YingZhen Niu

Abstract Globally, approximately 1.3 million total joint implants are placed annually, and around 80,000 patients develop aseptic loosening, a leading cause of implant failure driven by peri-implant fibrosis. Here, we show that the BMP-antagonist Gremlin-1 (GREM1), expressed by leptin receptor–expressing skeletal (LEPR⁺) cells, is a key regulator of this process. GREM1 is highly expressed by LEPR⁺ cells in peri-implant fibrotic tissue in mice and humans.

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REFERENCES 1, , . Projected volume of primary total joint arthroplasty in the U.S., 2014 to 2030. J Bone Joint Surg Am. 2018; 100: 1455-1460. 2. Joint registries. Bone Joint J. 2017; 99-B: 3-7. 3. Cementless total knee arthroplasty: current concepts review. Bone Joint J. 2016; 98-B: 867-873. 4, , , . Cementless hip implants: an expanding choice. Hip Int. 2016; 26: 413-423. 5, . Osseointegration of bone implants. A review of an alternative mode of fixation. Acta Orthop Scand. 1987; 58: 567-577. 6, , , .