- MeSH
- Research Support as Topic MeSH
- Humeral Fractures etiology surgery MeSH
- Calcitonin administration & dosage therapeutic use MeSH
- Bone Substitutes MeSH
- Humans MeSH
- Adolescent MeSH
- Osteolysis diagnosis classification therapy MeSH
- Brachial Plexus pathology MeSH
- Syndrome diagnosis etiology therapy MeSH
- Check Tag
- Humans MeSH
- Adolescent MeSH
- Male MeSH
- Publication type
- Case Reports MeSH
- Review MeSH
- Comparative Study MeSH
Jednou z nejzávažnějších komplikací kloubní náhrady je uvolnění implantátu z kostního lůžka, vedoucí k jeho selhání. Za základní příčinu je považována reakce organismu na otěr. Při funkci kloubní náhrady dochází k tření kontaktních ploch a k produkci otěrových částic – polyetylénu, polymetylmetakrylátu, kovu event. keramiky. Pro organismus nejsou otěrové částice biokompatibilní. Probíhá reakce organismu na cizí těleso. Otěrový materiál je fagocytován makrofágy. Aktivované buňky produkují zánětlivé mediátory, které vyvolávají kaskádu, zatím ne zcela prozkoumaných procesů, jejímž výsledkem je změna poměru novotvorba – resorpce kosti směrem k převaze odbourávání. Klinickým projevem procesu je tvorba otěrového granulomu a periprotetická osteolýza vedoucí k uvolnění a selhání endoprotézy. Detailní pochopení uvedeného mechanismu je nezbytné pro zlepšení dlouhodobých výsledků kloubních náhrad. Možnosti jeho ovlivnění jsou jednak ve změnách konstrukce implantátů, volbě nových mechanicky rezistentních a biologicky inertních materiálů a případném farmakologickém zásahu do procesů vedoucích k osteolýze. Článek je přehledným shrnutím dosud známých skutečností i pracovních teorií o této problematice.
One of the most serious complications of articular prostheses is loosening of the implant from the osseous bed leading to its failure. The assumed basic cause is the reaction of the organism to abrasion. During function of the articular prosthesis the abrasion of the contact surfaces occurs and abrasion particles such as polyethylene, polymethylacrylate, metal and possibly ceramics are produced. The abrased particles are not biocompatible for the organism. A reaction of the organism to the foreign body occurs. The abrasion material is phagocytosed by macrophages. Activated cells produce inflammatory mediators, which cause a cascade of so far not quite elucidated processes the result of which is a change of the ratio: new formation – resorption of bone with a predominance of breakdown. The clinical manifestation of the process is the development of an abrasion granuloma and periprosthetic osteolysis leading to loosening and failure of the endoprosthesis. Detailed understanding of the mentioned mechanism is essential for the improvement of long-term results of articular prostheses. They can be possibly influenced by changes in the construction of implants, the selection of new mechanically resistant and biologically inert materials and possible pharmacological interference with processes leading to osteolysis. The article is a review of hitherto known processes leading to osteolysis and working theories on this problem.
- MeSH
- Diagnostic Imaging methods MeSH
- Diagnosis, Differential methods MeSH
- Adult MeSH
- Clinical Laboratory Techniques methods statistics & numerical data MeSH
- Humans MeSH
- Bone Diseases, Metabolic diagnosis MeSH
- Neoplasm Metastasis pathology MeSH
- Stomach Neoplasms pathology MeSH
- Osteolysis diagnosis MeSH
- Check Tag
- Adult MeSH
- Humans MeSH
- Male MeSH
- Publication type
- Case Reports MeSH
- MeSH
- Pain diagnosis etiology MeSH
- Adult MeSH
- Hip pathology MeSH
- Hip Prosthesis adverse effects MeSH
- Humans MeSH
- Joint Instability diagnosis etiology MeSH
- Osteolysis diagnosis MeSH
- Signs and Symptoms MeSH
- Body Weights and Measures statistics & numerical data MeSH
- Check Tag
- Adult MeSH
- Humans MeSH
- Male MeSH
- Female MeSH
Acta orthopaedica Scandinavica, ISSN 0300-8827 Supplementum Vol. 69. 278
16 s. : il. ; 24 cm
- Conspectus
- Ortopedie. Chirurgie. Oftalmologie
- NML Fields
- ortopedie
- MeSH
- Chronic Disease MeSH
- Adult MeSH
- Leukemia, Myeloid complications MeSH
- Bone Resorption MeSH
- Ribs MeSH
- Check Tag
- Adult MeSH
- Male MeSH
- Publication type
- Case Reports MeSH
Aseptic loosening and osteolysis are the most frequent causes of total hip or total knee arthroplasty failure. Osteolysis is induced predominantly by polyethylene particles that are produced by adhesive wear of the prosthesis. The particles trigger a complex host's reaction varying in intensity even in response to the same number of particles. These differences indicate that individual predisposition may have an important role in the pathogenesis of osteolysis. The major key mediators of wear-induced osteolysis include the cytokines RANKL, TNF-a, IL-1, IL-6 and IL-8. The inter-individual differences in the extent of bone destruction may therefore be related to variation in the amount and/or activity of these cytokines based on their gene polymorphism. Our pilot study suggests an association of some variants of the cytokine genes (e.g., IL1A-889) with a predisposition to development of severe osteolysis. If this assumption is confirmed by future investigations, this approach can facilitate the pre-operative identification of patients at risk of the development of severe periprosthetic osteolysis and premature failure of the implant.
- MeSH
- Cytokines genetics immunology MeSH
- Research Support as Topic MeSH
- Humans MeSH
- Disease Susceptibility immunology MeSH
- Osteolysis genetics immunology physiopathology MeSH
- Polymorphism, Genetic genetics immunology MeSH
- Joint Prosthesis classification MeSH
- Prosthesis Failure MeSH
- Check Tag
- Humans MeSH
