CAJ | 학술논문

Artiifcial joint replacement is the most important technical innovation in the ifeld of surgery in the 20th century, and at present total hip replacement has become the gold standard in the treatment of severe hip joint trauma and bone diseases. However, with the increase in the number of cases of replacement and the extension of the usage time, the problem of advanced loosening of artiifcial prostheses has become more and more prominent. Wear particle-mediated osteolysis is a major cause of aseptic loosening of artiifcial prostheses, but the mechanism is unclear. Circulating blood mononuclear cells can be activated by wear particles, and also be recruited around the prostheses. While the differentiation and transformation of the mononuclear cells have begun in the circulation process. At the same time, osteoclast precursor cells will also gather around the foreign body monocytes. The periprosthetic phagocytic cells are stimulated by wear particles of the joint prostheses, and the osteoclast formation and bone resorption are induced by various cytokines that are produced by ifbroblast cells. Wear particles not only exist around the prostheses, but also could enter the marrow cavity and further affect the differentiation of bone marrow mesenchymal stem cells into osteoblasts and the function of osteoblasts. The osteoclast differentiation will be increased and the bone resorption will be enhanced. In the meanwhile, the osteoblast differentiation and mineralization and the bone formation will be inhibited. Wear particles may be swallowed by many cells in the periprosthetic tissues. Finally, a series of biological reactions of the periprosthetic tissues will occur, which are induced by wear particles, with the results of periprosthetic osteolysis. So the occurrence and development of prosthetic failure are mainly caused by the periprosthetic osteolysis that is mediated by various wear particles produced in the prosthetic activities. In the paper, the recent research progress of biological changes of the periprosthetic tissues caused by wear particles are reviewed.