Adverse reactions to metal orthopedic implants after knee arthroplasty

Abstract

Based on several clinical examples, the range of adverse or hypersensitive reactions to metal implants especially after total knee replacement are presented. In general, we found the patients to generally be women who present with pain, swelling, and local or generalized eczema. Some also present with early aseptic loosening mainly in the first 4years after implantation. For these patients, adetailed allergy-specific history should be taken and apatch test should be performed; if necessary, blood ion levels should be evaluated to exclude cobaltism. Before revision surgery and exchange of the implant we always perform arthroscopic inspection to obtain biopsies for microbiology and histopathology. Using the Consensus Classification agood evaluation for planning revision with the different implant options is possible.