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ARTICLE TYPE : REVIEW ARTICLE

Published on :   08 Nov 2025, Volume - 1
Journal Title :   WebLog Journal of Orthopaedics | WebLog J Orthop
Source URL:   weblog iconhttps://weblogoa.com/articles/wjor.2025.k0802
Permanent Identifier (DOI) :  doi iconhttps://doi.org/10.5281/zenodo.17655518

The Role of Human Leukocyte Antigens in Orthopaedics: Clinical Relevance from Autoimmune Joint Disorders to Implant Compatibility

Dr. Bikram Kesari Kar 1
Dr. Punit Gaurav 2 *
Dr. Himanshu 2
Dr. Neeraj Khare 2
Dr. Dushyant Chouhan 3
1Additional Professor, Department of Orthopaedics, All India Institute of Medical Sciences (AIIMS), Raipur, India
2Senior Resident, Department of Orthopaedics, All India Institute of Medical Sciences (AIIMS), Raipur, India
3Assistant Professor, Department of Orthopaedics, All India Institute of Medical Sciences (AIIMS), Raipur, India

Abstract

Background: The human leukocyte antigen (HLA) system is central to immune recognition, orchestrating the distinction between self and non-self-antigens. Its significance in orthopaedics has gained increasing attention due to its involvement in autoimmune disorders, tissue transplantation, and implant-related complications.

Methods: This review synthesises evidence from published literature on the structure, function, and polymorphism of HLA genes located on chromosome 6, with emphasis on their clinical relevance in musculoskeletal disorders, bone and tissue transplantation, and implant hypersensitivity.

Results: Specific HLA alleles demonstrate strong associations with autoimmune musculoskeletal conditions such as rheumatoid arthritis (HLA-DRB1) and ankylosing spondylitis (HLA-B27), offering value in diagnosis, prognostication, and surgical risk stratification. In transplantation, preoperative HLA typing facilitates donor–recipient matching, reducing graft rejection and improving long-term survival. Implant-related reactions, particularly to metal alloys, have been linked to HLA polymorphisms, with certain alleles predisposing patients to aseptic loosening, osteolysis, and soft tissue injury. Advances in genetic profiling suggest that HLA typing can enhance personalised care by guiding material selection, surgical planning, and immunomodulatory interventions.

Conclusion: The HLA system underpins many clinically relevant processes in orthopaedics, from autoimmune pathogenesis to transplant survival and implant biocompatibility. Incorporating HLA typing into orthopaedic practice provides opportunities for precision medicine, enabling tailored therapeutic strategies, improved patient outcomes, and reduced implant-related morbidity.

Keywords: Human Leucocyte Antigen; Ankylosing Spondylosis; Rheumatoid Arthritis; Spondyloarthropathy; Autoimmune Disease; HLA Typing; Orthopaedics

Citation

Kesari Kar B, Gaurav P, Himanshu, Khare N, Chouhan D. The Role of Human Leukocyte Antigens in Orthopaedics: Clinical Relevance from Autoimmune Joint Disorders to Implant Compatibility. WebLog J Orthop. wjor.2025.k0802. https://doi.org/10.5281/zenodo.17655518
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