Polyethylene wear debris and the cellular response in periprosthetic tissues from 19 failed total knee replacements (TKR) was compared to that from 24 failed total hip replacement prostheses (THR) using polarized microscopy and a semiquantitative grading system. The foreign body inflammatory reaction in the THR cases was characterized by plump macrophages with a diffuse cytoplasmic birefringence when examined under polarized light. In TKR cases, the inflammatory reaction was characterized by giant cells with fewer macrophages. The size distribution of the PE wear particles in the two cases were also determined.
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