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The local inflammatory environment and microorganisms in “aseptic” loosening of hip prostheses
Author(s) -
Hoenders Caroline S. M.,
Harmsen Marco C.,
van Luyn Marja J. A.
Publication year - 2008
Publication title -
journal of biomedical materials research part b: applied biomaterials
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.665
H-Index - 108
eISSN - 1552-4981
pISSN - 1552-4973
DOI - 10.1002/jbm.b.30992
Subject(s) - proinflammatory cytokine , ccl3 , chemokine , biofilm , ccl2 , bone resorption , immunology , medicine , inflammation , biology , bacteria , genetics
Long term loosening of hip prostheses remains an important problem in orthopedics. Although various loosening mechanisms have been proposed, the exact process is still unclear. Particle disease and the pressure theory are widely known and generally accepted hypotheses to explain long term implant failure. Each proposed mechanism recognizes a local inflammatory response in which macrophages represent the main cell‐type and several proinflammatory and antiinflammatory cytokines (IL‐1β, IL‐6, TNFα, IL‐10, TGFβ), chemokines (IL‐8/CXCL8, MCP‐1/CCL2, RANTES/CCL5, MIP‐1α/CCL3) and other mediators (GM‐CSF, M‐CSF, MMP‐1, PDGF‐α, PGE 2 , IL‐11) are identified. The cytokines have different functions and some are capable of stimulating bone resorption in various ways; either directly or indirectly. Even though the implant loosening is thought to be “aseptic”, several studies suggested a possible role for bacteria and a bacterial biofilm in implant failure. Biofilm‐derived bacteria and bacterial products might have an underestimated and potential role in the loosening process. In this article we will discuss the possible role of a bacterial biofilm and the importance of the local surrounding environment in “aseptic” loosening of hip prostheses. © 2007 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 2008