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lysis of bone caused by disease or infection or inadequate blood supply

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2016/01/23 01:02:59」(JST)

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Osteolysis is an active resorption of bone matrix by osteoclasts during the natural formation of healthy bones. Osteolysis can be seen as the reverse of ossification. Osteolysis often occurs in the proximity of a prosthesis that causes either an immunological response or changes in the bone's structural load. Osteolysis may also be caused by pathologies like bone tumors, cysts, or chronic inflammation.

In joint replacement

While bone resorption is commonly associated with many diseases or joint problems, the term osteolysis generally refers to a problem common to artificial joint replacements such as total hip replacements, total knee replacements and total shoulder replacements.^[1] Osteolysis can also be associated with the radiographic changes seen in those with bisphosphonate-related osteonecrosis of the jaw.

There are several biological mechanisms which may lead to osteolysis. In total hip replacement, the generally accepted explanation^[2] for osteolysis involves wear particles (worn off the contact surface of the artificial ball and socket joint). As the body attempts to clean up these wear particles (typically consisting of plastic or metal), it triggers an autoimmune reaction which causes resorption of living bone tissue. Osteolysis has been reported to occur as early as 12 months after implantation and is usually progressive. This may require a revision surgery (replacement of the prosthesis).^{[citation needed]}

Although osteolysis itself is clinically asymptomatic, it can lead to implant loosening or bone breakage, which in turn causes serious medical problems.

Distal clavicular osteolysis

Distal clavicular osteolysis (DCO) is often associated with problems weightlifters have with their acromioclavicular joints due to high stresses put on the clavicle as it meets with the acromion. This condition is often referred to as "weight lifter's shoulder".^[3] Medical ultrasonography readily depicts resorption of the distal clavicle as irregular cortical erosions, whereas the acromion remains intact.^[4] Associated findings may include distended joint capsule, soft-tissue swelling, and joint instability.

A common surgery to treat recalcitrant DCO is re-sectioning of the distal clavicle, removing a few millimetres of bone from the very end of the bone.^[3]

References

^ Osteolysis "Hip and Knee Replacements". Retrieved 10 April 2012.
^ Sanjeev Agarwal (2004). "Osteolysis - basic science, incidence and diagnosis". Current Orthopaedics 18: 220–231. doi:10.1016/j.cuor.2004.03.002.
^ ^a ^b Schwarzkopf R, Ishak C, Elman M, Gelber J, Strauss DN, Jazrawi LM (2008). "Distal clavicular osteolysis: a review of the literature". Bull NYU Hosp Jt Dis 66 (2): 94–101. PMID 18537776. [A Review of Weight-Lifter's Shoulder Lay summary] Check |laysummary= value (help) – eOrthopod.
^ Arend CF. Ultrasound of the Shoulder. Master Medical Books, 2013. Sample chapter available at ShoulderUS.com

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English Journal

Relationship between the pelvic osteolytic volume on computed tomography and clinical outcome in patients with cementless acetabular components.

Yun HH, Shon WY, Hong SJ, Yoon JR, Yang JH.SourceDepartment of Orthopaedics, Seoul Veterans Hospital, Seoul, South Korea.
International orthopaedics.Int Orthop.2011 Oct;35(10):1453-9. Epub 2010 Oct 7.
The purpose of this study was to evaluate the relationship between the pelvic osteolytic volume on computed tomography (CT) and clinical outcome in patients with cementless acetabular components. We reviewed 87 patients (104 hips) who met the following inclusion criteria: (1) there was evidence of p
PMID 20927513

A cementless elastic monoblock socket in young patients: a ten to 18-year clinical and radiological follow-up.

Pakvis D, Biemond L, van Hellemondt G, Spruit M.SourceDepartment of Orthopaedic Surgery, St. Maartenskliniek Hospital, P.O. Box?9011, 6500 GM, Nijmegen, The Netherlands, D.Pakvis@maartenskliniek.nl.
International orthopaedics.Int Orthop.2011 Oct;35(10):1445-51. Epub 2010 Sep 5.
The survival of acetabular components depends on several factors: wear, osteolysis and septic or aseptic loosening. Osteolysis seems to be the main cause for concern in cementless arthroplasties. Acetabular osteolysis results from particle debris and segmental unloading of acetabular bone by rigid s
PMID 20820777