Early Clinical Failure of Total Joint Replacement in Association with Follicular Proliferation of B-Lymphocytes

The long-term clinical results of prosthetic joint replacement have drawn attention to the adverse local and systemic responses to the particulate material that is released from prosthetic components made of metal, polyethylene, or acrylic bone cement. These responses range from inflammatory immune responses to premalignant and malignant changes 1-5. A particle-induced local cellular response is associated with macrophage and foreign-body granulomatous reactions, the development of osteolytic lesions, and the clinical failure of total joint replacements 6-8. Various studies have also demonstrated bone and bone-marrow necrosis, lymphadenopathy, the formation of tumors 9-11, and recently, a systemic granulomatous reaction (in the liver, spleen, and lymph nodes) to prosthetic particles in patients managed with total hip replacement 12.