Periprosthetic osteolysis: Genetics, mechanisms and potential therapeutic interventions

Shahryar Noordin, Bassam Masri

Research output: Contribution to journalReview articlepeer-review

47 Citations (Scopus)


Aseptic loosening and periprosthetic osteolysis occur as a result of the biological response to particulate wear debris and are one of the leading causes of arthroplasty failure. Periprosthetic osteolysis originates from chronic inflammatory responses triggered by implant-derived particulate debris, which cause recruitment of cells, including macrophages, fibroblasts, lymphocytes and osteoclasts. These cells secrete pro - inflammatory and osteoclastogenic cytokines, exacerbating the inflammatory response. In addition to their direct activation by phagocytosis, there are contributing autocrine and paracrine effects that create a complex milieu within the periprosthetic space, which ultimately governs the development of osteolysis. Chronic cell activation may upset the delicate balance between bone formation and bone resorption leading to periprosthetic osteolysis. This article summarizes the genetic mechanisms underlying periprosthetic loosening and identifies potential therapeutic agents.

Original languageEnglish
Pages (from-to)408-417
Number of pages10
JournalCanadian Journal of Surgery
Issue number6
Publication statusPublished - Dec 2012
Externally publishedYes


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