[Contact allergy to metals and bone cement components in patients with intolerance of arthroplasty]

Abstract

Introduction: Complications in arthroplasty are mostly attributed to wear particle related loosening, infections or mechanical failure. There is no investigation in a large patient series giving data about the frequency of allergic reactions to metals or bone cement components in arthroplasty with complications.

Methods: In 92 patients with cemented hip or knee arthroplasty (66 patients with complications, 26 without symptoms) patch testing and medical history were evaluated. Contact allergy rates to metals and potential bone cement components were analyzed as well as type of complaints and allergy history.

Results: Main complaints were pain (81.8%), reduced range of motion (54.5%) and local swelling (56.1%). Contact allergy to nickel was shown in 16/66 patients (24.2%), 6.1% were allergic to cobalt and 3.0% to chromium. 21/66 patients (31.8%) showed an allergic reaction to bone cement components (gentamicin 23.8%, benzoyl peroxide 10.6%, hydroquinone 4.5%). Sensitization rates in patients without symptoms were 3.8% to nickel as well as to cobalt and chromium, and 15.4% to gentamicin.

Conclusion: Contact allergy rates to metals and potential bone cement components are higher in arthroplasty patients with complications than in the general population.