Osteolysis - basic science, incidence and diagnosis

Osteolysis is one of the foremost problems limiting the survival of current hip arthroplasty procedures. It is induced by the wear particles and corrosion products which incite an inflammatory response resulting in bone resorption and eventual Loosening and failure of the prosthesis. Host factors are presumed to play a role in the process which involves a variety of cytokines and mediators. It is clinically asymptomatic and is diagnosed by serial radiographic follow-up or CT scan. Future research will help to limit the effects of wear particles by identifying the most suitable bearing surfaces. The pathologic cascade of events triggered by wear particles may be a potential site of action for drugs intended to prevent or check the progression of the disease. (C) 2004 Elsevier Ltd. All rights reserved.