Department of Orthopedics, Marshfield Clinic–Weston Center,Weston, Wisconsin 54476, USA.
J Arthroplasty. 2011 Feb;26(2):338.e5-7. doi: 10.1016/j.arth.2009.11.006. Epub 2010 Feb 9.
An emerging concern with metal-on-metal total hip arthroplasty is metal-induced hypersensitivity. Currently, this is a diagnosis of exclusion in patients with groin pain after metal-on-metal total hip arthroplasty. We describe a patient presenting nearly a year after arthroplasty with incisional drainage. Infection was presumed; but preoperative studies were nondefinitive, and the wound was explored. The operative cultures were negative; the histology revealed lymphocytic vasculitis. The patient recovered uneventfully after exchange to a metal polyethylene bearing couple. We believe that metal-induced hypersensitivity should be considered with draining wounds with this bearing couple if infection cannot be proven.
金属对金属全髋关节置换术后出现的一个新问题是金属诱导的过敏反应。目前，这是金属对金属全髋关节置换术后出现腹股沟疼痛患者的排除性诊断。我们描述了一位患者在关节置换术后近一年出现切口引流。最初怀疑是感染；但术前检查不明确，因此进行了伤口探查。手术培养为阴性；组织学显示为淋巴细胞性血管炎。在更换为金属聚乙烯对置后，患者顺利康复。我们认为，如果不能确定感染，对于这种关节假体出现渗液的伤口，应考虑金属诱导的过敏反应。
