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Related Experiment Videos

Metal sensitivity in patients undergoing hip replacement. A prospective study

G D Rooker, J D Wilkinson

    The Journal of Bone and Joint Surgery. British Volume
    |November 1, 1980
    PubMed
    Summary

    Routine patch testing for metal sensitivity is not required before metal-on-plastic total hip replacement. This study found no increased metal sensitivity after these procedures, suggesting sensitivity may follow loosening, not cause it.

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    Area of Science:

    • Orthopedic Surgery
    • Dermatology
    • Biomaterials Science

    Background:

    • Allergic contact dermatitis is a concern with metal implants.
    • Metal sensitivity is documented with metal-on-metal prostheses.
    • The relationship between metal sensitivity and hip implant loosening is debated.

    Purpose of the Study:

    • To investigate the incidence of allergic contact dermatitis and metal sensitivity following metal-on-plastic total hip replacement.
    • To determine if routine pre-operative patch testing is necessary for metal-on-plastic hip arthroplasty.

    Main Methods:

    • Prospective study of 69 patients undergoing metal-on-plastic total hip replacement.
    • Assessment of pre- and post-operative metal sensitivity through patch testing.
    • Clinical review of patients for surgical outcomes and implant loosening.

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    Main Results:

    • No increased cutaneous metal sensitivity was detected post-operatively in patients receiving metal-on-plastic prostheses.
    • Only one patient with pre-existing metal sensitivity remained sensitive after surgery, using a titanium implant.
    • No cases of implant loosening occurred in the study group.

    Conclusions:

    • Metal-on-plastic total hip replacement does not appear to induce new metal sensitivity.
    • Routine pre-operative patch testing for metal sensitivity may not be necessary for metal-on-plastic hip arthroplasty.
    • Cutaneous metal sensitivity might be a consequence, rather than a cause, of implant loosening.