Total Hip Arthroplasty: Osteolysis and its Prevention with Systemic Therapy

Abstract

Total joint replacement has undergone a continual development process since its inception in the late 1960s and as a result of the pioneering work of Sir John Charnley. As the numbers of treated patients increased, so did the complications. These complications have been characterized and addressed by many researchers. The generation of particulate wear debris and its pivotal role in the development of periprosthetic osteolysis remain significant concerns. Our understanding of the pathological processes involved in periprosthetic bone loss remains incomplete, but advances in pharmacology and cooperation among investigators promise to address the problem of the failing hip. This paper discusses the basic science, pharmacology, and future developments of therapeutic intervention and reviews the most recently reported treatment results.