4.7 Article

Metal hypersensitivity and pro-inflammatory cytokine production in patients with failed orthopedic implants: A case-control study

Journal

CLINICAL IMMUNOLOGY
Volume 245, Issue -, Pages -

Publisher

ACADEMIC PRESS INC ELSEVIER SCIENCE
DOI: 10.1016/j.clim.2022.109152

Keywords

Orthopedic implants; Implant failure; Metal hypersensitivity; MELISA ?; Cytokines

Categories

Funding

  1. Ministry of Health
  2. Czech Republic [NV19-08-00070]
  3. First Faculty of Medicine, Charles University, Czech Republic [207030]

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This study found a correlation between metal hypersensitivity and failed orthopedic implants. Metal hypersensitivity testing should be conducted on patients undergoing orthopedic implant surgery to minimize the risk of implant failure.
Orthopedic implants heal well without complications in most patients but fail for unclear reasons in some in-dividuals. This study determined the relevance of metal hypersensitivity in patients with failed orthopedic im-plants and those requiring orthopedic implant surgery. The study included 35 patients with failed orthopedic implants and 15 subjects scheduled for orthopedic implant surgery. The production of selected pro-inflammatory cytokines was measured in patients with failed orthopedic implants. Metal hypersensitivity was measured in all subjects using the MELISA (R) test. Of common metals in orthopedic alloys, the patients with failed orthopedic implants responded most frequently to nickel, chromium, titanium, iron, and molybdenum. Hypersensitivity to metals found in implants was measured in 40% of patients with failed implants. The study also showed that titanium exposure in patients with titanium hypersensitivity might lead to implant failure. Metal hypersensitivity testing should be offered to patients before surgery to minimize the risk of implant failure.

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