Peri-prosthetic interface tissue around aseptic loosened prostheses: not waste, but a potential therapeutic target?

Abstract

The research in this thesis

represents part of a project aimed at developing a minimally invasive treatment

for aseptic loosened orthopaedic implants (e.g. hip-, knee implants).

The objective of the research described in this thesis is to increase the knowledge on the biology behind the process of aseptic loosening. For this purpose, we aim to study the loosening process from three different biological perspectives, according to the following research questions: 1. Does the cellular content of peri-prosthetic interface tissue shed new light on the mechanism of implant loosening? 2. Do peri-prosthetic interface tissue cells possess osteogenic potential, which can ultimately be used to prevent or slow loosening? 3. Does the individual host immune response relate to prosthesis migration, which can ultimately predict loosening? Ultimately, these findings may lay down the foundation for the identification of biological targets to counteract the aseptic implant loosening process. Ultimately this knowledge provides the basis for the development of therapeutic strategies for the treatment of loosened prostheses at an earlier stage, before gross loosening due to severe osteolysis is present. In the end, this will hopefully result in the redundancy of extensive revision surgery, with high risk of morbidity to the patient might be prevented.