Metal sensitivity in patients with joint replacement arthroplasties before and after surgery

The object of the present study was to determine the incidence of metal sensitivity in patients with joint replacement arthroplasties before and after surgery and whether this is of significance as regards the final outcome of the operative procedure. A questionnaire-based survey involved 1,335 patients with an average age of 61 years and joint replacement arthroplasties before and after surgery. A history of dermal sensitivity to metal was given in 99 (7%) patients with almost equal frequency in the pre- and postoperative groups (7.6 vs 7.2%). In only 27 of 99 cases was the metal sensitivity recorded in the patient chart. In 46 cases investigation was done after knee or hip replacement arthroplasty with an average implant time in situ of 68 months. In 32 of 46 patients a sensitivity to the implanted material was known and they did not show any complications related to the metal sensitivity. It is currently unclear whether metal sensitivity could be induced by joint replacement arthroplasties and it remains uncertain whether loosening or infection causes the sensitization as a consequence of increased release of metal ions or vice versa. To draw further conclusions considerably more detailed studies involving more patients are clearly indicated.