Contributions of human tissue analysis to understanding the mechanisms of loosening and osteolysis in total hip replacement.
Contributions of human tissue analysis to understanding the mechanisms of loosening and osteolysis in total hip replacement.
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DOI：
10.1016/j.actbio.2014.02.003
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发表时间：
2014-06
影响因子：
9.7
通讯作者：
Thyssen JP
中科院分区：
文献类型：
--
作者：
Gallo J;Vaculova J;Goodman SB;Konttinen YT;Thyssen JP
无菌性松动和骨质溶解是全髋关节置换术（THA）最常见的晚期并发症，导致假体翻修。这篇综述旨在证明组织病理学研究如何有助于我们理解无菌性松动/骨质溶解发展的机制。仅纳入了分析从人类失败种植体中取出的假体周围组织的研究。纳入了1974年至2013年期间以英语或德语发表的101项研究（5532例THA植入物失败的患者）的数据。101项研究中有45项报告了“对照”样本。最常检查的组织是骨-植入物界面膜和假滑膜组织。组织学研究对确定无菌性松动和骨质溶解生物学机制的关键细胞群有重要作用。这些研究在蛋白质水平上证明了宿主反应的关键分子（趋化因子、细胞因子、一氧化氮代谢物、金属蛋白酶）。然而，这些研究也有重要的局限性。翻修手术时采集的组织反映了特定的终末期失败，可能无法充分揭示导致假体松动和骨质溶解的病理生理事件的演变。一种可能的解决方案是检查从多中心研究中因脱位或假体周围骨折而在不同时间段翻修的稳定全髋关节置换术中采集的组织。
Aseptic loosening and osteolysis are the most frequent late complications of total hip arthroplasty (THA) leading to revision of the prosthesis. This review aims to demonstrate how histopathological studies contribute to our understanding of the mechanisms of aseptic loosening/osteolysis development. Only studies analysing periprosthetic tissues retrieved from failed implants in humans were included. Data from 101 studies (5532 patients with failure of THA implants) published in English or German between 1974 and 2013 were included. “Control” samples were reported in 45 of the 101 studies. The most frequently examined tissues were the bone-implant interface membrane and pseudosynovial tissues. Histopathological studies contribute importantly to determination of key cell populations underlying the biological mechanisms of aseptic loosening and osteolysis. The studies demonstrated the key molecules of the host response at the protein level (chemokines, cytokines, nitric oxide metabolites, metalloproteinases). However, these studies also have important limitations. Tissues harvested at revision surgery reflect specifically end-stage failure and may not adequately reveal the evolution of pathophysiological events that lead to prosthetic loosening and osteolysis. One possible solution is to examine tissues harvested from stable total hip arthroplasties that have been revised at various time periods due to dislocation or periprosthetic fracture in multicenter studies.
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影响因子：
3.7
作者：
Edwards, James;Schulze, Eva;Athanasou, Nicholas Anthony
通讯作者：
Athanasou, Nicholas Anthony
影响因子：
4.9
作者：
Arora, A;Song, Y;Goodman, S
通讯作者：
Goodman, S
影响因子：
7.5
作者：
Bori, Guillem;Munoz-Mahamud, Ernesto;Soriano, Alex
通讯作者：
Soriano, Alex
DOI：
10.1302/0301-620x.76b1.8300682
发表时间：
1994-01-01
影响因子：
--
作者：
BOEHLER, M;KNAHR, K;SCHREIBER, V
通讯作者：
SCHREIBER, V
DOI：
10.1302/0301-620x.77b1.7822391
发表时间：
1995-01-01
影响因子：
--
作者：
ATHANASOU, NA;PANDEY, R;SMITH, PM
通讯作者：
SMITH, PM