The pathobiology and pathology of aseptic implant failure.
The pathobiology and pathology of aseptic implant failure.
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DOI：
10.1302/2046-3758.55.bjr-2016-0086
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发表时间：
2016-05
影响因子：
4.6
通讯作者：
Athanasou NA
中科院分区：
文献类型：
--
作者：
Athanasou NA
假体周围组织的病理学评估不仅对于诊断，而且对于理解种植体失效的病理生物学是重要的。宿主对假体周围组织中磨损颗粒沉积的反应的特征在于细胞和组织损伤，以及修复性和炎症反应，其中存在对植入物磨损的材料组分的先天性和适应性免疫反应。植入物磨损的物理和化学特征影响假体周围组织的反应性质，并导致导致植入物失效的特定并发症的发生，例如导致无菌性松动的骨质溶解和可能导致假瘤形成的软组织坏死/炎症。先天性反应涉及巨噬细胞吞噬植入物衍生的磨损颗粒;这由模式识别受体决定，并导致细胞因子、趋化因子和生长因子的表达，促进炎症和破骨细胞生成;吞噬的颗粒也可能具有细胞毒性，并导致细胞和组织坏死。对磨屑的适应性免疫反应的特征在于存在淋巴样细胞，并且很可能是由于对细胞和组织成分的细胞介导的超敏反应而发生的，细胞和组织成分通过与颗粒磨损的材料成分，特别是从钴铬合金磨粒中释放的金属离子的相互作用而改变。本文作者：Professor N. A.阿萨纳苏无菌种植失败的病理生物学和病理学。骨关节研究2016;5：162-168。DOI：10.1302/2046-3758.55.BJR-2016-0086。
Pathological assessment of periprosthetic tissues is important, not only for diagnosis, but also for understanding the pathobiology of implant failure. The host response to wear particle deposition in periprosthetic tissues is characterised by cell and tissue injury, and a reparative and inflammatory response in which there is an innate and adaptive immune response to the material components of implant wear. Physical and chemical characteristics of implant wear influence the nature of the response in periprosthetic tissues and account for the development of particular complications that lead to implant failure, such as osteolysis which leads to aseptic loosening, and soft-tissue necrosis/inflammation, which can result in pseudotumour formation. The innate response involves phagocytosis of implant-derived wear particles by macrophages; this is determined by pattern recognition receptors and results in expression of cytokines, chemokines and growth factors promoting inflammation and osteoclastogenesis; phagocytosed particles can also be cytotoxic and cause cell and tissue necrosis. The adaptive immune response to wear debris is characterised by the presence of lymphoid cells and most likely occurs as a result of a cell-mediated hypersensitivity reaction to cell and tissue components altered by interaction with the material components of particulate wear, particularly metal ions released from cobalt-chrome wear particles. Cite this article: Professor N. A. Athanasou. The pathobiology and pathology of aseptic implant failure. Bone Joint Res 2016;5:162–168. DOI: 10.1302/2046-3758.55.BJR-2016-0086.