Abstract
BackgroundThe aim of the study was to examine the reactivity of peripheral human leukocytes to various metal ions prior and following hip replacement in order to investigate implant-induced metal sensitivity.MethodsThree patient groups were set up: (1) individuals without implants and no history of metal allergy (7 cases), (2) individuals without implants and known history of metal allergy (7 cases), and (3) patients undergoing cementless hip replacement (40 cases). Blood samples were taken in groups 1 and 2 at three different occasions; in group 3, prior and 3, 6, 12, 24, and 36 months after surgery. Peripheral leukocytes were separated and left either untreated or challenged with Ti, NiCl2, CoCl2, CrCl3, and phytohemagglutinin. Cell proliferation, cytokine release, and leukocyte migration inhibition assays were performed. Metal-induced reactivity was considered when all three assays showed significant change. Skin patch tests were also carried out.ResultsBoth skin patch tests and leukocyte functional tests were negative in group 1, and both were positive in group 2. In group 3, after 6 months, 12% of the patients showed reactivity to the tested metals except for NiCl2. Following the 36-month period, 18% of group three became sensitive to metals (including all the earlier 12%). In contrast, patch tests were negative at each time point in group 3.ConclusionsOrthopedic implant material may induce metal reactivity after implantation in a manner where susceptibility is yet to be elucidated. Leukocyte triple assay technique might be a useful tool to test implant material-related sensitivity.
Highlights
The aim of the study was to examine the reactivity of peripheral human leukocytes to various metal ions prior and following hip replacement in order to investigate implant-induced metal sensitivity
Our aim was to examine the reactivity of human leukocytes to various metals before and after hip replacement and detect possible implant-induced metal reactivity/allergy in a prospective manner
Patient groups Three patient groups were established: (1) age-matched patients without any implant and no history of metal allergy tested via skin patch test analysis (7 cases: 4 male, 3 female, average age: 59 years), (2) age-matched patients without any implant with a positive history of metal hypersensitivity analyzed by skin patch test (7 cases: 3 male, 4 female, average age: 62 years), and (3) patients undergoing cementless hip replacement with no history of metal allergy prior the surgery (40 cases: 20 male, 20 female, average age: 61 years) analyzed by skin patch testing and leukocyte functional testing
Summary
The aim of the study was to examine the reactivity of peripheral human leukocytes to various metal ions prior and following hip replacement in order to investigate implant-induced metal sensitivity. Joint replacement has become a routine procedure, over 1 million performed annually worldwide. The predominant components of orthopedic implant materials are various metals. The up-to-date metal alloy endoprostheses have great biomechanical and biocompatible properties. Undergo corrosion, and various degradation products are released including metal ions [1,2]. These molecules can activate the immune system as haptens by forming complexes with naturally occurring proteins. Metal–protein complexes are potential antigens inducing hypersensitivity responses
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
