Background: The aim of the study was to examine the reactivity of peripheral human leukocytes to various metal\r\nions prior and following hip replacement in order to investigate implant-induced metal sensitivity.\r\nMethods: Three patient groups were set up: (1) individuals without implants and no history of metal allergy (7 cases),\r\n(2) individuals without implants and known history of metal allergy (7 cases), and (3) patients undergoing cementless\r\nhip replacement (40 cases). Blood samples were taken in groups 1 and 2 at three different occasions; in group 3, prior\r\nand 3, 6, 12, 24, and 36 months after surgery. Peripheral leukocytes were separated and left either untreated or\r\nchallenged with Ti, NiCl2, CoCl2, CrCl3, and phytohemagglutinin. Cell proliferation, cytokine release, and leukocyte\r\nmigration inhibition assays were performed. Metal-induced reactivity was considered when all three assays showed\r\nsignificant change. Skin patch tests were also carried out.\r\nResults: Both skin patch tests and leukocyte functional tests were negative in group 1, and both were positive in\r\ngroup 2. In group 3, after 6 months, 12% of the patients showed reactivity to the tested metals except for NiCl2.\r\nFollowing the 36-month period, 18% of group three became sensitive to metals (including all the earlier 12%). In\r\ncontrast, patch tests were negative at each time point in group 3.\r\nConclusions: Orthopedic implant material may induce metal reactivity after implantation in a manner where\r\nsusceptibility is yet to be elucidated. Leukocyte triple assay technique might be a useful tool to test implant materialrelated\r\nsensitivity.
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