A review of UHMWPE wear-induced osteolysis:the role for early detection of the immune response  

作　　者：Adrese M Kandahari Xinlin Yang Kevin A Laroche Abhijit S Dighe Dongfeng Pan Quanjun Cui 

机构地区：[1]Department of Orthopaedic Surgery, University of Virginia [2]Department of Radiology and Medical Imaging,University of Virginia

出　　处：《Bone Research》2016年第2期72-84,共13页骨研究（英文版）

摘　　要：In a world where increasing joint arthroplasties are being performed on increasingly younger patients, osteolysis as the leading cause of faiIure after total joint arthroplasty （TJA） has gained considerable attention. Ultra-high molecular weight polyethylene wear-induced osteolysis is the process by which prosthetic debris mechanicaIly released from the surface of prosthetic joints induces an immune response that favors bone catabolism, resulting in loosening of prostheses with eventual failure or fracture. The immune response initiated is innate in that it is nonspecific and self-propagating, with monocytic cells and osteoclasts being the main effectors. To date, detecting disease early enough to implement effective intervention without unwanted systemic side effects has been a major barrier. These barriers can be overcome using newer in vivo imaging techniques and modules linked with fluorescence and/or chemotherapies. We discuss the pathogenesis of osteolysis, and provide discussion of the challenges with imaging and therapeutics. We describe a positron emission tomography imaging cinnamoyl-Phe-（D）-Leu-Phe-（D）-Leu-Phe-Lys module, specific to maerophages, which holds promise in early detection of disease and localization of treatment. Further research and increased collaboration among therapeutic and three-dimensional imaging researchers are essential in realizing a solution to clinical osteolysis in TJA.In a world where increasing joint arthroplasties are being performed on increasingly younger patients, osteolysis as the leading cause of faiIure after total joint arthroplasty （TJA） has gained considerable attention. Ultra-high molecular weight polyethylene wear-induced osteolysis is the process by which prosthetic debris mechanicaIly released from the surface of prosthetic joints induces an immune response that favors bone catabolism, resulting in loosening of prostheses with eventual failure or fracture. The immune response initiated is innate in that it is nonspecific and self-propagating, with monocytic cells and osteoclasts being the main effectors. To date, detecting disease early enough to implement effective intervention without unwanted systemic side effects has been a major barrier. These barriers can be overcome using newer in vivo imaging techniques and modules linked with fluorescence and/or chemotherapies. We discuss the pathogenesis of osteolysis, and provide discussion of the challenges with imaging and therapeutics. We describe a positron emission tomography imaging cinnamoyl-Phe-（D）-Leu-Phe-（D）-Leu-Phe-Lys module, specific to maerophages, which holds promise in early detection of disease and localization of treatment. Further research and increased collaboration among therapeutic and three-dimensional imaging researchers are essential in realizing a solution to clinical osteolysis in TJA.

关 键 词：UHMWPE RANKL A review of UHMWPE wear-induced osteolysis 

分 类 号：R687.4[医药卫生—骨科学]