Categories
- Fat Embolism (4)
- Internet resources relating to Fat Embolism
- Infection (7)
- Internet resources relating to orthopaedic Surgical Site Infection (SSI)
- Thromboembolism (4)
- Internet resources relating to Venous Thrombolembolism (VTE) after orthopaedic procedures or trauma
Links
http://www.wheelessonline.com/ortho/thr_osteolysis
Wheeless Textbook of Orthopaedics
Discussion:
- most common complication in total hip arthroplasty and most common cause of component failure;
- osteolysis is a time dependent process which arises from inflammatory reaction against polyethylene particulate debris;
- patho-biology:
- osteolysis is mediated primary by macrophages (fibroblasts and endothelial cells also play a role);
- these cells are activated by wear debris (primarily polyethylene, but also metal and polymethylmethacrylate debris);
- chemical mediators include: interleukin-1 (bone-resorbing cytokine) and tumor necrosis factor;
- in the report by Yanming Bi et al (JBJS 2001), the authors present study showed that
titanium particles induced both murine marrow cells and human peripheral blood
monocytes to produce factors that stimulated osteoclast differentiation;
- mean increase in osteoclast differentiation was 29.3 ± 9.4-fold.
- they showed that titanium particles stimulate in vitro bone resorption primarily
by inducing osteoclast differentiation;
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