Metal sensitivity before and after total hip arthroplasty

Deutman, R; Mulder, TJ; Brian, R Waterman; Jp, Nater

doi:10.2106/00004623-197759070-00004

Cited by 166 publications

(62 citation statements)

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“…The guinea pig has classically been the animal of choice for modeling human allergy and has been studied quite thoroughly as an excellent model for chromium hypersensitivity and contact dermatitis (Polak et al 1973). However, it would appear that the guinea pig can be sensitized to nickel only with great difficulty if at all (Turk & Parker 1977). Furthermore, the guinea pig has not served as a model for orthopedic surgery.…”

Section: Discussionmentioning

confidence: 99%

“…However, the contribution of this metal sensitivity to such complications is still con-0001-6470/80/030403-09$02.50/0 troversial; whether or not and for how long sensitive individuals can accept metal appliances is still open to question. Some claim there is no problem (Fisher 1973(Fisher , 1977, while others will deviate from their usual implant material selection so as to avoid implanting appliances with one or more metal alloy constituents to which the patient is sensitive (Deutman et al 1977). Certainly sensitivity is not the cause of all problems, although in some cases it may be a major factor.…”

mentioning

confidence: 99%

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Tissue Reaction and Metal Sensitivity:An Animal Study

Merritt

Brown

1980

Acta Orthopaedica Scandinavica

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Tissue Reaction and Metal Sensitivity:An Animal Study

Merritt

Brown

1980

Acta Orthopaedica Scandinavica

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“…In a study involving 50 patients, the prevalence of metal sensitivity in patients with unexplained loosening of implants was 73.7%, which is significantly higher than 14.8% in those with stable implants [47]. Other small studies support this association [42,48]. On the other hand, Brown et al [49] studied patients (n=20) with sterile, loose MoM McKee-Farrar hip replacements and found that none had positive patch test results and that the biopsy specimen from the surrounding tissue in the 17 patients who had revision surgery showed no histological evidence of metal hypersensitivity [49].…”

Section: Orthopedic Implantsmentioning

confidence: 95%

Hypersensitivity Reactions to Implanted Metal Devices: Facts and Fictions

2016

J Investig Allergol Clin Immunol

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The use of metals in the medical field has become increasingly prevalent over the past few decades. Patients find themselves being exposed to metals in a variety of ways, ranging from external exposure to instruments such as the stainless steel in surgical blades to internal exposure via medical devices being implanted in their bodies. There has been growing interest in the possibility of developing hypersensitivity reactions to constituent metals in medical implant devices, both in cutaneous and systemic forms. Hypersensitivity reactions to metals are uncommon, but they are reported and require appropriate evaluation and management, particularly if they are symptomatic. In view of the lack of consensus in the field on the appropriate steps to evaluate and manage patients with suspected metal hypersensitivity reactions, this review aims to analyze current evidence on hypersensitivity reactions to metallic implants in orthopedic surgery, endovascular surgery, obstetrics and gynecology, and dental surgery. Key words: Metal hypersensitivity. Metallic implants. ResumenEl empleo de metales dentro de la medicina ha ido aumentando de forma progresiva en las últimas décadas. Los pacientes se exponen a metales de diferentes formas desde fuentes externas, como instrumental quirúrgico como el presente en las hojas de acero de los bisturíes, hasta implantes metálicos. Como consecuencia de ello se está produciendo un interés creciente por la posibilidad de desarrollar reacciones de hipersensibilidad a metales presentes en los materiales y objetos implantados, tanto en forma de reacciones cutáneas como sistémicas. Las reacciones de hipersensibilidad a metales no son frecuentes, pero pueden desarrollarse, y por ello, requieren de un diagnóstico y tratamiento adecuado, especialmente en aquellos pacientes que desarrollen síntomas. No existe un consenso en el proceso diagnóstico ni en el tratamiento de estas reacciones en los pacientes con sospecha de alergia a metales. Esta revisión tiene por objeto actualizar la evidencia existente sobre las reacciones de hipersensibilidad a implantes metálicos en cirugía ortopédica, cirugía endovascular, cirugía obstétrica y ginecológica (OB-GYN) así como la dental. Palabras clave: Hipersensibilidad a metales. Implantes metálicos.

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“…1,3,4,8,12,13,16,44,45 Polymers provide a low-friction surface for articulation as well as some degree of "shock absorption." 67 Metals provide a base of support for the polymer surfaces as well as a surface for fixation to bone to be done.…”

Section: Biomaterials Used In Joint Replacementmentioning

confidence: 99%

“…When this degradative process is severe enough it can damage the structural integrity of the implant, and corrosion products are potentially toxic. 1,[5][6][7]9,14,16,18,24,33,37,46,49,50,56,57,[59][60][61][62][63][64]70 Disc replacement designs incorporate cobalt-chromium-molybdenum alloy endplates that are externally coated with titanium for bone ingrowth. The metallic endplates are fixed to polymeric cores and motion takes place between articulating polymer surfaces.…”

Section: Biomaterials Used In Joint Replacementmentioning

confidence: 99%

The future of spinal arthroplasty: a biomaterial perspective

Oskouian

Whitehill²,

Samii³

et al. 2004

FOC

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Both total hip and knee arthroplasty have demonstrated outstanding clinical results. The functional spinal unit composed of the intervertebral disc and facet joints is at least as complex. The intricacies of the coupled motions of the functional spinal unit have made development of an artificial disc a challenge. There have been several failed attempts to create a disc replacement that recapitulates normal motion while providing significant longevity and a low incidence of complications. Better understanding of the biomechanics of the intervertebral disc complex and improvements in implant material have made successful intervertebral disc replacement a likely reality, now that several artificial discs have completed Food and Drug Administration clinical trials. In this manuscript the authors detail the biomaterials used in disc arthroplasty and discuss joint wear and the host response to wear debris.

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Metal sensitivity before and after total hip arthroplasty

Cited by 166 publications

References 0 publications

Tissue Reaction and Metal Sensitivity:An Animal Study

Tissue Reaction and Metal Sensitivity:An Animal Study

Hypersensitivity Reactions to Implanted Metal Devices: Facts and Fictions

The future of spinal arthroplasty: a biomaterial perspective

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