It has long been known that the body provides a hostile environment to implants made of supposedly inert plastics, metals and alloys. The tissue response to implanted materials covers a wide range of inflammation, hyperplasia and occasionally, even neoplasia. The response would depend on the physico-chemical characteristics of the implant and host factors, such as the kind of tissue, site of implantation and the animal species receiving the implant. Even when an implant is linked firmly to the host and remains functional like a prosthetic joint or heart valve, it should be noted that the connection at the tissue-material interface is no more than a smooth mechanical linkage by collagen and not a union at the molecular level. This is precisely what makes the tissue material interface in all tissues—soft and hard, vulnerable to implant failure.

However, the success story of implants is undeniable; their use has exploded and impinged on practically every speciality in surgery; they account for a multi-billion dollar global industry, which continues to grow; their research and development has become a major discipline in science and technology with societies, journals and an extensive literature. In spite of these striking developments, the absence of an atlas on the manifold tissue responses to prosthetic materials, highlighting wide-ranging histopathological changes has been a glaring deficiency. There is little doubt that such a publication will be highly useful not only to the pathologist who studies the slides from tests of newer materials but also to the medical and veterinary scientists, toxicologists, engineers and others who are involved in the making of the implants story. It is the gap, which Dr Mira has sought to fill by preparing the present atlas based on her vast experience at the Sree Chitra Tirunal lnstitute, Thiruvananthapuram, Kerala, India. A highly competent pathologist, Dr Mira set up her Division of Implant Biology at the Chitra Institute three decades ago when few such Divisions existed in the world. It received plenty of tissue samples and case histories from the Devices Laboratories as well as the Hospital of the Institute, which provided a rich source of varied material for Dr Mira and her group. Their painstaking study over several years has culminated in this splendid atlas, which begins by a lucid description of the preparation of tissues for microscopy and goes on to deal with implants in soft tissue, implants in bone, preclinical evaluation of biomaterials and devices during research and development (R&D), study of retrieved implants and finally, experimental artifacts, which can complicate the interpretation of slides. Each chapter is profusely illustrated with excellent photographs and graphic descriptions, which will benefit investigators and students of this new branch of pathology, which will grow in proportion to the steady expansion in the range and variety of new implants.

Dr Mira and her colleagues deserve our thanks for their admirable effort in preparing this valuable and much-needed atlas.

Books on biomaterial science abound with details regarding different materials, their physical and chemical characteristics and their interactions with tissue. However, visual detail is what is most informative for the material scientist. This is brought forth in this atlas, which is a collection of gross features and photomicrographs of events taking place at the material-tissue interface. The book brings to the reader first hand details regarding the sequence of events that occur in different tissues following implantation of different types of material. It informs the young researcher briefly of the common procedures used in the laboratory for preparation of tissues for microscopy, how to identify different cells in tissues, and how to assess responses elicited in tissues, essentially how to evaluate whether a material is compatible with tissues or not.

Our laboratory is a nodal laboratory for receiving different types of tissues for assessment of suitability of different types of materials for medical devices. We feel that it is appropriate that this laboratory provides a means to educate students and researchers in material science about the morphological features and changes identified over a time period post-implantation.