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Current
Chapter:
Pathophysiological Aspects of Hip Implants (Published March 2006)
Osteolysis and aseptic loosening are the major causes of failure of total hip replacements (THRs). These processes are induced by wear debris released from components of implants over time. Wear particles are a clinically relevant size (0.1-10μm) that activates macrophages and induces a foreign body response. Activated macrophages stimulate the production of proinflammatory cytokines (IL-1, IL-6, and TNF-α) to the synovial capsule, leading to chronic inflammation and bone resorption. Wear mechanics, including characteristics of wear particles from metal, polyethylene, and ceramic articulating surfaces, fixation materials, and surface coatings, have been reported in literature and are compiled here. Data concerning the pathophysiological effects of wear debris has been reported in this chapter whereas, the metal ions released from implants presented in “Ion Concentrations from Hip Implants.” Clinical data obtained from in vivo use and laboratory studies conducted in vitro were summarized.
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