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Advancements in prosthesis design are therefore essential, as the best current protective measure is well-produced implants with a low wear rate, reducing the particle load in the patient's tissues and also the potential for secondary sensitization.
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Such nonassociative and activity-dependent sensitization of convergent pathway mediating allodynia lends further support for our definition of secondary sensitization as a generic mode of nonassociative learning in neural pathways (Sect. 2.2.2).
Desensitization (converse of secondary sensitization) is distinguished from habituation (converse of primary sensitization) by the explicit expression of memory rebound and recovery effects in the post-stimulation response [37].
This conjecture is in actuality an oxymoron as the generalization of intrinsic sensitization simply amounts to extrinsic sensitization, both being instances of secondary sensitization.
This secondary hyperalgesic effect is indicative of secondary sensitization or central sensitization involving secondary nociceptive or allodynic pathways, perhaps via wide dynamic range neurons in spinal dorsal horn [ 56].
The notion of secondary sensitization also rectifies another archaic conjecture of the dual-process theory, namely, the so-called "generalization of sensitization" where sensitization to one input may supposedly spread to other inputs [ 9, 10].
Thus, primary and secondary sensitization effectively account for all experimental data that formed the cornerstone of the dual-process theory.
Thus, secondary sensitization satisfactorily accounts for extrinsic sensitization and reconciles the seeming discrepancy with the above-mentioned anomalies [ 48, 54, 55].
Similarly, secondary sensitization is analogous to extrinsic sensitization in that both are expressed for a stimulus different than the sensitizing stimulus, but secondary sensitization is distinguished from primary sensitization by its indirect expression.
However, it is still unknown whether metal allergy prior to implantation may be a risk factor for revision surgery or whether it is a result of implant failure resulting in secondary sensitization (Thyssen et al. 2009a).
Habituation in conjunction with secondary sensitization gives a primary differentiator – secondary integrator pair (Fig. 6A).
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