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J Am Acad Orthop Surg, Vol 16, No suppl_1, July 2008, S7-S13.
© 2008 the American Academy of Orthopaedic Surgeons
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What patient and surgical factors contribute to implant wear and osteolysis in total joint arthroplasty?

Audrey K. Tsao, MD, Lynne C. Jones, PhD and David G. Lewallen, MD

Dr. Tsao is in private practice, Sun City West, AZ. Dr. Jones is Associate Professor, Orthopaedic Surgery, Johns Hopkins University School of Medicine, Baltimore, MD. Dr. Lewallen is Professor of Orthopedic Surgery, Mayo Clinic College of Medicine, and Chair, Division of Adult Reconstructive Surgery, Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN.

*The Implant Wear Symposium 2007 Clinical Work Group included John J. Callaghan, MD, John M. Cuckler, MD, Jorge O. Galante, MD, DMSc, Alejandro González Della Valle, MD, Stuart B. Goodman, MD, PhD, James I. Huddleston, MD, Lynne C. Jones, PhD, David G. Lewallen, MD, Henrik Malchau, MD, PhD, William Maloney, MD, Amanda Marshall, MD, Wayne Paprosky, MD, Hollis G. Potter, MD, Michael D. Ries, MD, Aaron Rosenberg, MD, Thomas P. Sculco, MD, Bernard N. Stulberg, MD, Audrey K. Tsao, MD, and Timothy Wright, PhD.

Dr. Tsao or a member of her immediate family has received miscellaneous nonincome support, commercially derived honoraria, or other nonresearch-related funding from Zimmer, holds stock or stock options in Implex, and is a consultant or employee of Zimmer. Dr. Lewallen or a member of his immediate family has received royalties from Zimmer; serves as a consultant to or is an employee of Orthosonics, Zimmer, and Bristol-Myers Squib; and has received research or institutional support from DePuy, Stryker, and Zimmer. Neither Dr. Jones nor a member of her immediate family has received anything of value or owns stock in a commercial company or institution related directly or indirectly to the subject of this article.

Total joint arthroplasty has been a successful operation for decades. Our current patients are younger and more active than those in the past. They place higher demands on themselves and have expectations commensurate with their lifestyles. Time-limited longevity with the large number of anticipated total joint replacement procedures and their potential burden to health care is a growing concern. In the past two decades, implant wear and osteolysis have been identified as major causes for the failure of otherwise well-functioning implants. Osteolysis can be divided into several categories: patient-specific, implant-specific, and the result of surgical factors. Although these categories are interrelated and not mutually exclusive, they enable us to build a framework in which to further advance our understanding of osteolysis and apply this information in a clinically relevant manner.






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Copyright © 2008 by the American Academy of Orthopaedic Surgeons.