The Induction of Bone Resorption by Prosthetic Loosening

Abstract

Prosthetic loosening represents a major complication of joint replacement arthroplasty. In our studies of the undesired loosening of implants for the internal fixation of fractures (Perren et al., 1975), we have observed that micromovements in the contact zone between plate screws and the bone lead to superficial bone resorption and secondary instability. Similarly, the loosening of endoprostheses is based upon a change in the geometry of the contact zones between the bone, cement and implant. This may occur as a result of excessive mechanical loading or a biological resorption of the surrounding bone. In the present article we shall show how discoveries from internal fixation experiments with mechanically induced bone resorption can be applied to the problem of prosthetic loosening.