Introduction
Seppo Santavirta: The Life and Work of an Orthopaedic Surgeon and Scientist. A Tribute From His Friends
How prevalent are implant wear and osteolysis, and how has the scope of osteolysis changed since 2000?
What patient and surgical factors contribute to implant wear and osteolysis in total joint arthroplasty?
How are wear-related problems diagnosed and what forms of surveillance are necessary?
What are the guidelines for the surgical and nonsurgical treatment of periprosthetic osteolysis?
What is the outcome of treatment for osteolysis?
How have alternative bearings (such as metal-on-metal, highly cross-linked polyethylene, and ceramic-on-ceramic) affected the prevention and treatment of osteolysis?
Clinical Issues Summary
What are the local and systemic biologic reactions and mediators to wear debris, and what host factors determine or modulate the biologic response to wear particles?
How has the biologic reaction to wear particles changed with newer bearing surfaces?
What other biologic and mechanical factors might contribute to osteolysis?
What experimental approaches (eg, in vivo, in vitro, tissue retrieval) are effective in investigating the biologic effects of particles?
Are there biological markers of wear?
What potential biologic treatments are available for osteolysis?
Biology Summary
How have new sterilization techniques and new forms of polyethylene influenced wear in total joint replacement?
How do alternative bearing surfaces influence wear behavior?
How do material properties influence wear and fracture mechanisms?
What design factors influence wear behavior at the bearing surfaces in total joint replacements?
How have new designs and new types of joint replacement influenced wear behavior?
How have wear testing and joint simulator studies helped to discriminate among materials and designs?
Engineering Summary
Orthopaedic Joint Devices: The FDA's Short Answers to Your Questions