The interplay between implant design, biomaterial characteristics, and the local microenvironment adjacent to the implant is of utmost importance for implant performance and success of the joint replacement surgery. Reactive oxygen and nitrogen species (ROS/RNS) are among the various factors affecting the host as well as the implant components. Excessive formation of ROS and RNS can lead to oxidative stress, a condition that is known to damage cells and tissues and also to affect signaling pathways. It may further compromise implant longevity by accelerating implant degradation, primarily through activation of inflammatory cells. In addition, wear products of metallic, ceramic, polyethylene, or bone cement origin may also generate oxidative stress themselves. This review outlines the generation of free radicals and oxidative stress in arthroplasty and provides a conceptual framework on its implications for soft tissue remodeling and bone resorption (osteolysis) as well as implant longevity. Key findings derived from cell culture studies, animal models, and patients' samples are presented. Strategies to control oxidative stress by implant design and antioxidants are explored and areas of controversy and challenges are highlighted. Finally, directions for future research are identified. A better understanding of the host‐implant interplay and the role of free radicals and oxidative stress will help to evaluate therapeutic approaches and will ultimately improve implant performance in arthroplasty.

中文翻译：

---

关节置换术中的活性氧/氮（ROS/RNS）和氧化应激。

植入物设计、生物材料特性和植入物附近的局部微环境之间的相互作用对于植入物性能和关节置换手术的成功至关重要。活性氧和氮物质 (ROS/RNS) 是影响宿主和植入物成分的各种因素之一。ROS 和 RNS 的过度形成会导致氧化应激，这种情况会损害细胞和组织，也会影响信号通路。它可能会加速植入物降解，主要是通过激活炎症细胞，从而进一步损害植入物的寿命。此外，金属、陶瓷、聚乙烯或骨水泥来源的磨损产品本身也可能产生氧化应激。本综述概述了关节成形术中自由基和氧化应激的产生，并提供了一个概念框架，说明其对软组织重塑和骨吸收（骨溶解）以及植入物寿命的影响。介绍了来自细胞培养研究、动物模型和患者样本的主要发现。探索了通过植入物设计和抗氧化剂控制氧化应激的策略，并强调了争议和挑战的领域。最后，确定了未来的研究方向。更好地了解宿主-植入物的相互作用以及自由基和氧化应激的作用将有助于评估治疗方法，并最终改善关节置换术中的植入物性能。