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Purported symptoms of metallosis generally include pain around the site of the implant, pseudotumors (a mass of inflamed cells that resembles a tumor but is actually collected fluids), and a noticeable rash that indicates necrosis. [1] The damaged and inflamed tissue can also contribute to loosening the implant or medical device.
Macrophages at the implant site fuse to form foreign body giant cells. [6] Following the inflammatory response, granulation tissue form. The end stage of the foreign body reaction is the fibrous capsule formation around the implanted biomaterial. [6] The biocompatibility of the device affects the severity of the foreign body reaction. [7]
Foreign body giant cells are involved in the foreign body reaction, phagocytosis, and subsequent degradation of biomaterials which may lead to failure of the implanted material. [4] When produced, the FBGC's place themselves along the surface of the implantation, and will remain there for as long as the foreign material remains in the body. [1]
Two major types of reaction occur in response to retained surgical foreign bodies. In the first type, an abscess may form with or without a secondary bacterial infection . The second reaction is an aseptic fibrinous response, resulting in tissue adhesions and encapsulation and eventually foreign body granuloma . [ 2 ]
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If surgery fails or the PJI persists despite optimal antibiotic therapy, resection arthroplasty of the hip with a pseudarthrosis (Femoral head ostectomy) is sometimes done. [2] Or in cases of knee PJIs failing treatment; an arthrodesis (artificial induction of ossification of the knee joint) is done. [2]
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In order to remove the bacteria, the implant would have to be removed. Lastly, the immune system may accept the presence of the implant and repair and remodel the surrounding tissue. Similar responses occur when the body initiates an allergic foreign body response. In the case of an allergic foreign body response, the implant would have to be ...