Role of Gene Polymorphisms in the Development of Aseptic Loosening of Knee and Hip Prostheses: A Review

Background. Aseptic loosening is a significant issue in the endoprosthetics of major joints of the lower limbs. In the modern view, aseptic loosening of joint prostheses is primarily caused by prolonged inflammation, which induces periprosthetic osteolysis. Various factors, such as sex, age, activity level, and others, can influence the development of periprosthetic osteolysis and aseptic loosening. Some researchers attribute to the factors gene polymorphisms related to inflammation, bone metabolism, and other processes. Understanding the connection between specific genetic markers and the development of endoprosthetic complications can provide deeper insights into the mechanisms of periprosthetic osteolysis and aseptic loosening, as well as allow for better prediction of complications in patients. The aim of the study - based on a literature review, to identify the role of individual genetic traits in the development of periprosthetic osteolysis and aseptic loosening of joint prostheses. Methods. The search for original studies was conducted in the PubMed, Google Scholar, and eLIBRARY databases using the following keywords: endoprosthetics, genetics, aseptic loosening, polymorphism. Relevance to the research topic was verified by titles and abstracts of the articles, followed by analysis of the full-text versions. Papers with no access to the full text were not assessed. Results. Polymorphisms in genes regulating inflammation, bone metabolism, differentiation, apoptosis, and cell division processes can influence the development of aseptic loosening. Among such genes are IL1B, IL6, RANK, OPG, FRZB, and others. Data from genome-wide association studies are contradictory and may suggest that genetic factors influencing aseptic loosening can differ among various populations. Conclusions. Individual genetic traits might play a significant role in the development of periprosthetic osteolysis and aseptic loosening of joint prostheses. Although several studies have identified genetic polymorphisms that presumably influence the development of loosening, further research is needed to verify these results and assess the possibility of extrapolating the findings to other populations.