On the impact of implant-related particle exposure on immun and cellular response in human bone and bone marrow.

While the release of wear debris form orthopedic implants with metal-on-metal articulating surfaces is commonly described in literature, the effects of the slowly but steady metal release from the loadbearing but non-articulating implant components is disregarded or ignored. Released metal implant materials can induce a delayed type hypersensitivity (DTH) that is associated chronic inflammation and can lead implant loosening. Although the prevalence of such metal allergies is relatively high, hypersensitivity reactions in response to implant materials after arthroplasty are highly controversial discussed and have not been systematically investigated. By combing patient-based investigations with laboratory-based basic research studies, we aim provide scientific evidence that delayed type hypersensitivity towards implant metals in the bone marrow is clinical reality and offer new opportunities for early prognostic and intervention strategies

尽管学界已普遍报道金属对金属关节界面骨科植入物的磨屑释放现象，但来自承重而非摩擦界面的植入部件所产生的缓慢且持续的金属释放效应，却常被忽视或未受重视。释放出的金属植入物材料可诱发迟发型超敏反应（delayed type hypersensitivity, DTH），该反应与慢性炎症相关，并可导致植入物松动。尽管此类金属过敏的患病率相对较高，但关节置换术后针对植入物材料的超敏反应仍存在较大争议，且尚未得到系统性研究。本研究将基于患者的临床调查与实验室基础研究相结合，旨在为骨髓中针对植入物金属的迟发型超敏反应的临床真实性提供科学依据，并为早期预后与干预策略提供新的思路。