Osteolysis Complicating Total Knee Arthroplasty.

Journal and index pages often block iframe embedding. This reader keeps the evidence details in Orthonotes and leaves the source page one click away.

Abstract

[Indexed for MEDLINE] 11. J Biomed Mater Res B Appl Biomater. 2020 Jul;108(5):2073-2087. doi: 10.1002/jbm.b.34546. Epub 2020 Jan 2. Reactive oxygen/nitrogen species (ROS/RNS) and oxidative stress in arthroplasty. Hameister R(1), Kaur C(1), Dheen ST(1), Lohmann CH(2), Singh G(3). Author information: (1)Department of Anatomy, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore. (2)Department of Orthopaedic Surgery, Otto-von-Guericke University, Magdeburg, Germany. (3)Centre for Orthopaedics Pte Ltd, Singapore, Singapore. The interplay between implant design, biomaterial characteristics, and the local microenvironment adjacent to the implant is of utmost importance for implant performance and success of the joint replacement surgery. Reactive oxygen and nitrogen species (ROS/RNS) are among the various factors affecting the host as well as the implant components. Excessive formation of ROS and RNS can lead to oxidative stress, a condition that is known to damage cells and tissues and also to affect signaling pathways. It may further compromise implant longevity by accelerating implant degradation, primarily through activation of inflammatory cells. In addition, wear products of metallic, ceramic, polyethylene, or bone cement origin may also generate oxidative stress themselves. This review outlines the generation of free radicals and oxidative stress in arthroplasty and provides a conceptual framework on its implications for soft tissue remodeling and bone resorption (osteolysis) as well as implant longevity. Key findings derived from cell culture studies, animal models, and patients' samples are presented. Strategies to control oxidative stress by implant design and antioxidants are explored and areas of controversy and challenges are highlighted. Finally, directions for future research are identified. A better understanding of the host-implant interplay and the role of free radicals and oxidative stress will help to evaluate therapeutic approaches and will ultimately improve implant performance in arthroplasty. © 2020 Wiley Periodicals, Inc. DOI: 10.1002/jbm.b.34546