The use of metal implants and joint prosthetics occupy an important place in modern traumatology and orthopedics. With the increasing proportion of surgical methods for treating bone fractures and joint diseases, complications develop more frequently. Along with early and late wound infections, there are various response changes in tissues in the area of the implant of an abacterial nature. The results of clinical and experimental studies in the development of fibro-proliferative, immuno-allergic and granulomatous tissue changes around implants determine the important role of macrophages, fibroblasts, cells of the immune system, the peculiarities of the pathophysiology of which this article is devoted to.