Ostéolyse périprothétique sous une prothèse de genou

Principal investigatorsM.HamadoucheM. Bensidhoum

Investigators: E. Gibon

Hip prostheses, by replacing the affected joint by a synthetic substitute, have become the most effective way to restore function and mobility in the arthritic hip. In the long term, however, the wear of the bearing couple (metal-on-polyethylene) results in the accumulation of wear debris, with may lead to bone rarefaction around the implant (osteolysis). The prosthesis, then, gets loose (aseptic loosening), which often requires corrective surgery.

To improve the longevity of these hip prostheses, one of the surgical departments affiliated to the B3OA is directing its efforts to reduce the formation of wear debris in metal-on-polyethylene bearing couple by improving the mechanical properties of polyethylene (cross-linked ultra-high molecular weight polyethylene stimulated with vitamin E). These studies will provide important information on the behavior and durability of this new type of prosthesis and, most importantly, will contribute to a better management of osteoarthritic patients.

Area (red arrows) of periprosthetic osteolysis induced by wear debris of hip prosthesis

In order to reduce the aseptic loosening, it is also necessary to better understand the biological processes leading to the periprosthetic osteolysis. For example, the inflammatory reaction associated the osteolysis could be reduced to limit the consequences of this phenomenon. In that regard, the B3OA has shown that depletion in estrogen reduces the osteolysis induced by wear debris. Estrogen receptors may, then, be therapeutic targets of choice to counteract osteolysis.

Publications of the project

Nich C, Rao AJ, Valladares RD, Li C, Christman JE, Antonios JK, Yao Z, Zwingenberger S, Petite H, Hamadouche M, Goodman SB. Role of direct estrogen receptor signaling in wear particle-induced osteolysis. Biomaterials. 2013 Jan;34(3):641-50. Link for the publication .

Rao AJ, Zwingenberger S, Valladares R, Li C, Lane Smith R, Goodman SB, Nich C. Direct subcutaneous injection of polyethylene particles over the murine calvaria results in dramatic osteolysis. Int Orthop. 2013 Jul;37(7):1393-8. Link for the publication .