Particles generated by wear disseminate to liver, spleen, regional LNs, and may cause granulomatous disease


? wear particles from ultra-high-molecular-weight polyethylene when ? irradiation sterilization used


Macrophages release MMPs in proportion to amount of particulate debris in periprosthetic tissue


? levels of ILK-IB and tartrate resistant acid? in synovial fluid of osteolysis associated arthroplasties


Focal osteolysis at modular stainless steel nail junction reported


Titanium particles suppress osteoblast function and induce differentiation of osteoclasts (stimulates bone resorption)


Foreign-body reaction to absorbable pins/screws


Osteolytic/cystic changes of the implant tracks (6.1%)


0.8% overall develop osteoarthritis


Polyglycolide, polylactide, glycolide-lactide plymeric debris


± sinus development with exudate


Extensive skin sloughing has been reported


Immunogenic reactions


Metal sensitivity


Corrosion causes release of ions and formation of colloidal organometallic complexes (which may be antigens)


Be, Ni (most common), Co, Cr, Tantalum, Ti, Vanadium


Associated with PMMA reported


Humeral response


Type I, II, III reactions


Cell-mediated response


Type IV delayed-type hypersensitivity


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