The role of macrophages in osteolysis of total joint replacement
Abstract
The osteolysis associated with conventional polyethylene on metal total joint replacements is associated with the formation of an inflamed periprosthetic membrane rich in macrophages, cytokines and implant-derived wear particles. There is a wealth of evidence to indicate that the presence and activation of macrophages in the periprosthetic tissues around joint replacements is stimulated by UHMWPE particles. Particles within the size range 0.1-1.0 microm have been shown to be the most reactive. Animal studies have provided increasing evidence that, of the milieu of cytokines produced by particle-stimulated macrophages, TNF-alpha is a key cytokine involved in osteolysis. Recent advances in the understanding of the mechanisms of osteoclastogenesis and osteoclast activation at the cellular and molecular level have indicated that bone marrow-derived macrophages may play a dual role in osteolysis associated with total joint replacement. Firstly, as the major cell in host defence responding to UHMWPE particles via the production of cytokines and secondly as precursors for the osteoclasts responsible for the ensuing bone resorption.
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Wear byproducts from total joint replacements include particulate polymeric, ceramic, and metallic debris and metallic ions, which cause pro-inflammatory responses that can persist for the life of the implant.
“The byproducts of wear include particulate polymeric, ceramic and metallic debris (mostly in the nano, submicron, and micron size range) and in the case of metal-on-metal implants, metallic ions [143]. These byproducts are well known to cause pro-inflammatory responses which can persist for the life of the implant [144,145].”
From Macrophage polarization: an opportunity for improved outcomes in biomaterials and regenerative medicine (2012) · cites this paper as [145]
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- Authors
- Ingham, E., & Fisher, J.
- Affiliations
- University of Leeds (GB)
- Corresponding author
- Ingham, Eileen
- Venue
- Biomaterials
- Publisher
- Elsevier BV
- Published
- 2005-04
- Volume
- 26
- Issue
- 11
- Pages
- 1271-1286
- ISSN
- 0142-9612 (ISSN-L)
- OpenAlex
- W2158193380
- Cited by
- 667
- References
- 6
- Citations by year
- 2026: 9 · 2025: 17 · 2024: 19 · 2023: 18 · 2022: 27 · 2021: 34 · 2020: 28 · 2019: 28 · 2018: 35 · 2017: 39 · 2016: 32 · 2015: 43 · 2014: 45 · 2013: 48 · 2012: 50
- FWCI
- 3.94
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Biomaterials (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Surgery › Orthopaedic implants and arthroplasty
- Health Sciences › Medicine › Surgery › Orthopedic Infections and Treatments
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Bone Metabolism and Diseases
- Keywords
- macrophages, periprosthetic osteolysis, total joint arthroplasty, polyethylene wear particles, periprosthetic membrane, TNF-α, osteoclastogenesis, osteoclast activation, bone resorption, bone marrow-derived macrophages, cytokines
- MeSH terms
- Animals, Foreign-Body Reaction, Hip Prosthesis, Humans, Macrophages, Osteolysis, Prosthesis Failure, Cytokines, Prosthesis-Related Infections, Arthroplasty, Replacement, Hip
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