ABSTRACT
Osteolysis is a result of a particle-induced biologic process at the metal-bone or cement-bone interface, resulting in bone loss. Manifestations of this type of bone loss in patients range from new radiolucency around previously well-fixed implants, which usually progress and may result in loosening, to rapidly expanding focal lesions that may result in mechanical instability or pathologic fracture. Among orthopaedic surgeons, for ease of description, the former process is generally termed aseptic loosening and the latter is widely known as ‘‘osteolysis.’’ Due to the popular usage of these two terms, a common misconception is that each phenomenon represents a distinct clinical entity with dissimilar implications. However, it is important to appreciate that the radiological appearance of osteolysis or aseptic loosening depends on the access of the particulate debris to the metal-bone or cement-bone interface and that the underlying biologic process is the same in both instances.
