Fig. 7

Schematic diagram demonstrating circulating miRNA targeting genes in the periprosthetic bone leading to osteoblast inhibition and osteoclast activation and subsequent aseptic loosening. Circulating miRNA in plasma (miR-1246 and miR-6089) of aseptic loosening patients with target genes in the local periprosthetic bone and soft tissues. These genes, some upregulated, some downregulated, act on the Wnt signalling pathway, which in-turn results in the inhibition of osteoblasts and activation of osteoclasts. Over time, this process results in bone resorption around the prosthesis, osteolysis and aseptic loosening