[Mechanisms, prevention, and treatments of prosthetic aseptic loosening].
OBJECTIVE
To introduce the occurrence mechanisms, prevention, and treatment measures of prosthetic aseptic loosening.


METHODS
The recent original articles about prosthetic aseptic loosening were extensively reviewed and analyzed.


RESULTS
Prosthetic aseptic loosening was a very complex process involving many mechanical and biological aspects. The main mechanical factors included prosthetic materials, shapes and sizes, implant fixation methods (including surface treatments), clinical installation, interface micromotion, stress shielding, implant wear, interface integrity, and peri prosthetic high hydraulic pressure, etc.; the main biological factors included the types and sizes of wear particles, cell-activated responses, cytokine release, enzyme activation and allergic reactions to wear particles, etc.. Many measures should be adopted to effectively prevent and treat it, including improving materials and designs of prostheses, fixation techniques, surgical techniques, and drug treatments.


CONCLUSIONS
Prosthetic aseptic loosening is still a troublesome complication after joint replacements in orthopaedics, and more attention should be paid for its effective prevention and treatment.
Wei
Junqiang
J
The 7th Department, Special Hospital of Orthopaedics, General Hospital of Chinese PLA, Beijing, 100853, P.R. China.
Cai
Xu
X
Wang
Yan
Y
Chen
Hua
H
Zhang
Boxun
B
D019643:Arthroplasty, Replacement / Q000009:adverse effects / Q000295:instrumentation*; D006801:Humans; D007595:Joint Prosthesis; D011183:Postoperative Complications / Q000517:prevention & control; D011475:Prosthesis Failure