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Biology of Foreign Bodies: Tolerance, Osteolysis, and Allergy

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Total Knee Arthroplasty

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Summary

In most individuals implanting the polymers and metals used in contemporary knee replacement surgery results in little or no reaction from the immune system. These materials are described as biologically tolerated or bioinert. However, as the functioning joint begins to wear, generating primarily polymer debris, the immune system commonly mounts an aggressive, macrophage-mediated response. This becomes evident after several years, both clinically and radiographically, as osteolysis [1, 2]. In a much smaller percentage of individuals, a second type of reaction, a very rapid, T-cell-mediated, “allergic”response, usually to metal, may be identified [3]. While the underlying processes are quite different, both reactions may ultimately lead to implant failure.

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  1. S. Nasser
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Editors and Affiliations

  1. Universitair Ziekenhuis, Weligerveld 1, 3212, Pellenberg-Leuven, Belgium

    Johan Bellemans (Professor) (Professor)

  2. Department of Orthopedic Surgery, San Francisco Medical Center, 500 Parnassus Ave., MU 320-W, San Francisco, CA, 94143, USA

    Michael D. Ries (Professor) (Professor)

  3. AZ St-Lucas Hospital, Sint-Lucaslaan 29, 8310, Brugge, Belgium

    Jan M.K. Victor M.D.

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Nasser, S. (2005). Biology of Foreign Bodies: Tolerance, Osteolysis, and Allergy. In: Bellemans, J., Ries, M.D., Victor, J.M. (eds) Total Knee Arthroplasty. Springer, Berlin, Heidelberg. https://doi.org/10.1007/3-540-27658-0_55

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