Immune response in adverse reactions to metal debris following metal-on-metal total hip arthroplasty

BMC Musculoskeletal Disorders

Research Article

Akihiro Sudo¹  Takahiro Iino¹  Masahiro Hasegawa¹ 

[1] Department of Orthopaedic Surgery, Mie University Graduate School of Medicine, 2-174 Edobashi, 514-8507, Tsuv, Mie, Japan;

关键词: Adverse reaction to metal debris;    Metal hypersensitivity;    Metal-on-metal;    Total hip arthroplasty;   

DOI  :  10.1186/s12891-016-1069-9

 received in 2015-11-27, accepted in 2016-05-11,  发布年份 2016

来源: Springer

【 摘 要 】

BackgroundThe purpose of the present study was to determine whether T cell-mediated type IV hypersensitivity reactions could be a major cause of adverse reaction to metal debris (ARMD) after metal-on-metal total hip arthroplasty (THA).MethodsThirteen patients (1 man and 12 women; mean age 68 years, age range 60 to 83 years) with ARMD underwent revision surgery following metal-on-metal THA (15 hips). Lymphocyte stimulation testing was conducted. Periprosthetic tissue specimens underwent immunohistochemical studies.ResultsLymphocyte stimulation testing showed that five patients were nickel-sensitive, and one patient was also cobalt-sensitive. Immunohistochemical studies showed that T cells were dominant in five hips, and B cells were dominant in 10 hips. In four of the five patients with a positive lymphocyte stimulation test, the dominant lymphocytes were T cells, suggesting type IV hypersensitivity. The major cause of ARMD was not type IV hypersensitivity in the remaining nine patients.ConclusionMetal hypersensitivity does not appear to be the dominant biological reaction involved in the occurrence of ARMD.

【 授权许可】

CC BY   
© Hasegawa et al. 2016