Lauren Gorelick, Ayala Rozano-Gorelick, Anwar Saab, Edward Ram
Local Tissue Damage as a Possible Trigger to Giant Cell’s Inflammatory Response and Failure Following Trapezectomy and Interposition of Polylactic Acid Arex Trapezium Implant: A Case Report.
Polylactic acid (PLA) braid rolled on itself AREX trapezium implant is a part of surgical treatment in patients with Eaton type III-IV of trapeziometacarpal joint (TM) osteoarthritis. The foreign body reaction composed of macrophages and foreign body giant cells is the end-stage of the inflammatory responses following implantation of the PLA prosthesis. Prolonged resorptive giant cells immune inflammatory response, leading the patients to undergo revision surgery for removal of the implant before the end of the third postoperative year. This article describes a patient after successful implantation of the PLA prosthesis and without record of any autoimmune disease. The patient developed onset acute-on-chronic autoimmune response due to a second-degree burn at site of implantation after physiotherapy. Discussion: On the base of this case, authors make assumption that the onset of the acute-onchronic immune inflammatory response in a previously normal responded patient to biocompatible implant is the results of local tissue damage by external factor like burn. It is possible that other unpredictable factors causes the changes in degradation rate as for example acidosis, infection, trauma and genetic differences.
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