Allergy to Joint Replacements
Summary
A small number of patients suffer from a form of allergy or hypersensitivity to wear products from metal-on-metal bearing hip replacements, even in the absence of high wear. Diagnosing metal sensitivity involves excluding all other sources of pain, especially a reaction to excessive wear products. Clinically, the reaction is manifest as ongoing groin pain, often from effusions (also seen with the reaction to high wear). Histologically, the reaction involves abundant lympho-plasmacytic infiltrations, often with extensive necrosis and/or fibrin deposition. Reliable screening tests are not yet available. The relationship between skin sensitivity and hip joint sensitivity is poorly defined.
