What potential biologic treatments are available for osteolysis?

Edward M. Schwarz*, Thomas W. Bauer, Joan Bechtold, Mathias Bostrom, Patricia A. Campbell, Victor Goldberg, Stuart B. Goodman, Ed M. Greenfield, Joshua J. Jacobs, Yrjö Konttinen, Regis O'Keefe, Francis Young In Lee, Arun S. Shanbhag, Robert Lane Smith, Rocky S. Tuan, J. Mark Wilkinson

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

37 Scopus citations


The host response to wear debris particles constitutes a major component of periprosthetic osteolysis and aseptic loosening. Thus, biologic interventions represent a logical approach to prevent this complication of total joint replacement. Several major obstacles must be overcome before a therapeutic intervention can emerge, most notably the development of a safe and effective drug, as well as the development of a quantitative outcome measure that can prove efficacy in a relatively small multicenter trial of patients with established osteolysis. Research is needed in several areas, including whether a threshold phenomenon exists for osteolytic progression, whether anabolic agents administered postoperatively can significantly increase osteointegration of the implant and reduce the potential for aseptic loosening, and whether RANKL antagonists can inhibit the progression of periprosthetic osteolysis. Imaging advancements and an osteolysis registry would significantly enhance the potential for a successful clinical trial.

Original languageEnglish
Pages (from-to)S72-S75
JournalThe Journal of the American Academy of Orthopaedic Surgeons
Issue number1
StatePublished - 2008


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