Pathophysiology of Osteolysis

ABSTRACT

Total joint replacement has been successful and cost-effective for restoring function and mobility to patients since its advent more than thirty years ago. With the improvements in prophylaxis against infection and the fatigue strength of the components, skeletal fixation, wear and its sequelae have become the primary limitations for the longevity of joint replacement. Initially termed "cement disease," osteolysis is believed to be a biological response not only to polymethylmethacrylate, but also to a variety of particles that may originate at several locations around a joint replacement. Recent research has been directed at understanding the biological cascade of events that is initiated by particulate debris and that results in periprosthetic bone loss.