ReviewActa biomaterialia2013
Osteolysis around total knee arthroplasty: a review of pathogenetic mechanisms.
Review in Acta biomaterialia, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 149 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
149 citing papers in PubMed, 3 syntheses or guidelines pooled it, 342 citations in OpenAlex.
- "Systematic review and meta-analysis of ceramic coated implants in total knee arthroplasty. Comparable mid-term results to uncoated implants."Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2023Pooled it
- The lexicon for periprosthetic bone loss versus osteolysis after cervical disc arthroplasty: a systematic review.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2022Pooled it
- Is reverse total shoulder arthroplasty (rTSA) more advantageous than anatomic TSA (aTSA) for osteoarthritis with intact cuff tendon? A systematic review and meta-analysis.Journal of orthopaedics and traumatology : official journal of the Italian Society of Orthopaedics and Traumatology · 2022Pooled it
- Long-term migration of monoblock vs modular design in uncemented total knee arthroplasty: a secondary report of a randomized trial using radiostereometric analysis.Acta orthopaedica · 2025Trial
- Monoblock versus modular polyethylene insert in uncemented total knee arthroplasty.Acta orthopaedica · 2016Trial
- Knee Flexion and Daily Activities in Patients following Total Knee Replacement: A Comparison with ISO Standard 14243.BioMed research international · 2015Trial
- Soft, Reactive, and Alive: A Dynamic Framework for Degradation and Functional Stability of Polymeric Biomaterials.Polymers · 2026Review
- Bilateral Revision for Periprosthetic Osteolysis Around Primary Total Knee Prostheses: A Case Report.Cureus · 2026Article
- The histone demethylase KDM5C aggravates titanium particle-induced osteolysis by promoting macrophage inflammation and osteoclastogenesis.Cellular and molecular life sciences : CMLS · 2026Article
- Cobalt and titanium levels in the brain are associated with Alzheimer's disease pathology but not cognition: A study of older adults with and without total joint replacement.Acta biomaterialia · 2026Article
- Does tibial sclerosis severity influence bone resorption risk following total knee arthroplasty? : finite element analysis considering implant design and surgical technique.Bone & joint research · 2026Article
- Network Toxicology and Molecular Docking Analysis of Targets and Potential Mechanisms of PEEK-Induced Bone Resorption.International journal of molecular sciences · 2026Article
- "Squeaky Hip": Are Noises Important?Arthroplasty today · 2026Article
- Copper-doped β-tricalcium phosphate: synthesis, characterization, andMaterials today. Bio · 2026Article
- Femoral finite element analysis of a novel cementless revision total knee arthroplasty system.Scientific reports · 2026Article
- Magnesium-containing implants enhance bone healing: A mechanobiological perspective.Mechanobiology in medicine · 2025Review
- Review
- [Revision analysis and successful solutions for my failed primary total knee arthroplasties].Orthopadie (Heidelberg, Germany) · 2025Review
- The relationship between stress shielding, bone density changes and implant migration, failure and fracture after total knee arthroplasty: A systematic review.Journal of experimental orthopaedics · 2025Review
- Higher bone cement volume in total knee arthroplasty lowers the risk of postoperative radiolucent lines.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2025Article
89 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors at 4 institutions in 3 countries.
Funding
Abstract
Aseptic loosening and other wear-related complications are some of the most frequent late reasons for revision of total knee arthroplasty (TKA). Periprosthetic osteolysis (PPOL) pre-dates aseptic loosening in many cases, indicating the clinical significance of this pathogenic mechanism. A variety of implant-, surgery- and host-related factors have been delineated to explain the development of PPOL. These factors influence the development of PPOL because of changes in mechanical stresses within the vicinity of the prosthetic device, excessive wear of the polyethylene liner, and joint fluid pressure and flow acting on the peri-implant bone. The process of aseptic loosening is initially governed by factors such as implant/limb alignment, device fixation quality and muscle coordination/strength. Later, large numbers of wear particles detached from TKA trigger and perpetuate particle disease, as highlighted by progressive growth of inflammatory/granulomatous tissue around the joint cavity. An increased accumulation of osteoclasts at the bone-implant interface, impairment of osteoblast function, mechanical stresses and increased production of joint fluid contribute to bone resorption and subsequent loosening of the implant. In addition, hypersensitivity and adverse reactions to metal debris may contribute to aseptic TKA failure, but should be determined more precisely. Patient activity level appears to be the most important factor when the long-term development of PPOL is considered. Surgical technique, implant design and material factors are the most important preventative factors, because they influence both the generation of wear debris and excessive mechanical stresses. New generations of bearing surfaces and designs for TKA should carefully address these important issues in extensive preclinical studies. Currently, there is little evidence that PPOL can be prevented by pharmacological intervention.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.