Aseptic looseningis is one of the most frequent long-term complications after joint replacement, which limits the service lire of prosthesis. A lot of studies have been focused on macrophage, osteoblast, osteoclast and fibroblast in interface membranes around prostheses recently. Aseptic loosening of orthopedic implants used in joint replacement results from bone loss that occurs through the resorptive activity of inflammatory cells activated by the presence of wear particles. Apoptosis has been observed in the periprosthetic site and it has been interpreted as a sign of resolution of inflammation suggesting that apoptosis-related events are indeed associated with periprosthetic osteolysis,targeting the Apoptosis pathway may lead to novel therapeutic approaches for the treatment of aseptic prosthesis loosening. In this thesis,the relationship between wear debris-induced apoptosis and aseptic loosening of prostheses are expounded in detail.
Apoptosis ; Humans ; Joint Prosthesis ; adverse effects ; Osteolysis ; Prosthesis Failure ; etiology

Acro-Osteolysis ; etiology ; Child ; Follow-Up Studies ; Hereditary Sensory and Autonomic Neuropathies ; complications ; Humans ; Male

Multiple myeloma (MM) is a plasma cell malignancy characterized by the high capacity to induce bone destruction. Osteolytic bone lesions in MM patients mainly result from an increased bone resorption related to the stimulation of osteoclast recruitment and activity. SDF-1a would represent a potential role and may provide a suitable therapeutic target for MM-mediated osteolysis. In this article the structure of SDF-1/CXCR4, the expression of SDF-1/CXCR4 in bone microenvironment of MM patients and its effect on osteoclasts, relation of SDF-1/CXCR expression with osteolytic bone lesions and prognosis of MM, SDF-1/CXCR4 as potential target for treatment of myeloma-osteopathia were reviewed.
Chemokine CXCL12 ; metabolism ; physiology ; Humans ; Multiple Myeloma ; complications ; metabolism ; Osteolysis ; etiology ; Receptors, CXCR4 ; metabolism ; physiology

Acne Vulgaris ; complications ; Follow-Up Studies ; Humans ; Osteolysis ; etiology ; Time Factors ; Tooth Socket

PURPOSE: This study analyzed the long-term results of cementless total hip arthroplasty using an extensively porous coated stem in patients younger than 45 years old. MATERIALS AND METHODS: The clinical and radiographic results of 45 hips from 38 patients who underwent cementless total hip replacement arthroplasty with an AML prosthesis were reviewed retrospectively. The average follow-up was 12 years (range, 10-15 years). RESULTS: The average Harris hip score at the time of final follow-up was 87.3 (range 77-94) points. Forty two hips (93.3%) showed excellent and good clinical results. Osteolysis occurred around the stem in 20 hips (44.4%) and around the cup in 26 hips (57.8%). Stress-mediated femoral resorption was observed in 33 hips (73.3%) at 10 years. There was no incidence of resorption progressing after 5 years postoperatively. There was no stem loosening. Five hips were revised for osteolysis, cup loosening and polyethylene wear. CONCLUSION: The long term results of total hip arthroplasty using an extensively porous coated stem were acceptable, and there was no case involving the progression of proximal bone resorption.
Adult ; Arthroplasty, Replacement, Hip/*adverse effects ; Female ; Hip Prosthesis/*adverse effects ; Humans ; Male ; Osteolysis/etiology ; Retrospective Studies ; Treatment Outcome

OBJECTIVETo study the clinical and radiographic results of tatal hip arthroplasty (THA) with an uncemented femoral component after 6 to 10 years follow-up, and to investigate factors effecting their efficacy.

METHODSFrom January 2000 to December 2003, 58 patients were treated with primary total hip arthroplasty. Among the patients, 27 patients were male and 31 patients were female, ranging in age from 25 to 73 years, with an average of 56 years. The 58 patients were clinically and radiographically followed up including before operation, postoperative 1.5, 3, 6 and 12 months, and then once a year. Therapeutic evaluation was measured by using Harris scoring system. The incidence of osteolysis around the components in different Gruen zones was radiologically determined. The data were analyzed by SPSS 16.0 software.

RESULTSAll the patients were followed up, and the duration ranged from 6 to 10 years, with a mean of 8.2 years. The Harris hip score of the patients improved from preoperative mean of (54.0 +/- 7.8) to (88.3 +/- 6.1) at the latest follow-up. There were 32 patients with an excellent result, 22 good, 3 fair and 1 poor. Radiological analysis showed that 48 patients had stable bone in growth, 10 patients got stable fibrous in growth and nobody showed unstable fixation with aseptic loosening. Subsidence (1 to 3 mm) was observed in 4 patients. Osteolysis of the femoral cortex was seen in 4 patients without progressive development, and the latest follow-up radiographs showed a significantly greater incidence of osteolysis in Gruen zone I, VI, VII compared with others (P = 0.031). All the patients with low Harris score had received prostheses which were undersized in the intramedullary canal, and these differences were statistically significant.

CONCLUSIONThe uncemented femoral component has good medium-term clinical follow-up results because of high stability and no aseptic loosening.

Adult ; Aged ; Arthroplasty, Replacement, Hip ; adverse effects ; methods ; Female ; Femur ; diagnostic imaging ; pathology ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Osteolysis ; etiology ; Postoperative Complications ; etiology ; Radiography ; Retrospective Studies

The periprosthetic osteolysis is one of the complications of artificial joint replacement. The function and the stability of the hip joint will be severely affected once the periprosthetic osteolysis occurred postoperatively,so it's necessary to fully recognize the mechanism of the osteolysis. There is no globally accepted diagnostic standard of this disease, and then, the grading of the postoperative hip joint function is indispensable. The using of diphosphonate to prevent the osteolysis has positive significance, but it is not broadly used in clinical. Taking the periprosthetic osteolysis of hip arthroplasty as the central, this article shows a briefly overview of this subject.
Arthroplasty, Replacement, Hip ; adverse effects ; Humans ; Osteolysis ; diagnosis ; drug therapy ; etiology ; prevention & control ; Postoperative Complications ; diagnosis ; drug therapy ; etiology ; prevention & control

Seventy consecutive primary total hip arthroplasties in which a Harris-Galante porous-coated acetabular component had been used from October, 1986 to December, 1989 were reviewed for 5 to 9 years follow-up. We performed the retrospective, clinical and radiological analysis of the hemispheric, porous-coated, cementless acetabular component using press-fit and screw fixation. No component had detectable migration or any other position change. No acetabular fractures and no screw problems were noted. Initial peripheral gaps were observed in 11 cases (16%). Twelve cases had a postoperative polar gap less than 0.5 mm which were stabilized at 2 years postoperatively. Radiolucent line was present in at least one zone in 53% of cases and occurred most frequently in zones 1 and 3. No continuous radiolucent line greater than 2 mm was seen in any zone and radiolucent lines were stabilized 2-3 years postoperatively. Twelve hips (17.1%) had osteolysis of the acetabulum. No acetabular component was revised because of aseptic loosening. Revision arthroplasties were performed in 9 hips during follow-up. We concluded that the hemispheric porous-coated, acetabular components using press-fit and screw fixation had good results with a 5 to 9-year follow-up.
Adult ; Aged ; Arthroplasty, Replacement, Hip/methods* ; Arthroplasty, Replacement, Hip/adverse effects ; Female ; Follow-Up Studies ; Hip Joint/radiography ; Human ; Male ; Middle Age ; Osteolysis/etiology ; Retrospective Studies

Polyfibromatosis syndrome is a rare disease entity that is characterized by various clinical features such as palmar, plantar, and penile fibromatoses, keloid formations of the skin, and erosive arthropathy. Its precise pathophysiology or etiology remains unclear. In addition to distinctive diverse skin manifestations, patients with polyfibromatosis have been previously reported to show erosive arthropathy with significant limitation of movement at affected joints. However, the presence of erosive polyarthropathy in polyfibromatosis has not emphasized in previous cases. Here, we report a case of polyfibromatosis syndrome combined with painless massive structural destruction of hand and foot joints, and review the characteristics of erosive arthropathy in previous cases.
Adult ; Arthrography ; Diagnosis, Differential ; Fibroma/*diagnosis/pathology/radiography ; Foot Joints/pathology/radiography ; Hand Joints/pathology/*radiography ; Humans ; Magnetic Resonance Imaging ; Male ; Metacarpophalangeal Joint/pathology/radiography ; Osteolysis/*diagnosis/etiology

OBJECTIVESTo measure the linear polyethylene wear with use of a computer-assisted two-dimensional method, and to evaluate the relationship between wear and long-term clinic-radiological findings.

METHODSBetween December 1991 and December 1995, the senior author performed 40 primary total hip arthroplasties with use of H/G porous-coated acetabular component. Radiographs of 40 H/G cementless total hip arthroplasties were examined for osteolysis, radiolucent line, cup migration and so on. To measure the linear polyethylene wear, migration in the femoral head center relative to the cup shell center was calculated on digitized consecutive radiographs with special computer software program.

RESULTSThe minimum follow-up was 10 years. Total linear wear was 2-8 mm, the mean rate of linear polyethylene wear was (0.32+/-0.31) mm/year. Twelve acetabular components (30%) were revised at an average follow-up point of 12 years. Three types of polyethylene liner failure were identified: wear-through of the polyethylene liner with resultant metallosis (5 hips), excessive wear necessitating revision (5 hips), and polyethylene liner dissociation without gross evidence of wear (2 hips).

CONCLUSIONSHigh wear rates and femoral and acetabular osteolysis have been and still are the main problems in uncemented total hip replacement. There is clear relationship between wear and acetabular osteolysis or loosening of the prostheses. The poor long-term results with these uncemented total hip arthroplasties illustrate the necessity of regular radiographic evaluation in order to detect osteolysis and liner failure, which are both generally asymptomatic until catastrophic failure appears.

Adult ; Aged ; Arthroplasty, Replacement, Hip ; methods ; Follow-Up Studies ; Hip Prosthesis ; Humans ; Middle Aged ; Osteolysis ; etiology ; Polyethylene ; Postoperative Complications ; Prosthesis Failure ; Retrospective Studies