“…When the membrane surrounding loose components is examined microscopically, plastic and metallic debris are found associated with a foreign body reaction with histiocytes, giant cells and lymphocytes embedded in a fibrous tissue stroma (Heilmann et al 1975, Vernon-Roberts and Freeman 1976, Willert and Semlitsch 1977, Mirra et al 1982, Goldring et al 1983, Linder et al 1983, Johanson et al 1987, Maguire et al 1987, Appel et al 1988, Schmalzried et al 1992. The adverse biological effects of polymethylmethacrylate (PMMA) in particulate form have been intensively investigated both in vitro and in vivo , Horowitz et al 1988, Davis et al 1989, Herman et al 1989, Davis et al 1990, Goodman and Chin 1990. Recently, the role of polyethylene debris in potentiating the process of prosthetic loosening has been emphasized , Howie et al 1988, Campbell et al 1990, Willert et al 1990, Fomasier et al 1991, Santavirta et al 1991, Schmalzried et al 1992.…”