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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