Metal sensitivity causing loosened joint prostheses.
Metal sensitivity, as measured by an in-vitro assay on peripheral blood lymphocytes, was evaluated in patients with failed joint prostheses. Lymphocyte transformation to chromium, cobalt, and nickel was measured in 24 patients having revision surgery for a painful or loose prosthesis and compared with that in 11 patients who had a successful hip prothesis in situ for at least 2 years previously. A positive response (lymphocyte stimulation index greater than 3) to at least one of the metals was found in 71% of the revision group compared to 9% of controls (P < 0.01). The positive correlation between prosthesis failure and in-vitro metal sensitivity suggests that cell-mediated immunity to metals to metals may play a role in prosthesis failure. Furthermore, this simple in-vitro test may provide the basis of a useful diagnostic test for an often difficult clinical problem.
D000368:Aged; D002857:Chromium / Q000009:adverse effects; D003035:Cobalt / Q000009:adverse effects; D005260:Female; D006801:Humans; D006967:Hypersensitivity / Q000209:etiology* / Q000276:immunology; D007595:Joint Prosthesis / Q000009:adverse effects*; D008213:Lymphocyte Activation; D008297:Male; D008670:Metals / Q000009:adverse effects*; D008875:Middle Aged; D009532:Nickel / Q000009:adverse effects
D008670:Metals; D002857:Chromium; D003035:Cobalt; D009532:Nickel