[The significance of immunology in orthopaedics today]

Within the last years, basic science in immunology has been able to extensively increase the knowledge about the pathogenesis of many diseases. Although much hesitation persists, it has been possible to develop new immunomodulatory strategies which have proven their efficiency and safety in a number of clinical studies. Prior to that, a large number of in vitro and in vivo investigations have established a knowledge base for the development of drugs used in clinical settings. In orthopedic diseases, these immunomodulatory strategies are directed mainly towards the treatment of rheumatoid arthritis and osteoarthritis. Furthermore, immunotherapeutic approaches to bone and soft tissue tumor/metastasis has been improved and we expect first clinical results soon. Moreover, improvement of our understanding of the pathogenesis of inflammation occurring in various diseases, such as aseptic loosening of endoprostheses might help identify a whole field of orthopedic problems as a target for immunomodulatory therapies. In this review, recent developments and applications of immunomodulation in orthopedics will be discussed and a view into the future of such therapies will be given.