Fluid pressure and flow as a cause of bone resorption

Background Unstable implants in bone become surrounded by an osteolytic zone. This is seen around loose screws, for example, but may also contribute to prosthetic loosening. Previous animal studies have shown that such zones can be induced by fluctuations in fluid pressure or flow, caused by implant...

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Bibliographic Details
Published in:Acta orthopaedica 2010-08, Vol.81 (4), p.508-516
Main Authors: Fahlgren, Anna, Bostrom, Mathias PG, Yang, Xu, Johansson, Lars, Edlund, Ulf, Agholme, Fredrik, Aspenberg, Per
Format: Article
Language:English
Subjects:
Animals
Biological and medical sciences
Body Fluids
Bone Resorption - etiology
Bone Resorption - physiopathology
Disease Models, Animal
Diseases of the osteoarticular system
Fundamental and applied biological sciences. Psychology
Hydrostatic Pressure - adverse effects
Medical sciences
MEDICIN
MEDICINE
Osteolysis - etiology
Osteolysis - physiopathology
Prosthesis Failure
Rats
Rheology
Skeleton and joints
Tibia - pathology
Tibia - physiopathology
Vertebrates: osteoarticular system, musculoskeletal system
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Summary:Background Unstable implants in bone become surrounded by an osteolytic zone. This is seen around loose screws, for example, but may also contribute to prosthetic loosening. Previous animal studies have shown that such zones can be induced by fluctuations in fluid pressure or flow, caused by implant instability. Method To understand the roles of pressure and flow, we describe the 3-dimensional distribution of osteolytic lesions in response to fluid pressure and flow in a previously reported rat model of aseptic loosening. 50 rats had a piston inserted in the proximal tibia, designed to produce 20 local spikes in fluid pressure of a clinically relevant magnitude (700 mmHg) twice a day. The spikes lasted for about 0.3 seconds. After 2 weeks, the pressure was measured in vivo, and the osteolytic lesions induced were studied using micro-CT scans. Results Most bone resorption occurred at pre-existing cavities within the bone in the periphery around the pressurized region, and not under the piston. This region is likely to have a higher fluid flow and less pressure than the area just beneath the piston. The velocity of fluid flow was estimated to be very high (roughly 20 mm/s). Interpretation The localization of the resorptive lesions suggests that high-velocity fluid flow is important for bone resorption induced by instability.
ISSN:1745-3674
1745-3682
1745-3682
DOI:10.3109/17453674.2010.504610