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Metal sensitivity causing loosened joint prostheses

K Christiansen, K Holmes, P J Zilko

    Annals of the Rheumatic Diseases
    |October 1, 1980
    PubMed
    Summary
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    Patients with failed joint prostheses showed significantly higher metal sensitivity compared to controls. This suggests cell-mediated immunity to metals may contribute to prosthesis failure and could aid in diagnosis.

    Area of Science:

    • Orthopedic Surgery
    • Immunology
    • Biomaterials Science

    Background:

    • Joint prostheses can fail due to various reasons, including mechanical issues and biological responses.
    • Metal hypersensitivity is a potential, yet often overlooked, factor in adverse reactions to implants.

    Purpose of the Study:

    • To investigate the correlation between in-vitro metal sensitivity and joint prosthesis failure.
    • To assess the diagnostic potential of lymphocyte transformation assays for metal sensitivity in patients with failed prostheses.

    Main Methods:

    • Evaluated in-vitro metal sensitivity using lymphocyte transformation assays.
    • Measured lymphocyte response to chromium, cobalt, and nickel in peripheral blood lymphocytes.
    • Compared metal sensitivity in patients undergoing revision surgery for prosthesis failure versus controls with successful prostheses.

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    Main Results:

    • 71% of patients with failed joint prostheses exhibited positive in-vitro metal sensitivity.
    • Only 9% of patients with successful prostheses showed positive metal sensitivity (P < 0.01).
    • A significant positive correlation was observed between prosthesis failure and in-vitro metal sensitivity.

    Conclusions:

    • Cell-mediated immunity to implant metals may play a role in joint prosthesis failure.
    • In-vitro metal sensitivity testing shows promise as a diagnostic tool for prosthesis failure.
    • This assay could help identify patients at risk or experiencing adverse reactions to metal implants.