Aseptic Loosening in Total Hip Arthroplasty: Pathophysiology, Biomarkers, and Preventive Treatment Strategies
Source abstract
Abstract
Aseptic loosening (AL) represents the leading cause of long-term failure in total joint arthroplasty, often necessitating revision surgery. This review explores the complex mechanisms underlying AL, which involve a multifaceted interaction between the implanted biomaterials and the host immune response. We outline the key inflammatory mechanisms triggered by wear debris from polyethylene, polymethylmethacrylate, metal, and ceramic materials. We also examine emerging biomarkers for early detection and differentiation between stable and loosened implants, including proinflammatory cytokines, bone metabolism markers, extracellular matrix degradation products, microRNAs, and genetic polymorphisms. Lastly, we discuss current and future strategies for prevention and treatment, ranging from surgical optimization and biomaterial selection to pharmacological interventions. A comprehensive understanding of these mechanisms may help reduce the incidence of AL and improve long-term outcomes in arthroplasty patients.
Source: crossref · Quality: baseline
Research context
OpenAlex topics: Orthopedic Infections and Treatments · Orthopaedic implants and arthroplasty · Total Knee Arthroplasty Outcomes
SciVX discovery tags are terminology-based. OpenAlex topics are source-provided classifications.
Affiliations
BIOMORF Department of Biomedical, Dental, Morphological and Functional Imaging Sciences, A.O.U. Policlinico “G.Martino”-Via Consolare Valeria 1, 98124 Messina, Italy
Istituto Clinico Polispecialistico C.O.T. Cure Ortopediche Traumatologiche s.p.a., 98124 Messina, Italy
BIOMORF Department of Biomedical, Dental, Morphological and Functional Imaging Sciences, Section of Orthopaedic and Trauma Surgery, A.O.U. Policlinico “G.Martino”, University of Messina, Via Consolare Valeria 1, 98125 Messina, Italy
Operative Research Unit of Orthopaedic and Trauma Surgery, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo 200, 00128 Rome, Italy
Research Unit of Orthopaedic and Trauma Surgery, Department of Medicine and Surgery, Università Campus Bio-Medico Di Roma, Via Alvaro del Portillo 21, 00128 Rome, Italy
Department of Human Pathology of Adults and Developmental Age “Gaetano Barresi”, Division of Pathology, University of Messina, 98125 Messina, Italy
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