Fluid pressure and flow as a cause of bone resorption.
BACKGROUND
Unstable implants in bone become surrounded by an osteolytic zone. This is seen around loose screws, for example, but may also contribute to prosthetic loosening. Previous animal studies have shown that such zones can be induced by fluctuations in fluid pressure or flow, caused by implant instability.


METHODS
To understand the roles of pressure and flow, we describe the 3-dimensional distribution of osteolytic lesions in response to fluid pressure and flow in a previously reported rat model of aseptic loosening. 50 rats had a piston inserted in the proximal tibia, designed to produce 20 local spikes in fluid pressure of a clinically relevant magnitude (700 mmHg) twice a day. The spikes lasted for about 0.3 seconds. After 2 weeks, the pressure was measured in vivo, and the osteolytic lesions induced were studied using micro-CT scans.


RESULTS
Most bone resorption occurred at pre-existing cavities within the bone in the periphery around the pressurized region, and not under the piston. This region is likely to have a higher fluid flow and less pressure than the area just beneath the piston. The velocity of fluid flow was estimated to be very high (roughly 20 mm/s).


CONCLUSIONS
The localization of the resorptive lesions suggests that high-velocity fluid flow is important for bone resorption induced by instability.
Fahlgren
Anna
A
Division of Orthopaedics, Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden. Anna.Fahlgren@liu.se
Bostrom
Mathias P G
MP
Yang
Xu
X
Johansson
Lars
L
Edlund
Ulf
U
Agholme
Fredrik
F
Aspenberg
Per
P
D000818:Animals; D001826:Body Fluids; D001862:Bone Resorption / Q000209:etiology* / Q000503:physiopathology; D004195:Disease Models, Animal; D006874:Hydrostatic Pressure / Q000009:adverse effects; D010014:Osteolysis / Q000209:etiology / Q000503:physiopathology; D011475:Prosthesis Failure; D051381:Rats; D012212:Rheology; D013977:Tibia / Q000473:pathology / Q000503:physiopathology*