MicroRNAs in Aseptic Loosening of Prosthesis: Pathophysiology and Potential Therapeutic Approaches

Aseptic loosening (AL) is one of the leading causes of total joint arthroplasty (TJA) revision. Discovering the roles of microRNAs (miRNA/miR) in ontogenesis and osteolysis has attracted more attention to diagnosing and treating bone disorders. This review aimed to summarize miRNA biogenesis and describe the involvement of miRNAs in AL of implants. A detailed search was carried out on scientific search engines, including Google Scholar, Web of Science, and PubMed, to find appropriate papers related to subjects. The search process was performed using the following keywords: "Implant", "miRNAs", "Wear particles", "Osteoclasts", "Total joint replacement", and "Osteolytic diseases". miRNAs play an essential role in the regulation of gene expression. AL is associated with several pathologic properties, including wear particle-induced persistent inflammatory response, unbalanced osteoclastogenesis, abnormal osteoblast differentiation, and maturation. Recent researches have revealed that these pathological events are closely associated with miRNA deregulation, confirming the relationship between miRNA and AL of prostheses. With the results of the new approaches to target miRNA, the essential role of miRNA is further defined. Understanding the mechanisms of miRNAs and related signaling pathways in the pathophysiology of AL will help scientists illuminate novel therapeutic strategies and specific targeted drugs.