ArticleInternational orthopaedics2024
Hypersensitivity to metals in metal-on-metal hip arthroplasty: a prospective study of one hundred and thirty five lymphocyte transformation tests.
Article in International orthopaedics, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed, 6 citations in OpenAlex.
- Metal-on-metal hip implants: Revisiting degradation product chemistry and molecular mechanisms of ARMD.Biomaterials and biosystems · 2026Review
- Kinetics and Fluid-Specific Behavior of Metal Ions After Hip Replacement.Bioengineering (Basel, Switzerland) · 2025Article
- Ten year follow-up of hip resurfacing in patients under thirty years old.International orthopaedics · 2025Article
- Isolated acetabular cup revision in Metal-on-Metal total hip arthroplasty: a low-complication strategy feasible in only half of cases.International orthopaedics · 2025Article
- Comparative Study of Zirconium Nitride Multilayer Coatings: Crystallinity, In Vitro Oxidation Behaviour and Tribological Properties Deposited via Sputtering and Arc Deposition.Journal of functional biomaterials · 2024Article
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Authors and funding
2 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundMetal allergy remains a controversial topic in the orthopaedic community. It is not known if or to what degree metal sensitivity contributes to inflammatory soft tissue failures, unexplained residual pain, or clinical complications after total joint replacement with metal prostheses.
methodsWe investigated the efficacy of the lymphocyte transformation test (LTT) in predicting adverse outcomes in patients after receiving a metal joint replacement. Our study cohort consists of 135 metal-on-metal hip resurfacing arthroplasty cases performed between 2013 and 2015. All study patients had an LTT preoperatively. We retrospectively analyzed clinical outcomes and failures for our cohort.
resultsThere was no difference in LTT reactivity between men and women. Of the 135 patients tested, 46 (34.1% of cohort) tested positive to at least one of the materials comprising their implant, and 78 patients (57.8%) had at least one reactive score to any component of the LTT. After a minimum follow-up of two years, we did not observe an allergic response to the implant in any patients. There were no failures requiring revision. We observed a 2.2% rate of moderate residual pain; no patients with residual pain tested positive for metal sensitivity. When patients with moderate-high LTT reactivity (30.4% of cohort) were compared to the remainder of the study group, there was no difference in HHS or UCLA activity score. There was no correlation between blood metal ion levels and LTT reactivity.
conclusionWe were unable to prove any predictive value of the LTT. We failed to identify hypersensitivity to metals in patients with metal-on-metal hip resurfacing arthroplasty.
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