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Immune response in adverse reactions to metal debris following metal-on-metal total hip arthroplasty.
- Source :
-
BMC musculoskeletal disorders [BMC Musculoskelet Disord] 2016 May 21; Vol. 17, pp. 221. Date of Electronic Publication: 2016 May 21. - Publication Year :
- 2016
-
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).<br />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.<br />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.<br />Conclusion: Metal hypersensitivity does not appear to be the dominant biological reaction involved in the occurrence of ARMD.
- Subjects :
- Aged
Aged, 80 and over
Arthroplasty, Replacement, Hip adverse effects
Chromium immunology
Cobalt immunology
Female
Humans
Immunohistochemistry
Lymphocyte Activation
Male
Middle Aged
Nickel immunology
Reoperation
Arthroplasty, Replacement, Hip instrumentation
Hip Prosthesis adverse effects
Hypersensitivity, Delayed chemically induced
Metal-on-Metal Joint Prostheses adverse effects
Prosthesis Failure adverse effects
T-Lymphocytes immunology
Subjects
Details
- Language :
- English
- ISSN :
- 1471-2474
- Volume :
- 17
- Database :
- MEDLINE
- Journal :
- BMC musculoskeletal disorders
- Publication Type :
- Academic Journal
- Accession number :
- 27209084
- Full Text :
- https://doi.org/10.1186/s12891-016-1069-9