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