The innate immune system consists of functionally specialized "modules" that are activated in response to a particular set of stimuli via sensors located on the surface or inside the tissue cells. These cells screen tissues for a wide range of exogenous and endogenous danger/damage-induced signals with the aim to reject or tolerate them and maintain tissue integrity. In this line of thinking, inflammation evolved as an adaptive tool for restoring tissue homeostasis. A number of diseases are mediated by a maladaptation of the innate immune response, perpetuating chronic inflammation and tissue damage. Here, we review recent evidence on the cross talk between innate immune sensors and development of rheumatoid arthritis, osteoarthritis, and aseptic loosening of total joint replacements. In relation to the latter topic, there is a growing body of evidence that aseptic loosening and periprosthetic osteolysis results from long-term maladaptation of periprosthetic tissues to the presence of by-products continuously released from an artificial joint.

Department of Clinical Medicine University of Helsinki and ORTON Orthopaedic Hospital of the Invalid Foundation Helsinki Finland

Department of Immunology Faculty of Medicine and Dentistry Palacky University Hnevotinska 3 775 15 Olomouc Czech Republic

Department of Orthopaedic Surgery Stanford University Medical Center Redwood City CA

Department of Orthopedics University Hospital and Faculty of Medicine and Dentistry Palacky University Olomouc 775 20 Czech Republic

Laboratoire de Biomecanique et Biomateriaux Osteo Articulaires UMR CNRS 7052 Faculte de Medecine Universite Paris 7 Paris France; Department of Orthopaedic Surgery European Teaching Hospital Assistance Publique Hopitaux de Paris

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Periprosthetic Osteolysis: Mechanisms, Prevention and Treatment