In a rcccnl study by Ultncb-Vmfher M. ct al., (bey concluded thai -t single imramuscular injcclion of the rccombinant adeno-assoeialed virus (KAA V) vector co-expressing Oi'Ci can efficiently transduce fnyocytes^tcT produce  high   levels of OPCi effectively inbibits wear debris-induced osicoclashtgencsix and osleoivsis (71).

To tins end, recent work using soluble RANK:Fe, a molecule tbat blocks RANK signaling, suggests that blockade of the RANK-RANK!, interaction may prevent or correct "wear debris-induced osteolysis. Other RANK blockade strategies are being developed, and it is hoped that one or more of these agents will permit medical management of periprosthetic osteolysis (66).

2-Polyelhylene wear:

The evidence is strong that wear particle generation is a significant factor in stimulating periprosthetic inflammation and subsequent bone loss. This may be responsible for aseptic loosening as well as localized osteolysis chat may occur even if the prosthesis is well fixed (7).

Polyethylene wear debris in total knee replacement generates larger particles because of the reduced joint congruity compared to total hip replacement. This may be why biologic reaction to debris is less severe than total hips. Osteolysis is therefore much less common after total knee replacement (32).

I-Polyethylene damage mechanisms:

The mechanisms of damage at the tibiofemoral and patellofemoral articulations consist of delamination, adhesive wear, and abrasive wear of the polyethylene components (72).