Department of Orthopedics, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China.
Shantou University Medical College, Shantou, China.
Front Cell Infect Microbiol. 2023 Oct 3;13:1275086. doi: 10.3389/fcimb.2023.1275086. eCollection 2023.
Joint arthroplasty is an option for end-stage septic arthritis due to joint infection after effective control of infection. However, complications such as osteolysis and aseptic loosening can arise afterwards due to wear and tear caused by high joint activity after surgery, necessitating joint revision. Some studies on tissue pathology after prosthesis implantation have identified various cell populations involved in the process. However, these studies have often overlooked the complexity of the altered periprosthetic microenvironment, especially the role of nano wear particles in the etiology of osteolysis and aseptic loosening. To address this gap, we propose the concept of the "prosthetic microenvironment". In this perspective, we first summarize the histological changes in the periprosthetic tissue from prosthetic implantation to aseptic loosening, then analyze the cellular components in the periprosthetic microenvironment post prosthetic implantation. We further elucidate the interactions among cells within periprosthetic tissues, and display the impact of wear particles on the disturbed periprosthetic microenvironments. Moreover, we explore the origins of disease states arising from imbalances in the homeostasis of the periprosthetic microenvironment. The aim of this review is to summarize the role of relevant factors in the microenvironment of the periprosthetic tissues, in an attempt to contribute to the development of innovative treatments to manage this common complication of joint replacement surgery.
关节置换术是治疗因关节感染而导致的终末期化脓性关节炎的一种选择。然而,由于手术后关节活动度高导致的磨损,会出现骨溶解和无菌性松动等并发症,需要进行关节翻修。一些关于假体植入后组织病理学的研究已经确定了涉及该过程的各种细胞群体。然而,这些研究往往忽略了改变后的假体周围微环境的复杂性,尤其是纳米磨损颗粒在骨溶解和无菌性松动中的作用。为了解决这一差距,我们提出了“假体微环境”的概念。在这篇观点文章中,我们首先总结了从假体植入到无菌性松动的假体周围组织的组织学变化,然后分析了假体植入后假体周围微环境中的细胞成分。我们进一步阐明了假体周围组织内细胞之间的相互作用,并展示了磨损颗粒对紊乱的假体周围微环境的影响。此外,我们探讨了假体周围微环境平衡失调导致疾病状态的起源。本文综述的目的是总结假体周围组织微环境中相关因素的作用,以期为管理关节置换手术这一常见并发症的创新治疗方法的发展做出贡献。
Front Cell Infect Microbiol. 2023
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