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MINERVA ORTOPEDICA E TRAUMATOLOGICA
A Journal on Orthopedics and Traumatology
UPDATES ON HIP ARTHROPLASTY 102nd CONGRESS OF THE PIEMONTESE-LIGURIAN-LOMBARD SOCIETY OF ORTHOPEDICS AND TRAUMATOLOGY (S.P.L.L.O.T.) - Brescia September 9-10, 2005
NEW TECHNOLOGIES, MODERN INSTRUMENTARIUM IN ARTHROPLASTIC SURGERY
Minerva Ortopedica e Traumatologica 2005 August;56(4):199-207
Periprosthetic osteolysis. Biological or mechanical problem?
Rossi P. 1, Marmotti A. 2, Castoldi F. 1, Rossi R. 1
1 Dipartimento di Ortopedia-Traumatologia e Medicina del Lavoro Università degli Studi di Torino Ospedale Mauriziano Umberto I, Torino
2 UOA Ortopedia e Traumatologia Universitaria Ospedale Mauriziano Umberto I , Torino
Periprosthetic osteolysis is the dominant long term complication of total hip replacement and is the major cause of loosening of acetabular and femoral components. Mechanical factors and biological agents mutually interact in the genesis of this unique disease. In the microenvironment around total hip replacement prostheses, at the pseudosynovial membrane and at the interface membrane, debris diffusion and cell-particle interaction generate inflammation, but also mechanical factors play a pivotal role, as it is for prosthetic alignement, pressure at the surrounding bone tissue exerted by acetabular and femoral component, micromovement at the implant-to-host interface, pumping of synovial fluid around periprosthetic space during cyclic loading of the joint. Association of these and other elements constitutes the pathogenetic process leading, peculiarly in each individual, to osteolysis and aseptic loosening.