Osteolysis

Osteolysis
Classification and external resources
ICD-10	M89.5
DiseasesDB	1517
MeSH	D010014

Osteolysis refers to an active resorption of bone matrix by osteoclasts as part of an ongoing disease process.

Osteolysis 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. Osteolysis can also be associated with the radiographic changes seen in a person 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^[1] 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).

Although osteolysis itself is clinically asymptomatic, it can lead to implant loosening or bone breakage, which in turn cause 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.^[2]"

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

1. ^ Sanjeev Agarwal (2004). "Osteolysis - basic science, incidence and diagnosis". Current Orthopaedics 18: 220–231. doi:10.1016/j.cuor.2004.03.002. 
2. ^ [1] Ran Schwarzkopf, MD, MSc, et al. Distal Clavicular Osteolysis. A Review of the Literature. In Bulletin of the NYU Hospital for Joint Diseases. Vol. 66. No. 2. Pp. 94-101.
3. ^ Schwarzkopf R, Ishak C, Elman M, Gelber J, Strauss DN, Jazrawi LM. Distal clavicular osteolysis: a review of the literature. Bull NYU Hosp Jt Dis. 2008;66(2):94-101.