TOTBİD Dergisi

TOTBİD Dergisi

2011, Cilt 10, Sayı, 2     (Sayfalar: 114-121)

The biological response to orthopaedic implants

Ahmet Turan Aydın 1

1 Akdeniz Üniversitesi Tıp Fakültesi Ortopedi ve Travmatoloji Anabilim Dalı, Antalya

Görüntüleme: 582
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İndirme : 454

In order to provide their desired function in the body, biomaterials should maintain their three main properties, namely mechanical power, structural integrity, and biocompatibility. However, biomaterials coming in contact with tissues and body fluids may lose their integrities and functions due to acute and chronic inflammatory reactions, corrosion and chemical changes such as disintegration. These reactions result in the loss of the expected function the biomaterial and on the other hand, the reactions causing tissue destruction may lead to serious structural changes such as prosthetic osteolysis. Today, metallurgy and tribology experts are in an effort to develop more durable and more biocompatible biomaterials. Especially following the application of the prosthetic implant, during acute inflammatory phase, the prosthesis procedure and the thermal and toxic effects of cement results in the formation of a fibrovascular membrane containing macrophages, lymphocytes, and foregin body giant cells. The subsequent adaptive bone formation ensures a firm osseointegration. If this does not occur, the osteolysis resulting from the stimulation of macrophages induced by the wear particles leads to the loosening of prosthesis. The synthesis of proinflammatory cytokines stimulated by the particles initiates a series of events that stimulate osteoclastogenesis and affect the bone turnover. The receptor activator of nuclear factor kappa B ligand (RANKL) released from the inflammatory and stromal cells, induces formation of osteoclasts from monocyte precursors. TNF-alpha and RANKL are the main cytokines responsible for the formation of osteoclasts and osteolysis.

Anahtar Kelimeler : Biomaterials; osteoclastogenesis; osteointegration; osteolysis; proinflammatory cytokines; RANKL