Cappagh National Orthopaedic Hospital, Finglas, Dublin, Ireland.
Bone Joint J. 2013 Aug;95-B(8):1022-6. doi: 10.1302/0301-620X.95B8.31229.
Peri-prosthetic osteolysis and subsequent aseptic loosening is the most common reason for revising total hip replacements. Wear particles originating from the prosthetic components interact with multiple cell types in the peri-prosthetic region resulting in an inflammatory process that ultimately leads to peri-prosthetic bone loss. These cells include macrophages, osteoclasts, osteoblasts and fibroblasts. The majority of research in peri-prosthetic osteolysis has concentrated on the role played by osteoclasts and macrophages. The purpose of this review is to assess the role of the osteoblast in peri-prosthetic osteolysis. In peri-prosthetic osteolysis, wear particles may affect osteoblasts and contribute to the osteolytic process by two mechanisms. First, particles and metallic ions have been shown to inhibit the osteoblast in terms of its ability to secrete mineralised bone matrix, by reducing calcium deposition, alkaline phosphatase activity and its ability to proliferate. Secondly, particles and metallic ions have been shown to stimulate osteoblasts to produce pro inflammatory mediators in vitro. In vivo, these mediators have the potential to attract pro-inflammatory cells to the peri-prosthetic area and stimulate osteoclasts to absorb bone. Further research is needed to fully define the role of the osteoblast in peri-prosthetic osteolysis and to explore its potential role as a therapeutic target in this condition.
人工关节周围骨溶解和随后的无菌性松动是翻修全髋关节置换术最常见的原因。来自假体部件的磨损颗粒与假体周围区域的多种细胞类型相互作用，导致炎症过程，最终导致假体周围骨丢失。这些细胞包括巨噬细胞、破骨细胞、成骨细胞和成纤维细胞。大多数关于假体周围骨溶解的研究都集中在破骨细胞和巨噬细胞的作用上。本综述的目的是评估成骨细胞在假体周围骨溶解中的作用。在假体周围骨溶解中，磨损颗粒可能通过两种机制影响成骨细胞并有助于溶骨过程。首先，已经表明颗粒和金属离子通过减少钙沉积、碱性磷酸酶活性及其增殖能力，抑制成骨细胞分泌矿化骨基质的能力。其次，已经表明颗粒和金属离子刺激成骨细胞在体外产生促炎介质。在体内，这些介质有可能吸引促炎细胞到假体周围区域，并刺激破骨细胞吸收骨。需要进一步的研究来充分定义成骨细胞在假体周围骨溶解中的作用，并探讨其在这种情况下作为治疗靶点的潜在作用。
