IN-VITRO, IN-VIVO, AND TISSUE RETRIEVAL STUDIES ON PARTICULATE DEBRIS

The biologic effects of wear debris are an important factor limiting t he longevity of total joint replacements. In vivo, in vitro, and tissu e retrieval studies have underlined a central role for the macrophage in the etiology of loosening and periprosthetic osteolysis, Wear parti cles from the materials used for total joint replacement activate macr ophages to secrete proinflammatory factors. Complex interactions betwe en macrophages and other cells stimulate bone resorption and suppress bone formation at the prosthetic interface, To improve the long term o utcome of joint replacements, future research must find innovative app roaches to minimize the production and biologic effects of wear debris .