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Review
. 2022 Feb;20(1):43-52.
doi: 10.1007/s11914-022-00720-3. Epub 2022 Feb 8.

Macrophage Polarization and the Osteoimmunology of Periprosthetic Osteolysis

Stuart B Goodman  1 , Emmanuel Gibon  2 , Jiri Gallo  3 , Michiaki Takagi  4
Affiliations
Review

Macrophage Polarization and the Osteoimmunology of Periprosthetic Osteolysis

Stuart B Goodman et al. Curr Osteoporos Rep. 2022 Feb.

Abstract

Purpose of review: Joint replacement has revolutionized the treatment of end-stage arthritis. We highlight the key role of macrophages in the innate immune system in helping to ensure that the prosthesis-host interface remains biologically robust.

Recent findings: Osteoimmunology is of great interest to researchers investigating the fundamental biological and material aspects of joint replacement. Constant communication between cells of the monocyte/macrophage/osteoclast lineage and the mesenchymal stem cell-osteoblast lineage determines whether a durable prosthesis-implant interface is obtained, or whether implant loosening occurs. Tissue and circulating monocytes/macrophages provide local surveillance of stimuli such as the presence of byproducts of wear and can quickly polarize to pro- and anti-inflammatory phenotypes to re-establish tissue homeostasis. When these mechanisms fail, periprosthetic osteolysis results in progressive bone loss and painful failure of mechanical fixation. Immune modulation of the periprosthetic microenvironment is a potential intervention to facilitate long-term durability of prosthetic interfaces.

Keywords: Inflammation; Innate immune system; Joint replacement; Macrophage; Osteoimmunology; Periprosthetic osteolysis; Prosthesis.

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References

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