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BioMed Research International
Volume 2015, Article ID 137287, 10 pages
http://dx.doi.org/10.1155/2015/137287
Review Article

Biomaterial Hypersensitivity: Is It Real? Supportive Evidence and Approach Considerations for Metal Allergic Patients following Total Knee Arthroplasty

1Division of Orthopaedics and Rehabilitation, Department of Surgery, Southern Illinois University School of Medicine, P.O. Box 19679, Springfield, IL 62794-9679, USA
2Department of Orthopaedic Surgery & Biomedical Engineering, University of Tennessee, Memphis, TN 38017, USA
3Clinic for Orthopaedic Surgery, Campus Grosshadern, Ludwig Maximilians University, 80539 Munich, Germany
4Aesculap AG, Research & Development, 78532 Tuttlingen, Germany
5Colorado Joint Replacement, Denver, CO 80210, USA
6Department of Orthopaedic Surgery, Stanford University School of Medicine, Redwood City, CA 94063, USA

Received 28 August 2014; Accepted 19 September 2014

Academic Editor: Sandra Utzschneider

Copyright © 2015 Andrew J. Mitchelson et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Linked References

  1. M. W. Elves, J. N. Wilson, J. T. Scales, and H. B. S. Kempt, “Incidence of metal sensitivity in patients with total joint replacements,” British Medical Journal, vol. 4, no. 5993, pp. 376–378, 1975. View at Publisher · View at Google Scholar · View at Scopus
  2. E. M. Evans, M. A. R. Freeman, A. J. Miller, and B. Vernon Roberts, “Metal sensitivity as a cause of bone necrosis and loosening of the prosthesis in total joint replacement,” Journal of Bone and Joint Surgery—Series B, vol. 56, no. 4, pp. 626–642, 1974. View at Google Scholar · View at Scopus
  3. P. J. Cousen and D. J. Gawkrodger, “Metal allergy and second-generation metal-on-metal arthroplasties,” Contact Dermatitis, vol. 66, no. 2, pp. 55–62, 2012. View at Publisher · View at Google Scholar · View at Scopus
  4. J. L. Basko-Plluska, J. P. Thyssen, and P. C. Schalock, “Cutaneous and systemic hypersensitivity reactions to metallic implants,” Dermatitis, vol. 22, no. 2, pp. 65–79, 2011. View at Publisher · View at Google Scholar · View at Scopus
  5. P. C. Schalock, T. Menné, J. D. Johansen et al., “Hypersensitivity reactions to metallic implants—diagnostic algorithm and suggested patch test series for clinical use,” Contact Dermatitis, vol. 66, no. 1, pp. 4–19, 2012. View at Publisher · View at Google Scholar · View at Scopus
  6. E. Frigerio, P. D. Pigatto, G. Guzzi, and G. Altomare, “Metal sensitivity in patients with orthopaedic implants: a prospective study,” Contact Dermatitis, vol. 64, no. 5, pp. 273–279, 2011. View at Publisher · View at Google Scholar · View at Scopus
  7. N. Hallab, “Metal sensitivity in patients with orthopedic implants,” Journal of Clinical Rheumatology, vol. 7, no. 4, pp. 215–218, 2001. View at Publisher · View at Google Scholar · View at Scopus
  8. D. Granchi, E. Cenni, D. Tigani, G. Trisolino, N. Baldini, and A. Giunti, “Sensitivity to implant materials in patients with total knee arthroplasties,” Biomaterials, vol. 29, no. 10, pp. 1494–1500, 2008. View at Publisher · View at Google Scholar · View at Scopus
  9. N. A. Mesinkovska, A. Tellez, L. Molina et al., “The effect of patch testing on surgical practices and outcomes in orthopedic patients with metal implants,” Archives of Dermatology, vol. 148, no. 6, pp. 687–693, 2012. View at Publisher · View at Google Scholar · View at Scopus
  10. G. D. Rooker and J. D. Wilkinson, “Metal sensitivity in patients undergoing hip replacement. A prospective study,” Journal of Bone and Joint Surgery B, vol. 62, no. 4, pp. 502–505, 1980. View at Google Scholar · View at Scopus
  11. A. S. Carlsson, B. Magnusson, and H. Moller, “Metal sensitivity in patients with metal-to-plastic total hip arthroplasties,” Acta Orthopaedica Scandinavica, vol. 51, no. 1, pp. 57–62, 1980. View at Publisher · View at Google Scholar · View at Scopus
  12. S. B. Verma, B. Mody, and D. J. Gawkrodger, “Dermatitis on the knee following knee replacement: a minority of cases show contact allergy to chromate, cobalt or nickel but a causal association is unproven,” Contact Dermatitis, vol. 54, no. 4, pp. 228–229, 2006. View at Publisher · View at Google Scholar · View at Scopus
  13. K. B. Reed, M. D. P. Davis, K. Nakamura, L. Hanson, and D. M. Richardson, “Retrospective evaluation of patch testing before or after metal device implantation,” Archives of Dermatology, vol. 144, no. 8, pp. 999–1007, 2008. View at Publisher · View at Google Scholar · View at Scopus
  14. N. J. Hallab, S. Anderson, T. Stafford, T. Glant, and J. J. Jacobs, “Lymphocyte responses in patients with total hip arthroplasty,” Journal of Orthopaedic Research, vol. 23, no. 2, pp. 384–391, 2005. View at Publisher · View at Google Scholar · View at Scopus
  15. R. Eben, K.-A. Dietrich, C. Nerz et al., “Contact allergy to metals and bone cement components in patients with intolerance of arthroplasty,” Deutsche Medizinische Wochenschrift, vol. 135, no. 28-29, pp. 1418–1422, 2010. View at Publisher · View at Google Scholar · View at Scopus
  16. B. Kręcisz, M. Kieć-Świerczyńska, and K. Ba̧kowicz-Mitura, “Allergy to metals as a cause of orthopedic implant failure,” International Journal of Occupational Medicine and Environmental Health, vol. 19, no. 3, pp. 178–180, 2006. View at Publisher · View at Google Scholar · View at Scopus
  17. Y.-S. Park, Y.-W. Moon, S.-J. Lim, J.-M. Yang, G. Ahn, and Y.-L. Choi, “Early osteolysis following second-generation metal-on-metal hip replacement,” Journal of Bone and Joint Surgery A, vol. 87, no. 7, pp. 1515–1521, 2005. View at Publisher · View at Google Scholar · View at Scopus
  18. G. C. Brown, M. D. Lockshin, E. A. Salvati, and P. G. Bullough, “Sensitivity to metal as a possible cause of sterile loosening after cobalt chromium total hip replacement arthroplasty,” Journal of Bone and Joint Surgery A, vol. 59, no. 2, pp. 164–168, 1977. View at Google Scholar · View at Scopus
  19. D. Granchi, E. Cenni, G. Trisolino, A. Giunti, and N. Baldini, “Sensitivity to implant materials in patients undergoing total hip replacement,” Journal of Biomedical Materials Research B: Applied Biomaterials, vol. 77, no. 2, pp. 257–264, 2006. View at Publisher · View at Google Scholar · View at Scopus
  20. F. Cancilleri, P. De Giorgis, C. Verdoia, L. Parrini, A. Lodi, and C. Crosti, “Allergy to components of total hip arthroplasty before and after surgery,” Italian Journal of Orthopaedics and Traumatology, vol. 18, no. 3, pp. 407–410, 1992. View at Google Scholar · View at Scopus
  21. A. H. Waterman and J. J. Schrik, “Allergy in hip arthroplasty,” Contact Dermatitis, vol. 13, no. 5, pp. 294–301, 1985. View at Publisher · View at Google Scholar · View at Scopus
  22. J. P. Nater, R. G. Brian, R. Deutman, and J. Mulder Th., “The development of metal hypersensitivity in patients with metal to plastic hip arthroplasties,” Contact Dermatitis, vol. 2, no. 5, pp. 259–261, 1976. View at Publisher · View at Google Scholar · View at Scopus
  23. R. Deutman, T. J. Mulder, and R. Brian, “Metal sensitivity before and after total hip arthroplasty,” Journal of Bone and Joint Surgery A, vol. 59, no. 7, pp. 862–865, 1977. View at Google Scholar · View at Scopus
  24. Y. Niki, H. Matsumoto, T. Otani et al., “Screening for symptomatic metal sensitivity: a prospective study of 92 patients undergoing total knee arthroplasty,” Biomaterials, vol. 26, no. 9, pp. 1019–1026, 2005. View at Publisher · View at Google Scholar · View at Scopus
  25. N. J. Hallab and J. J. Jacobs, “Biologic effects of implant debris,” Bulletin of the NYU Hospital for Joint Diseases, vol. 67, no. 2, pp. 182–188, 2009. View at Google Scholar · View at Scopus
  26. D. Cadosch, E. Chan, O. P. Gautschi, and L. Filgueira, “Metal is not inert: role of metal ions released by biocorrosion in aseptic loosening—current concepts,” Journal of Biomedical Materials Research A, vol. 91, no. 4, pp. 1252–1262, 2009. View at Publisher · View at Google Scholar · View at Scopus
  27. D. Cadosch, O. P. Gautschi, E. Chan, H.-P. Simmen, and L. Filgueira, “Titanium induced production of chemokines CCL17/TARC and CCL22/MDC in human osteoclasts and osteoblasts,” Journal of Biomedical Materials Research Part A, vol. 92, no. 2, pp. 475–483, 2010. View at Publisher · View at Google Scholar · View at Scopus
  28. M. S. Caicedo, R. Desai, K. McAllister, A. Reddy, J. J. Jacobs, and N. J. Hallab, “Soluble and particulate Co-Cr-Mo alloy implant metals activate the inflammasome danger signaling pathway in human macrophages: a novel mechanism for implant debris reactivity,” Journal of Orthopaedic Research, vol. 27, no. 7, pp. 847–854, 2009. View at Publisher · View at Google Scholar · View at Scopus
  29. J. Luetzner, F. Krummenauer, A. M. Lengel, J. Ziegler, and W.-C. Witzleb, “Serum metal ion exposure after total knee arthroplasty,” Clinical Orthopaedics and Related Research, no. 461, pp. 136–142, 2007. View at Publisher · View at Google Scholar · View at Scopus
  30. D. Cadosch, E. Chan, O. P. Gautschi, H.-P. Simmen, and L. Filgueira, “Bio-corrosion of stainless steel by osteoclasts—in vitro evidence,” Journal of Orthopaedic Research, vol. 27, no. 7, pp. 841–846, 2009. View at Publisher · View at Google Scholar · View at Scopus
  31. D. Cadosch, M. S. Al-Mushaiqri, O. P. Gautschi, J. Meagher, H.-P. Simmen, and L. Filgueira, “Biocorrosion and uptake of titanium by human osteoclasts,” Journal of Biomedical Materials Research Part A, vol. 95, no. 4, pp. 1004–1010, 2010. View at Publisher · View at Google Scholar · View at Scopus
  32. J. P. Thyssen and T. Menné, “Metal allergys—a review on exposures, penetration, genetics, prevalence, and clinical implications,” Chemical Research in Toxicology, vol. 23, no. 2, pp. 309–318, 2010. View at Publisher · View at Google Scholar · View at Scopus
  33. M. W. Ashraf, “Levels of heavy metals in popular cigarette brands and exposure to these metals via smoking,” The Scientific World Journal, vol. 2012, Article ID 729430, 5 pages, 2012. View at Publisher · View at Google Scholar · View at Scopus
  34. Y. Teow, P. V. Asharani, M. P. Hande, and S. Valiyaveettil, “Health impact and safety of engineered nanomaterials,” Chemical Communications, vol. 47, no. 25, pp. 7025–7038, 2011. View at Publisher · View at Google Scholar · View at Scopus
  35. A. Borchers, S. S. Teuber, C. L. Keen, and M. E. Gershwin, “Food safety,” Clinical Reviews in Allergy and Immunology, vol. 39, no. 2, pp. 95–141, 2010. View at Publisher · View at Google Scholar · View at Scopus
  36. J. P. Thyssen, A. Linneberg, T. Menné, and J. D. Johansen, “The epidemiology of contact allergy in the general population—prevalence and main findings,” Contact Dermatitis, vol. 57, no. 5, pp. 287–299, 2007. View at Publisher · View at Google Scholar · View at Scopus
  37. T. Schäfer, E. Böhler, S. Ruhdorfer et al., “Epidemiology of contact allergy in adults,” Allergy, vol. 56, no. 12, pp. 1192–1196, 2001. View at Publisher · View at Google Scholar · View at Scopus
  38. K. A. Zug, E. M. Warshaw, J. F. Fowler Jr. et al., “Patch-test results of the North American Contact Dermatitis Group 2005–2006,” Dermatitis, vol. 20, no. 3, pp. 149–160, 2009. View at Publisher · View at Google Scholar · View at Scopus
  39. W. Uter, C. Rämsch, W. Aberer et al., “The European baseline series in 10 European Countries, 2005/2006—results of the European Surveillance System on Contact Allergies (ESSCA),” Contact Dermatitis, vol. 61, no. 1, pp. 31–38, 2009. View at Publisher · View at Google Scholar · View at Scopus
  40. N. J. Hallab, M. Caicedo, A. Finnegan, and J. J. Jacobs, “Th1 type lymphocyte reactivity to metals in patients with total hip arthroplasty,” Journal of Orthopaedic Surgery and Research, vol. 3, no. 1, article 6, 2008. View at Publisher · View at Google Scholar · View at Scopus
  41. P. Thomas, B. Summer, C. A. Sander, B. Przybilla, M. Thomas, and T. Naumann, “Intolerance of osteosynthesis material: evidence of dichromate contact allergy with concomitant oligoclonal T-cell infiltrate and TH 1-type cytokine expression in the peri-implantar tissue,” Allergy: European Journal of Allergy and Clinical Immunology, vol. 55, no. 10, pp. 969–972, 2000. View at Publisher · View at Google Scholar · View at Scopus
  42. B. Summer, C. Paul, F. Mazoochian et al., “Nickel (Ni) allergic patients with complications to Ni containing joint replacement show preferential IL-17 type reactivity to Ni,” Contact Dermatitis, vol. 63, no. 1, pp. 15–22, 2010. View at Publisher · View at Google Scholar · View at Scopus
  43. J. P. Thyssen, T. Menné, P. C. Schalock, J. S. Taylor, and H. I. Maibach, “Pragmatic approach to the clinical work-up of patients with putative allergic disease to metallic orthopaedic implants before and after surgery,” British Journal of Dermatology, vol. 164, no. 3, pp. 473–478, 2011. View at Publisher · View at Google Scholar · View at Scopus
  44. R. T. Beck, K. D. Illingworth, and K. J. Saleh, “Review of periprosthetic osteolysis in total joint arthroplasty: an emphasis on host factors and future directions,” Journal of Orthopaedic Research, vol. 30, no. 4, pp. 541–546, 2012. View at Publisher · View at Google Scholar · View at Scopus
  45. V. Y. Ng, A. V. Lombardi Jr., K. R. Berend, M. D. Skeels, and J. B. Adams, “Perivascular lymphocytic infiltration is not limited to metal-on-metal bearings,” Clinical Orthopaedics and Related Research, vol. 469, no. 2, pp. 523–529, 2011. View at Publisher · View at Google Scholar · View at Scopus
  46. L. Burton, D. Paget, N. B. Binder et al., “Orthopedic wear debris mediated inflammatory osteolysis is mediated in part by NALP3 inflammasome activation,” Journal of Orthopaedic Research, vol. 31, no. 1, pp. 73–80, 2013. View at Publisher · View at Google Scholar · View at Scopus
  47. G. Holt, C. Murnaghan, J. Reilly, and R. M. D. Meek, “The biology of aseptic osteolysis,” Clinical Orthopaedics and Related Research, no. 460, pp. 240–252, 2007. View at Publisher · View at Google Scholar · View at Scopus
  48. P. Bergschmidt, R. Bader, and W. Mittelmeier, “Metal hypersensitivity in total knee arthroplasty: revision surgery using a ceramic femoral component—a case report,” Knee, vol. 19, no. 2, pp. 144–147, 2012. View at Publisher · View at Google Scholar · View at Scopus
  49. S. Handa, S. Dogra, and R. Prasad, “Metal sensivity in a patient with a total knee replacement,” Contact Dermatitis, vol. 49, no. 5, pp. 259–260, 2003. View at Publisher · View at Google Scholar · View at Scopus
  50. M. Thomsen, M. Rozak, and P. Thomas, “Pain in a chromium-allergic patient with total knee arthroplasty: disappearance of symptoms after revision with a special surface-coated TKA—a case report,” Acta Orthopaedica, vol. 82, no. 3, pp. 386–388, 2011. View at Publisher · View at Google Scholar · View at Scopus
  51. N. Oiso, T. Komeda, K. Fukai, M. Ishii, T. Hirai, and A. Kugai, “Metal allergy to implanted orthopaedic prosthesis after postoperative Staphylococcus aureus infection,” Contact Dermatitis, vol. 51, no. 3, pp. 151–153, 2004. View at Google Scholar · View at Scopus
  52. J. Beecker, J. Gordon, and M. Pratt, “An interesting case of joint prosthesis allergy,” Dermatitis, vol. 20, no. 2, pp. E4–E9, 2009. View at Publisher · View at Google Scholar · View at Scopus
  53. N. van Opstal and F. Verheyden, “Revision of a tibial baseplate using a customized oxinium component in a case of suspected metal allergy. A case report,” Acta Orthopaedica Belgica, vol. 77, no. 5, pp. 691–695, 2011. View at Google Scholar · View at Scopus
  54. K.-A. Dietrich, F. Mazoochian, B. Summer, M. Reinert, T. Ruzicka, and P. Thomas, “Intolerance reactions to knee arthroplasty in patients with nickel/cobalt allergy and disappearance of symptoms after revision surgery with titanium-based endoprostheses,” JDDG - Journal of the German Society of Dermatology, vol. 7, no. 5, pp. 410–413, 2009. View at Publisher · View at Google Scholar · View at Scopus
  55. X. Gao, R.-X. He, S.-G. Yan, and L.-D. Wu, “Dermatitis associated with chromium following total knee arthroplasty,” The Journal of Arthroplasty, vol. 26, no. 4, pp. 665.e13–665.e16, 2011. View at Publisher · View at Google Scholar · View at Scopus
  56. P. Bergschmidt, R. Bader, S. Finze, C. Schulze, G. Kundt, and W. Mittelmeier, “Comparative study of clinical and radiological outcomes of unconstrained bicondylar total knee endoprostheses with anti-allergic coating,” The Open Orthopaedics Journal, vol. 5, pp. 354–360, 2011. View at Publisher · View at Google Scholar
  57. E. Thienpont and Y. Berger, “No allergic reaction after TKA in a chrome-cobalt-nickel-sensitive patient: case report and review of the literature,” Knee Surgery, Sports Traumatology, Arthroscopy, vol. 21, no. 3, pp. 636–640, 2013. View at Publisher · View at Google Scholar · View at Scopus
  58. F. Rui, M. Bovenzi, A. Prodi et al., “Nickel, cobalt and chromate sensitization and occupation,” Contact Dermatitis, vol. 62, no. 4, pp. 225–231, 2010. View at Publisher · View at Google Scholar · View at Scopus
  59. H.-G. Willert, G. H. Buchhorn, A. Fayyazi et al., “Metal-on-metal bearings and hypersensitivity in patients with artificial hip joints: A clinical and histomorphological study,” Journal of Bone and Joint Surgery A, vol. 87, no. 1, pp. 28–36, 2005. View at Publisher · View at Google Scholar · View at Scopus
  60. M. Kieffer, “Nickel sensitivity: relationship between history and patch test reaction,” Contact Dermatitis, vol. 5, no. 6, pp. 398–401, 1979. View at Publisher · View at Google Scholar · View at Scopus
  61. D. Granchi, E. Cenni, A. Giunti, and N. Baldini, “Metal hypersensitivity testing in patients undergoing joint replacement: a systematic review,” Journal of Bone and Joint Surgery Series B, vol. 94, no. 8, pp. 1126–1134, 2012. View at Publisher · View at Google Scholar · View at Scopus
  62. M. F. Swiontkowski, J. Agel, J. Schwappach, P. McNair, and M. Welch, “Cutaneous metal sensitivity in patients with orthopaedic injuries,” Journal of Orthopaedic Trauma, vol. 15, no. 2, pp. 86–89, 2001. View at Publisher · View at Google Scholar · View at Scopus
  63. E. Valentine-Thon, K. Müller, G. Guzzi, S. Kreisel, P. Ohnsorge, and M. Sandkamp, “LTT-MELISA is clinically relevant for detecting and monitoring metal sensitivity,” Neuroendocrinology Letters, vol. 27, supplement 1, pp. 17–24, 2006. View at Google Scholar · View at Scopus
  64. R. Treudler and J. C. Simon, “Benzoyl peroxide: is it a relevant bone cement allergen in patients with orthopaedic implants?” Contact Dermatitis, vol. 57, no. 3, pp. 177–180, 2007. View at Publisher · View at Google Scholar · View at Scopus
  65. S. A. Edwards and J. Gardiner, “Hypersensitivity to benzoyl peroxide in a cemented total knee arthroplasty: cement allergy,” Journal of Arthroplasty, vol. 22, no. 8, pp. 1226–1228, 2007. View at Publisher · View at Google Scholar · View at Scopus
  66. M. D. P. Davis, C. M. Mowad, and P. Scheinman, “Orthopedic prostheses: is there any point in patch testing?” Dermatitis, vol. 15, no. 4, pp. 210–212, 2004. View at Google Scholar · View at Scopus