PMID- 25747031
OWN - NLM
STAT- MEDLINE
DCOM- 20151002
LR  - 20220310
IS  - 1940-4379 (Electronic)
IS  - 1050-6934 (Print)
IS  - 1050-6934 (Linking)
VI  - 24
IP  - 4
DP  - 2014
TI  - Innate immune reactions in septic and aseptic osteolysis around hip implants.
PG  - 283-96
AB  - According to the long-standing definition, septic and aseptic total joint 
      replacement loosening are two distinct conditions with little in common. Septic 
      joint replacement loosening is driven by bacterial infection whereas aseptic 
      loosening is caused by biomaterial wear debris released from the bearing 
      surfaces. However, recently it has been recognized that the mechanisms that drive 
      macrophage activation in septic and aseptic total joint replacement loosening 
      resemble each other. In particular, accumulating evidence indicates that in 
      addition to mediating bacterial recognition and the subsequent inflammatory 
      reaction, toll-like receptors (TLRs) and their ligands, pathogen-associated 
      molecular patterns (PAMPs) and danger-associated molecular patterns (DAMPS), play 
      a key role in wear debris-induced inflammation and macrophage activation. In 
      addition, subclinical bacterial biofilms have been identified from some cases of 
      seemingly aseptic implant loosening. Furthermore, metal ions released from some 
      total joint replacements can activate TLR signaling similar to bacterial derived 
      PAMPs. Likewise, metal ions can function as haptens activating the adaptive 
      immune system similar to bacterial derived antigens. Thus, it appears that 
      aseptic and septic joint replacement loosening share similar underlying 
      pathomechanisms and that this strict dichotomy to sterile aseptic and 
      bacterial-caused septic implant loosening is somewhat questionable. Indeed, 
      rather than being two, well-defined clinical entities, peri-implant osteolysis 
      is, in fact, a spectrum of conditions in which the specific clinical picture is 
      determined by complex interactions of multiple local and systemic factors.
FAU - Pajarinen, Jukka
AU  - Pajarinen J
AD  - Department of Medicine, Institute of Clinical Medicine, Helsinki University 
      Central Hospital, 00029 HUS, Finland; Department of Orthopaedic Surgery, Stanford 
      Medical Center, Stanford CA 94305-5341 , USA.
FAU - Jamsen, Eemeli
AU  - Jamsen E
AD  - Department of Medicine, Institute of Clinical Medicine, University of Helsinki 
      and Helsinki University Central Hospital, Helsinki, Finland.
FAU - Konttinen, Yrjo T
AU  - Konttinen YT
AD  - Department of Clinical Medicine, University of Helsinki and ORTON Orthopaedic 
      Hospital of the Invalid Foundation, Helsinki, Finland.
FAU - Goodman, Stuart B
AU  - Goodman SB
AD  - Department of Orthopaedic Surgery Stanford University Medical Center Redwood 
      City, CA.
LA  - eng
GR  - R01 AR055650/AR/NIAMS NIH HHS/United States
GR  - R01 AR063717/AR/NIAMS NIH HHS/United States
GR  - 1R01AR063717/AR/NIAMS NIH HHS/United States
GR  - 2R01AR055650-05/AR/NIAMS NIH HHS/United States
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - J Long Term Eff Med Implants
JT  - Journal of long-term effects of medical implants
JID - 9110830
RN  - 0 (Toll-Like Receptors)
MH  - Arthroplasty, Replacement, Hip
MH  - Cell Polarity
MH  - Hip Prosthesis/*adverse effects
MH  - Humans
MH  - Immunity, Innate/*physiology
MH  - Macrophage Activation
MH  - Osteolysis/*physiopathology
MH  - Sepsis/*immunology
MH  - Toll-Like Receptors/metabolism
PMC - PMC4366426
MID - NIHMS670559
EDAT- 2014/01/01 00:00
MHDA- 2015/10/03 06:00
PMCR- 2015/03/20
CRDT- 2015/03/10 06:00
PHST- 2015/03/10 06:00 [entrez]
PHST- 2014/01/01 00:00 [pubmed]
PHST- 2015/10/03 06:00 [medline]
PHST- 2015/03/20 00:00 [pmc-release]
AID - 1bc2ffc717f40755,3e3b1904100aa638 [pii]
AID - 10.1615/jlongtermeffmedimplants.2014010564 [doi]
PST - ppublish
SO  - J Long Term Eff Med Implants. 2014;24(4):283-96. doi: 
      10.1615/jlongtermeffmedimplants.2014010564.