Immune response in adverse reactions to metal debris following metal-on-metal total hip arthroplasty.
BMC Musculoskelet Disord
; 17: 221, 2016 05 21.
Article
in En
| MEDLINE
| ID: mdl-27209084
ABSTRACT
BACKGROUND:
The 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).METHODS:
Thirteen 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.RESULTS:
Lymphocyte 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.CONCLUSION:
Metal hypersensitivity does not appear to be the dominant biological reaction involved in the occurrence of ARMD.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Prosthesis Failure
/
T-Lymphocytes
/
Arthroplasty, Replacement, Hip
/
Metal-on-Metal Joint Prostheses
/
Hip Prosthesis
/
Hypersensitivity, Delayed
Limits:
Aged
/
Aged80
/
Female
/
Humans
/
Male
/
Middle aged
Language:
En
Journal:
BMC Musculoskelet Disord
Journal subject:
FISIOLOGIA
/
ORTOPEDIA
Year:
2016
Type:
Article
Affiliation country:
Japan