. Author manuscript; available in PMC: 2015 Apr 8.

Published in final edited form as: Acta Biomater. 2014 Feb 10;10(6):2354–2366. doi: 10.1016/j.actbio.2014.02.003

Table 4.

Histopathological differences associated with type of prosthesis.

Type of fixation	cemented [18,24,35,41,42,48,50,52,62,74,77,82,90,91,100,106,120]	- abundance of macrophages, greater histiocytic reaction
Type of fixation		- well-developed synovial-like interface membrane
		- wear debris
	cementless [28,40–42,47,52,61,62,66,74,82,88]	- organized fibroblastic tissue
	cementless [28,40–42,47,52,61,62,66,74,82,88]	- fibroblasts forming bundles or sheets associated with collagen fibrils
Articulation surface	metal-on-metal [29,30,47,70,92,93,89,104,111,113,122,127,128,130– 132,134]	- more ulcerated, granulomatous pseudotumors and connective tissue necrosis
		- perivascular and diffuse lymphocytic infiltration
		- predominantly T lymphocytes
		- macrophages phagocytosing metallic wear-debris particles
	metal-on-polyethylene [38,63,93,94,133,135]	- predominantly histiocytic inflammation, loose connective tissue, fibrous and syno- vial cells
	ceramic-on-ceramic [58,94,112]	- necrosis, abundance of macrophages, neutrophils and lymphocytes
	ceramic-on-ceramic [58,94,112]	- particles in agglomerates
	ceramic-on-polyethylene [92,132]	- lower degree of diffuse perivascular lymphocytic infiltration than in metal on metal bearing
		� extensive necrosis