Cookies on this website
We use cookies to ensure that we give you the best experience on our website. If you click 'Continue' we'll assume that you are happy to receive all cookies and you won't see this message again. Click 'Find out more' for information on how to change your cookie settings.
Skip to main content

Despite the clinical effectiveness ofjoint 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.

Original publication




Journal article


Journal of long-term effects of medical implants

Publication Date





193 - 206


Department of Pathology, Nuffield Department of Orthopaedic Surgery, University of Oxford, Nuffield Orthopaedic Centre, Oxford.


Humans, Prosthesis-Related Infections, Soft Tissue Neoplasms, Prosthesis Failure, Arthroplasty