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Journal of Long-Term Effects of Medical Implants

ISSN Print: 1050-6934
ISSN Online: 1940-4379

Journal of Long-Term Effects of Medical Implants

DOI: 10.1615/JLongTermEffMedImplants.v17.i3.30
pages 193-206

Peri-Implant Pathology—Relation to Implant Failure and Tumor Formation

N. A. Athanasou
Department of Pathology, Nuffield Department of Orthopaedic Surgery, University of Oxford, Nuffield Orthopaedic Centre, Oxford


Despite the clinical effectiveness of joint replacement arthroplasty, a number of complications, most of which present clinically with signs and symptoms related to implant loosening, are associated with this procedure. Histological changes that occur in soft tissue and bone around an implant provide diagnostic information on the causes of implant loosening and give clues as to the nature of the pathological processes that lead to this and other complications of implant-related joint disease. These pathological processes include the biologically nonspecific body macrophage response to wear particles (aseptic loosening), a specific hypersensitivity immune reaction to implant-derived wear particles, infection (septic loosening), primary joint-related pathology in revision arthroplasty tissues, and tumor formation in peri-implant tissues. This review outlines pathological changes that reflect pathogenetic mechanisms contributing to implant loosening and other complications in peri-implant tissues.