Tuesday, July 19, 2011

Review of the Cell biology surrounding metal on metal hips (3 of x in a series)

Acta Orthop. 2008 Dec;79(6):734-47.
Metal-on-metal hip resurfacing arthroplasty: a review of periprosthetic biological reactions.
Mabilleau G, Kwon YM, Pandit H, Murray DW, Sabokbar A.

A third interesting finding.

This journal article reported that in skin tests done to detect osteolysis (a process in the bone joints that can lead to implant loosening or bone breakage, which in turn cause serious medical problems/often times associated with the metal debris from the implants), a higher rate of hypersensitivity reactions to cobalt and chromium were observed with cobalt chloride skin testing compared to the control group that had no osteolysis indicating a delayed hypersensitivity reaction. (Park et al, Jrnl of bone and joint surgery 2005.)  The findings suggested that early osteolysis is associated with abnormalities consistent with delayed-type hypersensitivity to metal.

The histological examination showed accumulation of  T-lymphocytes.

[I found this tidbit of interest because, for the most part, the physicians do not recommend skin testing to determine hypersensitivity to the metals.  I just asked my surgeon about this a week ago and was told that skin testing is not a reliable indicator of metal sensitivities.  Hmmm?  Perhaps his responce was based on skin testing prior to the surgery to indicate sensitivity to the metal not being a reliable indicator?]


  1. Connie,
    We (my wife had two of the ASR devices-one now revised) are wondering about leukopenia (low white cell counts) as a result of metallosis. I have reviewed your literature, but not seen a specific reference to blood counts. Any info?

  2. Sure. Type in lymphopenia in the search box on the landing page.

    lymphopenia, is the condition of having an abnormally low level of lymphocytes in the blood. Lymphocytes are a white blood cell with important functions in the immune system.