Hip & pelvis

The Korean Hip Society (대한고관절학회)
권호 표지
DOI QR코드

DOI QR Code

Pathophysiology of Osteolysis

골용해의 병태생리

  • Yang, Ick-Hwan (Department of Orthopaedic Surgery, College of Medicine, Yonsei University)
  • 양익환 (연세대학교 의과대학 정형외과학교실)
  • Published : 2011.03.31
⟨ Previous Next ⟩

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.

인공관절술은 지난 30년 이상 환자의 기능회복이나 비용 면에서 매우 효과적이었다고 볼 수 있다. 그러나 감염예방에서의 발전이 있었으나 피로파괴, 골성고정, 마모의 문제점들은 삽입물 유지와 수명에 제한이 있어왔다. 초기 치환술의 주된 실패 원인으로는 시멘트 실패(cement failure)와 기계적, 구조적 불안정이 원인으로 여겨졌으나, 많은 연구 결과, 인공관절술 후 발생하는 마모입자의 영향으로 삽입물 주변조직 세포에서 섬유조직 형성이나 파골세포의 골흡수를 자극하는 생물학적 반응이 주요한 원인으로 규명되었다.

Keywords

References

  1. Charnley J. Anchorage of the femoral head prosthesis to the shaft of the femur. J Bone Joint Surg Br. 1960;42-B:28-30.
  2. Charnley J. The bonding of the prostheses to bone by cement. J Bone Joint Surg Br. 1964;46:518-29.
  3. Charnley J, Follacci FM, Hammond BT. The long-term reaction of bone to self-curing acrylic cement. J Bone Joint Surg Br. 1968;50:822-9.
  4. Gruen TA, McNeice GM, Amstutz HC. "Modes of failure" of cemented stem-type femoral components: a radiographic analysis of loosening. Clin Orthop Relat Res. 1979;141:17-27.
  5. Willert HG, Ludwig J, Semlitsch M. Reaction of bone to methacrylate after hip arthroplasty: a long-term gross, light microslopic, and scanning electron microscopic study. J Bone Joint Surg Am. 1974;56:1368-82.
  6. Willert HG, Semlitsch M. Reactions of the articular capsule to wear products of artificial joint prostheses. J Biomed Mater Res. 1977;11:157-64. https://doi.org/10.1002/jbm.820110202
  7. Mirra JM, Amstutz HC, Matos M, Gold R. The pathology of the joint tissues and its clinical relevance in prosthesis failure. Clin Orthop Relat Res. 1976;117:221-40.
  8. Mirra JM, Marder RA, Amstutz HC. The pathology of failed total joint arthroplasty. Clin Orthop Relat Res. 1982;170:175-83.
  9. Goldring SR, Jasty M, Roelke MS, Rourke CM, Bringhurst FR, Harris WH. Formation of a synovial-like membrane at the bone-cement interface. Its role in bone resorption and implant loosening after total hip replacement. Arthritis Rheum. 1986;29:836-42. https://doi.org/10.1002/art.1780290704
  10. Goldring SR, Schiller AL, Roelke M, Rourke CM, O'Neil DA, Harris WH. The synovial-like membrane at the bonecement interface in loose total hip replacements and its proposed role in bone lysis. J Bone Joint Surg Am. 1983;65:575-84.
  11. Haynes DR, Rogers SD, Hay S, Pearcy MJ, Howie DW. The differences in toxicity and release of bone-resorbing mediators induced by titanium and cobalt-chromium-alloy wear particles. J Bone Joint Surg Am. 1993;75:825-34.
  12. Engh CA, Bobyn JD, Glassman AH. Porous-coated hip replacement. The factors governing bone ingrowth, stress shielding, and clinical results. J Bone Joint Surg Br. 1987;69:45-55.
  13. Engh CA, Massin P, Suthers KE. Roentgenographic assessment of the biologic fixation of porous-surfaced femoral components. Clin Orthop Relat Res. 1990;257:107-28.
  14. Harris WH. Traumatic arthritis of the hip after dislocation and acetabular fractures: treatment by mold arthroplasty. An end-result study using a new method of result evaluation. J Bone Joint Surg Am. 1969;51:737-55.
  15. Zicat B, Engh CA, Gokcen E. Patterns of osteolysis around total hip components inserted with and without cement. J Bone Joint Surg Am. 1995;77:432-9.
  16. Shanbhag AS, Glant TT, Jacobs JJ, Black J. Macrophage stimulation of fibroblastic proliferation is affected by size, composition and surface area of particulates. Trans Orthop Res Soc. 1992;17:342-8.
  17. Shanbhag AS, Jacobs JJ, Black J, Galante JO, Glant TT. Cellular mediators secreted by interfacial membranes obtained at revision total hip arthroplasty. J Arthroplasty. 1995;10:498-506. https://doi.org/10.1016/S0883-5403(05)80152-4
  18. Shanbhag AS, Jacobs JJ, Black J, Galante JO, Glant TT. Human monocyte response to particulate biomaterials generated in vivo and in vitro. J Orthop Res. 1995;13:792-801. https://doi.org/10.1002/jor.1100130520
  19. Bobyn JD, Mortimer ES, Glassman AH, Engh CA, Miller JE, Brooks CE. Producing and avoiding stress shielding. Laboratory and clinical observations of noncemented total hip arthroplasty. Clin Orthop Relat Res. 1992;274:79-96.
  20. Bugbee WD, Culpepper WJ 2nd, Engh CA Jr, Engh CA Sr. Long-term clinical consequences of stress-shielding after total hip arthroplasty without cement. J Bone Joint Surg Am. 1997;79:1007-12.