Quantitative small-animal surrogate to evaluate drug efficacy in preventing wear debris-induced osteolysis

Individuals who suffer from severe joint destruction caused by the various arthritidies often undergo total joint arthroplasty. A major limitation of this treatment is the development of aseptic loosening of the prosthesis in as many as 20% of patients. The current paradigm to explain aseptic loosen ing proposes that wear debris generated from the prosthesis initiates a mac rophage-mediated inflammatory response by resident macrophages, leading to osteoclast activation and bone resorption at the implant interface. No ther apeutic interventions have been proved to prevent or inhibit aseptic loosen ing. The development of therapeutic strategies is limited due to the absenc e of a quantitative surrogate in which drugs can be screened rapidly in lar ge numbers of animals. We have previously described a model in which titani um particles implanted on mouse calvaria induce an inflammatory response wi th osteolysis similar to that observed in clinical aseptic loosening. Here, we present new methods by which the osteolysis in this model can be quanti fied. We determined that 6-8-week-old mice in normal health have a sagittal suture area of 50 (+/-6) mum(2), which contains approximately five osteocl asts. As a result of the titanium-induced inflammation and osteolysis, the sagittal suture area increases to 197 (+/-27) mum(2), with approximately 30 osteoclasts, after 10 days of treatment. The sagittal suture area and the number of osteoclasts in the calvaria of sham-treated mice remained unchang ed during the 10 days. We also determined the effects of pentoxifylline, a drug that blocks the responses of tumor necrosis factor-a to wear debris, a nd the osteoclast inhibitor alendronate. We found that both drugs effective ly block wear debris-induced osteolysis but not osteoclastogenesis. In conc lusion, we found the measurements made with this model to be reproducible a nd to permit quantitative analysis of agents that are to be screened for th eir potential to prevent aseptic loosening.