Wound drainage after metal-on-metal hip arthroplasty secondary to presumed delayed hypersensitivity reaction.
An emerging concern with metal-on-metal total hip arthroplasty is metal-induced hypersensitivity. Currently, this is a diagnosis of exclusion in patients with groin pain after metal-on-metal total hip arthroplasty. We describe a patient presenting nearly a year after arthroplasty with incisional drainage. Infection was presumed; but preoperative studies were nondefinitive, and the wound was explored. The operative cultures were negative; the histology revealed lymphocytic vasculitis. The patient recovered uneventfully after exchange to a metal polyethylene bearing couple. We believe that metal-induced hypersensitivity should be considered with draining wounds with this bearing couple if infection cannot be proven.
Department of Orthopedics, Marshfield Clinic–Weston Center,Weston, Wisconsin 54476, USA.
Mark D
MD
Earll
Patrick G
PG
Earll
Russell S
RS
Rougeux
D019644:Arthroplasty, Replacement, Hip; D005260:Female; D006622:Hip Prosthesis / Q000009:adverse effects*; D006801:Humans; D006968:Hypersensitivity, Delayed / Q000209:etiology*; D008670:Metals; D008875:Middle Aged; D011474:Prosthesis Design; D013529:Surgical Wound Dehiscence / Q000209:etiology*
D008670:Metals