Abstract:Periprosthetic infection and osteolysis caused by infection are the most severe clinical challenges after total hip arthroplasty. As the first line of defense against infection, macrophages can not only play an anti-infection role through phagocytosis, polarization and other ways, but also secrete a variety of active factors to promote the osteogenic differentiation of bone marrow mesenchymal stem cells and realize bone integration. Therefore, in order to simultaneously prevent infection and promote osseointegration after hip arthroplasty, the immune regulation mechanism of macrophages at the prosthesis-bone interface has received extensive attention. This paper reviews the phenotypic transformation, anti-infection and osteogenesis of macrophages in the process of biomaterial implantation, which can provide a theoretical basis for the development of multifunctional prosthesis involving macrophage immune regulation.