The bone-implant interface biology and potential targets for pharmacological interventions

Abstract

Total joint replacement, although considered an excellent surgical procedure, can be complicated by osteolysis induced by particles and subsequent aseptic loosening of the implant. The pathogenesis of implant-associated osteolysis includes inflammatory and osteolytic processes. An appreciation of the complex network that leads to these cellular and molecular responses will form a foundation on which to develop therapeutic interventions to combat inflammatory periprosthetic bone loss. In this paper, the authors will try to arrange the current basic knowledge of the bone - implant interface biology. The cascade of events that occur at the cellular and molecular level during osseointegration, osteolysis and aseptic loosening will be also provided. This knowledge would be very useful for researchers and orthopaedic surgeons, in order to intervene with pharmacological agents either locally or systematically and optimize the osseointegration of implants. Such biological and pharmacological interventions that have been currently tested will be finally reported.