BACKGROUND: Loosening of the sterile prosthesis in joint replacement is a simple radiological phenomenon, but a complex immune process. The abrasive particles produced by the implant usually lead to osteolysis, which is known as particle-associated periprosthetic osteolysis. OBJECTIVE: To summarize the characteristics of particle-associated periprosthetic osteolysis in order to provide reference for early identification and treatment, thereby improving the patients' prognosis. METHODS: The first author retrieved PubMed database for the articles addressing particle-associated periprosthetic osteolysis using the English keywords of "wear particles, particle-associated periprosthetic osteolysis".RESULTS AND CONCLUSION: (1) Osteolysis can induce bone resorption, but the relevant clinical, animal and in vitro studies have shown that particle-associated periprosthetic osteolysis involves various biological reactions, not only osteoclasts, and the bioactivity highly depends on the property and quantity. (2) Although total hip arthroplasty has achieved rapid progression, particle-associated periprosthetic osteolysis and aseptic loosening are still the main factors for the life of prosthesis. (3) Biomarkers can be used as simple and objective diagnostic and prognostic criteria for osteolysis after total hip arthroplasty. (4) Further research is needed to identify new biomarkers in periprosthetic osteolysis to develop new treatments to reverse or inhibit the particle-associated biological response.%背景:关节置换假体的无菌植入物松动是一种简单的放射现象,但却是一种复杂的免疫过程.由植入物产生的磨损颗粒最常引起骨质溶解,这被称为颗粒相关的假体周围骨质溶解.目的:概述颗粒相关假体周围骨溶解的特点,以便于医生识别并开始早期治疗,从而改善患者预后.方法:综述磨损颗粒诱导假体周围骨溶解的相关生物机制研究进展,使用可用的数据库进行了全面的文献搜索,检索工具为PubMed,以涵盖近年国内外与磨损颗粒诱导的假体周围骨溶解相关生物机制已发表的重要研究.结果与结论:①经总结分析后发现,尽管骨溶解引起骨吸收,但是磨损颗粒生物反应性的临床、动物和体外研究表明,磨损颗粒诱导的假体周围骨溶解代表多种细胞类型的几种生物反应的共同作用,而不是仅由破骨细胞引起,生物活性高度依赖于磨损颗粒的特性和数量;②尽管目前在全髋关节置换方面取得一定进展,但磨损颗粒诱导的假体周围骨溶解和无菌性松动仍是影响假体关节寿命的主要因素;③生物标志物可以被用作简易而客观的诊断和预后标准,来检测全髋关节置换术后的骨溶解;④因此需要进一步研究以鉴定假体周围骨质溶解中新的生物标志物,从而开发出新的治疗方法以逆转或抑制对磨损颗粒的生物反应.
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