Tissues adjacent to orthopedic implants in humans exhibit an exhausted T cell phenotype. (a) H&E staining and CD45 immunohistochemistry analysis of tissues adjacent to orthopedic implants. Scale bar, 50 μm. (b-f) Proportions of various immune cells in tissues (“local” means tissue adjacent to an implant) based on flow cytometry: (b) leukocytes (CD45+), (c) myeloid cells (CD11b+), (d) monocytes/macrophages (CD11b+CD14+), (e) neutrophils (CD11b+CD15+), (f) dendritic cells (CD11b+CD11c+). (g) Immunohistochemistry analysis of PD-1 expression. (h-q) Flow cytometry images and corresponding quantitation of PD-1 expression in (h, i) T cells, (j, k) myeloid cells, (l, m) monocytes/macrophages, (n, o) neutrophils, and (p, q) DCs. (r–t) Concentrations of the inflammatory cytokines TNF-α (r), IL-1β (s), and IL-6 (t). Data are mean ± SEM (n=6–10). *P<0.05, **P<0.01, ***P<0.005, ****P<0.001 by Student`s t-test.