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The Journal of Bone and Joint Surgery (American) 82:1478 (2000)
© 2000 The Journal of Bone and Joint Surgery, Inc.

Instructional Course Lecture

The Basic Science of Periprosthetic Osteolysis*

Michael J. Archibeck, M.D., Joshua J. Jacobs, M.D., Kenneth A. Roebuck, Ph.D. and Tibor T. Glant, M.D., Ph.D.

An Instructional Course Lecture, American Academy of Orthopaedic Surgeons
*Printed with permission of the American Academy of Orthopaedic Surgeons. This article, as well as other lectures presented at the Academy's Annual Meeting, will be available in March 2001 in Instructional Course Lectures, Volume 50. The complete volume can be ordered online at www.aaos.org, or by calling 800-626-6726 (8 a.m.-5 p.m., Central time).
One or more of the authors has received or will receive benefits for personal or professional use from a commercial party related directly or indirectly to the subject of this article. In addition, benefits have been or will be directed to a research fund, foundation, educational institution, or other nonprofit organization with which one or more of the authors is associated. Funds were received in total or partial support of the research or clinical study presented in this article. The funding sources were National Institutes of Health/National Institute of Arthritis and Musculoskeletal and Skin Diseases Grants AR 39310 and AR 45835, Crown Family Chair of Orthopaedic Surgery, and Zimmer, Incorporated.
Department of Orthopaedic Surgery (M. J. A., J. J. J., and T. T. G.), Department of Immunology (K. A. R.), and Department of Biochemistry (T. T. G.), Rush-Presbyterian-St. Luke's Medical Center, 1653 West Congress Parkway, Chicago, Illinois 60612. E-mail address for J. J. Jacobs: jacobs@ortho4.pro.rpslmc.edu.

The first 150 words of the full text of this article appear below.


   Introduction
 
Total joint replacement has been very successful and cost-effective in restoring function and mobility to millions of patients worldwide since its advent more than thirty years ago. With improvements in prophylaxis against infection, the fatigue strength of the components, and skeletal fixation, wear and its sequelae have become the primary limitation to joint replacement longevity1. Initially termed "cement disease,"2 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. These include the articulating surfaces, modular component interfaces, fixation surfaces, and devices used for adjuvant fixation3.

Recent research has been directed at understanding the biological cascade of events that is initiated by particulate debris and results in periprosthetic bone loss. Clinically, periprosthetic osteolysis can lead to aseptic loosening of components, massive bone loss that renders revision surgery substantially more complex, . . . [Full Text of this Article]


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