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Immune response in adverse reactions to metal debris following metal-on-metal total hip arthroplasty

BACKGROUND: The purpose of the present study was to determine whether T cell-mediated type IV hypersensitivity reactions could be a major cause of adverse reaction to metal debris (ARMD) after metal-on-metal total hip arthroplasty (THA). METHODS: Thirteen patients (1 man and 12 women; mean age 68 ye...

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Autores principales: Hasegawa, Masahiro, Iino, Takahiro, Sudo, Akihiro
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4875693/
https://www.ncbi.nlm.nih.gov/pubmed/27209084
http://dx.doi.org/10.1186/s12891-016-1069-9
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author Hasegawa, Masahiro
Iino, Takahiro
Sudo, Akihiro
author_facet Hasegawa, Masahiro
Iino, Takahiro
Sudo, Akihiro
author_sort Hasegawa, Masahiro
collection PubMed
description BACKGROUND: The purpose of the present study was to determine whether T cell-mediated type IV hypersensitivity reactions could be a major cause of adverse reaction to metal debris (ARMD) after metal-on-metal total hip arthroplasty (THA). METHODS: Thirteen patients (1 man and 12 women; mean age 68 years, age range 60 to 83 years) with ARMD underwent revision surgery following metal-on-metal THA (15 hips). Lymphocyte stimulation testing was conducted. Periprosthetic tissue specimens underwent immunohistochemical studies. RESULTS: Lymphocyte stimulation testing showed that five patients were nickel-sensitive, and one patient was also cobalt-sensitive. Immunohistochemical studies showed that T cells were dominant in five hips, and B cells were dominant in 10 hips. In four of the five patients with a positive lymphocyte stimulation test, the dominant lymphocytes were T cells, suggesting type IV hypersensitivity. The major cause of ARMD was not type IV hypersensitivity in the remaining nine patients. CONCLUSION: Metal hypersensitivity does not appear to be the dominant biological reaction involved in the occurrence of ARMD. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12891-016-1069-9) contains supplementary material, which is available to authorized users.
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spelling pubmed-48756932016-05-22 Immune response in adverse reactions to metal debris following metal-on-metal total hip arthroplasty Hasegawa, Masahiro Iino, Takahiro Sudo, Akihiro BMC Musculoskelet Disord Research Article BACKGROUND: The purpose of the present study was to determine whether T cell-mediated type IV hypersensitivity reactions could be a major cause of adverse reaction to metal debris (ARMD) after metal-on-metal total hip arthroplasty (THA). METHODS: Thirteen patients (1 man and 12 women; mean age 68 years, age range 60 to 83 years) with ARMD underwent revision surgery following metal-on-metal THA (15 hips). Lymphocyte stimulation testing was conducted. Periprosthetic tissue specimens underwent immunohistochemical studies. RESULTS: Lymphocyte stimulation testing showed that five patients were nickel-sensitive, and one patient was also cobalt-sensitive. Immunohistochemical studies showed that T cells were dominant in five hips, and B cells were dominant in 10 hips. In four of the five patients with a positive lymphocyte stimulation test, the dominant lymphocytes were T cells, suggesting type IV hypersensitivity. The major cause of ARMD was not type IV hypersensitivity in the remaining nine patients. CONCLUSION: Metal hypersensitivity does not appear to be the dominant biological reaction involved in the occurrence of ARMD. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12891-016-1069-9) contains supplementary material, which is available to authorized users. BioMed Central 2016-05-21 /pmc/articles/PMC4875693/ /pubmed/27209084 http://dx.doi.org/10.1186/s12891-016-1069-9 Text en © Hasegawa et al. 2016 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Hasegawa, Masahiro
Iino, Takahiro
Sudo, Akihiro
Immune response in adverse reactions to metal debris following metal-on-metal total hip arthroplasty
title Immune response in adverse reactions to metal debris following metal-on-metal total hip arthroplasty
title_full Immune response in adverse reactions to metal debris following metal-on-metal total hip arthroplasty
title_fullStr Immune response in adverse reactions to metal debris following metal-on-metal total hip arthroplasty
title_full_unstemmed Immune response in adverse reactions to metal debris following metal-on-metal total hip arthroplasty
title_short Immune response in adverse reactions to metal debris following metal-on-metal total hip arthroplasty
title_sort immune response in adverse reactions to metal debris following metal-on-metal total hip arthroplasty
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4875693/
https://www.ncbi.nlm.nih.gov/pubmed/27209084
http://dx.doi.org/10.1186/s12891-016-1069-9
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