Related Experiment Video
Updated: Jul 20, 2026
04:37
A Periprosthetic Joint Candida albicans Infection Model in Mouse
Published on: February 2, 2024
Implant-related inflammatory arthritis
Thomas Dörner1, Judith Haas, Christoph Loddenkemper
1Coagulation Unit, Institute of Transfusion Medicine, Charité University Medicine, Berlin, Germany. thomas.doerner@charite.de
Nature Clinical Practice. Rheumatology
|August 26, 2006
Summary
A patient developed inflammatory arthritis after a titanium implant. Treatment involved medication and replacing the implant, resolving the symptoms.
Area of Science:
- Orthopedic surgery
- Rheumatology
- Biomaterials science
Background:
- A 54-year-old woman experienced joint pain and stiffness after receiving a titanium alloy C cage implant for disc prolapse.
- Symptoms of inflammatory arthritis emerged 1.5 years post-implantation, with no prior rheumatic history.
Purpose of the Study:
- To investigate the potential link between a titanium implant and the development of inflammatory arthritis.
- To identify the causative agent and effective treatment for implant-related arthritis.
Main Methods:
- Comprehensive diagnostic workup including physical examination, radiography, biopsies (skin and muscle), and extensive serological testing.
- Specific tests included HLA genotyping, tumor necrosis factor release assay, skin patch test, and lymphocyte transformation test to assess immune response and hypersensitivity.
Main Results:
- The patient was diagnosed with implant-related inflammatory arthritis.
- Successful management was achieved through a combination of corticosteroids, disease-modifying antirheumatic drugs (DMARDs), and nonsteroidal anti-inflammatory drugs (NSAIDs).
- Surgical intervention involved replacing the titanium-vanadium-aluminum alloy implant with a polyetherketone cage, leading to symptom resolution.
Conclusions:
- Titanium implants, specifically the titanium 6-aluminum 4-vanadium alloy, can potentially trigger inflammatory arthritis in susceptible individuals.
- Prompt diagnosis and a multi-modal treatment approach, including implant removal or replacement, are crucial for managing implant-related inflammatory arthritis.
Related Concept Videos
01:12Chronic Inflammation: Introduction
Chronic inflammation is a prolonged, dysregulated immune response that persists for weeks to years when the inciting stimulus is difficult to eradicate or when self‑antigens drive ongoing reactivity. Morphologically, it is defined by mononuclear cell infiltration, progressive tissue destruction, and concurrent attempts at healing via angiogenesis and fibrosis. Compared with acute inflammation, edema is less prominent while cellular infiltration predominates; triggers include persistent...
01:25Inflammatory Bowel Disease III: Crohn's Disease
Crohn’s disease is a chronic, relapsing form of inflammatory bowel disease characterized by segmental, transmural inflammation that can affect any part of the gastrointestinal tract. Its pathogenesis arises from a combination of genetic susceptibility, environmental exposures, epithelial barrier dysfunction, and immune dysregulation. Together, these factors lead to an exaggerated immune response against components of the gut microbiome.Genetic and Environmental InfluencesMultiple genetic...
01:30Inflammatory Bowel Disease II: Crohn's Disease
Introduction
Inflammatory bowel disease, commonly known as IBD, refers to a collection of disorders that lead to persistent inflammation of the gastrointestinal tract. The two types of IBD are ulcerative colitis, which impacts the colon, and Crohn's disease, which can involve any part of the gastrointestinal segment.
Crohn's disease
Crohn's disease is a chronic, systemic inflammatory bowel disease (IBD) that predominantly affects the gastrointestinal tract. It is marked by transmural...
Inflammatory bowel disease, commonly known as IBD, refers to a collection of disorders that lead to persistent inflammation of the gastrointestinal tract. The two types of IBD are ulcerative colitis, which impacts the colon, and Crohn's disease, which can involve any part of the gastrointestinal segment.
Crohn's disease
Crohn's disease is a chronic, systemic inflammatory bowel disease (IBD) that predominantly affects the gastrointestinal tract. It is marked by transmural...
01:26Acute Inflammation I: Inflammatory Response
Acute inflammation is a rapid, short-lived physiological response to tissue injury or infection, designed to eliminate harmful agents and initiate repair. This tightly regulated process typically lasts from minutes to several days and is triggered by factors such as microbial invasion, physical trauma, or chemical injury.Recognition and Mediator ReleaseThe inflammatory response begins when resident immune cells—such as mast cells, macrophages, and dendritic cells—detect damage-associated...
01:26Inflammatory Bowel Disease I: Introduction
Inflammatory bowel disease is a group of chronic disorders marked by recurrent inflammation of the gastrointestinal tract due to an abnormal immune response against gut microflora. This leads to tissue damage. The two main forms are Crohn’s disease and ulcerative colitis.Crohn’s DiseaseCrohn’s disease is a relapsing inflammatory disorder that can affect any part of the GI tract, from the mouth to the anus. It involves all layers of the bowel wall (transmural) and shows “skip lesions” in which...
01:20Inflammatory Bowel Disease II: Ulcerative Colitis
Ulcerative colitis is a chronic inflammatory disorder of the colon characterized by continuous mucosal inflammation that typically begins in the rectum and extends proximally in a uniform pattern. Its pathogenesis involves a complex interplay of genetic predisposition, immune dysregulation, and environmental influences. These factors converge to impair the colon’s epithelial defenses and promote an exaggerated inflammatory response against luminal contents.Breakdown of the Mucosal BarrierA...