Summary:
One of the most serious complications of articular prostheses is loosening of the implant from the
osseous bed leading to its failure. The assumed basic cause is the reaction of the organism to
abrasion. During function of the articular prosthesis the abrasion of the contact surfaces occurs
and abrasion particles such as polyethylene, polymethylacrylate, metal and possibly ceramics are
produced. The abrased particles are not biocompatible for the organism. A reaction of the organism
to the foreign body occurs. The abrasion material is phagocytosed by macrophages. Activated cells
produce inflammatory mediators, which cause a cascade of so far not quite elucidated processes the
result of which is a change of the ratio: new formation – resorption of bone with a predominance of
breakdown. The clinical manifestation of the process is the development of an abrasion granuloma
and periprosthetic osteolysis leading to loosening and failure of the endoprosthesis. Detailed
understanding of the mentioned mechanism is essential for the improvement of long-term results
of articular prostheses. They can be possibly influenced by changes in the construction of implants,
the selection of new mechanically resistant and biologically inert materials and possible pharmacological
interference with processes leading to osteolysis. The article is a review of hitherto known
processes leading to osteolysis and working theories on this problem
Key words:
periprosthetic osteolysis, polyethylene abrasion, abrasion granuloma,
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