Loosening of THR Prostehsis
Potential areas of lucency around femoral and acetabular components of THR according to Gruen (femur ) and De-Lee and Charnley (cup).
Ortho PG notes
Pathological process of aseptic loosening
Osteoclastic bone resorption at bone cement interface.
Polyethylene wear debris at bearing surfaces combined with cement debris formed from movement at interfaces.
In vitro, activated macrophages is the key. Macrophage after phagocytosis ,response in two ways.
a. secretion of TNF-alpha ,IL-1,IL-6,PGE2
b. activated macrophages differentiate into osteoclasts via distinct pathways (RANKL activated and TNF-alpha activated )
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