni

Мудни³

et al. 2018

Traumatology and Orthopedics of Russia

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Periprosthetic fractures are one of the main reasons for revision surgery according to the data of large joint replacement registers. Treatment of patients with periprosthetic fractures is associated with a big number of complications and still keeps its relevance. Purposeof the study is to evaluate treatment outcome of patients with periprosthetic femoral fractures in hipreplacement. Material and Methods.The authors performed a retrospective analysis of medical histories of 76 patients whounderwent treatment of periprosthetic femoral fractures. The patients were divided into groups by the Unified Classification System (UCS). Follow up period was from 6 to 124 months (mean of 34.90±28.81). Results.3 cases (3.9%) of periprosthetic femoral fractures were the complications after primary hip arthroplastyand occurred intraoperatively, 75 cases (96.1%) were complications after revision surgery; 56 cases (71.8%) were reported with uncemented and 22 cases (28.2%) with cemented femoral components. In 30 cases (38.5%) fractures had a iatrogenic nature and occurred intraoperatively, in 48 cases (61.5%) — occurred due to high- and low energy trauma. Type B fractures were observed most often — in 53 cases (68%). Conservative treatment, fixation by cerclage or by plate and screws has proven to be the least effective operative options. In the group of patients with extended osteotomy of the greater trochanter the healing was achieved in 90.5% of cases, while in the group without osteotomy — in 75% of cases. Low healing rate of periprosthetic fractures was observed for A and B1 type fractures (65% and 66.7% respectively). Follow up of patients with B2, B3 and C type fractures demonstrated consolidation in more than 80% of cases. Various complications were reported in 17 cases (21.8%). Conclusion.Effective treatment of patients with periprosthetic femoral fractures was associated with extendedosteotomy of the greater trochanter (γ = 0.51;p= 0.032), absence of complications in postoperative period (R= 0.55;p= 0.00001), B2, B3 and C fracture types (γ= 0.40;p= 0.02) and use of revision uncemented femoral components withdistal fixation (γ = 0.35;p= 0.018). In the authors opinion use of sutures or cerclage wires are not effective in cases of trochanteric fractures and stable femoral components; it would be preferable to perform internal fixation by a plate with hooks such as Dall-Miles. In case of doubts in regard of stem stability the revision should rather stipulate use of uncemented femoral components, in particular long stems with distal fixation.

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Osteolysis Propensity Among Bilateral Total Hip Arthroplasty Patients

Cited by 9 publications

References 24 publications

Macrophages—Key cells in the response to wear debris from joint replacements

Macrophages—Key cells in the response to wear debris from joint replacements

Wear of hip prostheses increases serum IGFBP-1 levels in patients with aseptic loosening

Outcome of Periprosthetic Femoral Fractures in Hip Arthroplasty

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