New Materials Improve Success of Joint Replacement Surgery

Orthopedic surgeons perform more than one million joint replacements every year in the United States. Although 90 percent of joint replacement procedures are successful, complications still occur, such as infection or mechanical problems.

Some patients experience allergies to the metal in the joint hardware or the bone cement used to attach the joint to the bone. The allergies can cause symptoms including:

• Itching
• Pain
• Swelling
• Loosening of the joint

According to a study published in the Journal of Allergy and Clinical Immunology: In Practice, using artificial joints containing non-allergenic components can reduce complications. Karin Pacheco, MD, professor of medicine at National Jewish Health, has been analyzing allergies as a potential reason artificial joints fail. She asserts that replacing the artificial joint with non-allergenic materials may bring relief to many patients.

Pacheco and a group of research associates examined 105 patients with a failed joint that neither infection nor mechanical issues caused. The study found 34 patients were allergic to the metal, 39 were allergic to the bone cement and 11 were allergic to both. The most common metals to cause allergic reactions were nickel, cobalt and chromium.

The research team also found:

• Patients who were allergic often felt a sensation of “internal itching”
• Most patients who were allergic had never experienced a metal allergy before

After a 12-month follow-up, Pacheco said the patients who had the artificial joint replaced with non-allergenic materials reported they experienced significant improvement in swelling, pain and instability.

More research is necessary to determine firm conclusions about metal allergies and joint replacement. However, this study shows the importance of testing for metal allergies when there seem to be no other causes for joint failure.

“Replacement of joints due to allergies clearly improves outcomes,” said Annyce Mayer, MD, associate professor of medicine at National Jewish Health and first author on the paper. “Although all patients with revised implants improved, the patients with allergies benefited the most” (Medical Xpress).

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