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Is early migration enough to explain late clinical loosening of hip prostheses?

Mjöberg, Bengt LU orcid (2020) In EFORT Open Reviews 5(2). p.113-117
Abstract

Prosthetic loosening has been debated for decades, both in terms of the timing and nature of the triggering events. Multiple radiostereometric studies of hip prostheses have now shown that early migration poses a risk of future clinical failure, but is this enough to explain late clinical loosening? To answer this question, the progression of loosening from initiation to radiographic detection is described; and the need for explanations other than early prosthetic loosening is analysed, such as stress-shielding, particle disease, and metal sensitivity. Much evidence indicates that prosthetic loosening has already been initiated during or shortly after the surgery, and that the subsequent progression of loosening is affected by... (More)

Prosthetic loosening has been debated for decades, both in terms of the timing and nature of the triggering events. Multiple radiostereometric studies of hip prostheses have now shown that early migration poses a risk of future clinical failure, but is this enough to explain late clinical loosening? To answer this question, the progression of loosening from initiation to radiographic detection is described; and the need for explanations other than early prosthetic loosening is analysed, such as stress-shielding, particle disease, and metal sensitivity. Much evidence indicates that prosthetic loosening has already been initiated during or shortly after the surgery, and that the subsequent progression of loosening is affected by biomechanical factors, fluid pressure fluctuations and inflammatory responses to necrotic cells and cell fragments, i.e. the concept of late loosening appears to be a misinterpretation of late-detected loosening. Clinical implications: atraumatic surgery and initial prosthetic stability are crucial in ensuring low risk of prosthetic loosening.

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Please use this url to cite or link to this publication:
author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Periprosthetic osteolysis, Prosthetic loosening, Radiostereometric analysis
in
EFORT Open Reviews
volume
5
issue
2
pages
5 pages
publisher
British Editorial Society of Bone & Joint Surgery
external identifiers
  • pmid:32175098
  • scopus:85080918584
ISSN
2396-7544
DOI
10.1302/2058-5241.5.190014
language
English
LU publication?
yes
id
17ea6f4d-21c2-4aac-aa08-d997d87805b6
date added to LUP
2020-03-18 16:42:11
date last changed
2024-06-12 10:48:18
@article{17ea6f4d-21c2-4aac-aa08-d997d87805b6,
  abstract     = {{<p>Prosthetic loosening has been debated for decades, both in terms of the timing and nature of the triggering events. Multiple radiostereometric studies of hip prostheses have now shown that early migration poses a risk of future clinical failure, but is this enough to explain late clinical loosening? To answer this question, the progression of loosening from initiation to radiographic detection is described; and the need for explanations other than early prosthetic loosening is analysed, such as stress-shielding, particle disease, and metal sensitivity. Much evidence indicates that prosthetic loosening has already been initiated during or shortly after the surgery, and that the subsequent progression of loosening is affected by biomechanical factors, fluid pressure fluctuations and inflammatory responses to necrotic cells and cell fragments, i.e. the concept of late loosening appears to be a misinterpretation of late-detected loosening. Clinical implications: atraumatic surgery and initial prosthetic stability are crucial in ensuring low risk of prosthetic loosening.</p>}},
  author       = {{Mjöberg, Bengt}},
  issn         = {{2396-7544}},
  keywords     = {{Periprosthetic osteolysis; Prosthetic loosening; Radiostereometric analysis}},
  language     = {{eng}},
  month        = {{02}},
  number       = {{2}},
  pages        = {{113--117}},
  publisher    = {{British Editorial Society of Bone & Joint Surgery}},
  series       = {{EFORT Open Reviews}},
  title        = {{Is early migration enough to explain late clinical loosening of hip prostheses?}},
  url          = {{http://dx.doi.org/10.1302/2058-5241.5.190014}},
  doi          = {{10.1302/2058-5241.5.190014}},
  volume       = {{5}},
  year         = {{2020}},
}