Orthopaedic joint implants and osteosynthetic materials are progressively being employed more often. Complications mainly include physical-mechanical problems and infections. Uncommonly, allergic reactions to an alloy metal or a bone cement component have been implicated. Less attention has been paid to the components of bone cement, such as acrylate, catalysers (e.g. peroxide), additive polymers or stabilisers. An important bone cement component is benzoylperoxide (BPO), an initiator of the process enhancement of the bone cement. Vitiligo is an acquired, progressive depigmenting disorder that can induce autoimmune diseases. The occurrence of vitiligo in combination with an infection or allergy is not well described, and this manuscript highlights the possibility of an occurrence of a vitiligo whenever the immunesystem is activated and T-cell activation is observed. The aim of this article was to analyze the diagnosis and management of vitiligo and allergic complications from orthopaedic joint implants due to benzoyl-peroxide and relevant patents.
Allergies against bone cement or bone cement components have been well-described. We report on a 63-year-old patient who presented with progressive vitiligo all over the body after implantation of a cemented total knee replacement. A dermatological examination was performed and an allergy to benzoyl peroxide was found. A low-grade infection was diagnosed 5 months after implantation of the total knee replacement and the prosthesis was replaced with a cement spacer. After treating the infection of the knee replacement non-cemented arthrodesis of the knee was performed. In cases of new, unknown skin efflorescence, urticaria and periprosthetic loosening of cemented joint replacement, the differential diagnosis should include not only infections but also possible allergies against bone-cement and components such as benzoyl peroxide or metal components.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.