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Metal-on-Metal Bearings pp 109–133Cite as

Wound Healing, Chronic Inflammation, and Immune Responses

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Abstract

The biocompatibility of orthopedic materials impacts the processes of wound healing, chronic inflammation, and immune responses. Metal alloys within the body present a complex problem, since they may take the form of solid components, particulate metal debris, and metallic ions. Biological responses to metals in particulate form share much in common with other stimuli of the inflammatory response, but metal ions have the capacity to both exert direct effects on cells and provoke the development of an immunological reaction. While wound healing, chronic inflammation, and the immune response share numerous common mediators and pathways, there are subtle variations between the processes that will influence the eventual biological resolution of any orthopedic biomaterial. The pathways pertinent to these basic responses are under genetic regulation, meaning that the precise reaction of any given patient to a particular biomaterial is difficult to predict. This chapter will review the primary pathways in cellular biology that regulate wound healing, inflammation, and immunity, with a particular focus upon common mediators that interact between the systems. We will further examine the current state of knowledge of the influence of metal in its various forms on these biological processes.

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Acknowledgment

Dr. Wooley is the Chief Scientific Officer of the National Center of Innovation for Biomaterials in Orthopaedic Research, inventor of the ArthrollergenTM biomaterial sensitivity test, consultant to Stryker Orthopaedics, Inc., and consultant to the legal representatives of Depuy, Inc. Dr. Wooley receives no financial benefit for these activities.

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Authors and Affiliations

  1. University of Kansas Medical School, Wichita, KS, USA

    Paul H. Wooley

  2. Orthopedic Analysis LLC, Chicago, IL, USA

    Nadim J. Hallab

  3. BioEngineerng Solutions Inc., Oak Park, IL, USA

    Nadim J. Hallab

  4. Department of Orthopedic Surgery, Rush University, 60612, Chicago, IL, USA

    Nadim J. Hallab

Authors
  1. Paul H. Wooley
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  2. Nadim J. Hallab
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Correspondence to Paul H. Wooley .

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Editors and Affiliations

  1. Department of Orthopaedic Surgery, Johns Hopkins University, Baltimore, USA

    Lynne C. Jones

  2. Department of Biomedical Engineering, University of Memphis, Memphis, Tennessee, USA

    Warren O. Haggard

  3. Orthopaedic Research Laboratories Lutheran Hospital, Cleveland Clinic, Cleveland, Ohio, USA

    A. Seth Greenwald

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Wooley, P., Hallab, N. (2014). Wound Healing, Chronic Inflammation, and Immune Responses. In: Jones, L., Haggard, W., Greenwald, A. (eds) Metal-on-Metal Bearings. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-8999-3_7

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