More on Reaction to a Foreign Body after Hip Replacement

To the Editor: Péoc'h and colleagues (July 11 issue) 1 reported a systemic granulomatous reaction to a foreign body after a hip replacement. We recently reported a case of a sarcoid-like reaction to particulate debris from a failed total knee replacement in an ipsilateral inguinal lymph node and in periprosthetic tissue. 2 The tissue had a pathological appearance similar to that reported by the authors. The potential for systemic dissemination of degradation products from joint-replacement components is well known. 3 One should be cautious, however, about identifying particulate material within tissues with the use of light-microscopical techniques alone. The composition of metallic and . . .