[Morphology of the implant site in cemented and uncemented joint implants]

After the insertion of a joint endoprosthesis a healing process is initiated which is comparable to the fracture healing. Thus, a border zone is built up against the implant, being composed of lining cells, connective tissue, vessels, bone marrow and bone. The bone of the implant bed is subjected to a remodeling in order to adapt its structure to the change of the biomechanic stresses. The tissue of the implant bed may react to infection, degradation or wear of the materials and mechanical instability of the fixation as well. The characteristic feature of this reaction is cell and tissue proliferation which causes bone resorption and, possibly, loosening of the implant.