Delayed Hypersensitivity Reaction: An Increasingly Recognized Complication of Metal-on-Metal Total Disc Replacement

Case Reports in Orthopedics
Mélodie-Anne KarnoubRichard Assaker

Abstract

We report the case of a 32-year-old woman who presented with pain recurrence 20 months after she underwent a C5C6 metal-on-metal total replacement. Plan radiographs demonstrated a modification of the shape of the vertebral bodies making the prosthesis more protruding. Then, infection has been ruled out and patch testing revealed a strongly positive reaction for chromium and cobalt. The prosthesis has been removed and a fusion achieved using a cage filled with bone graft. She has been immediately and fully relieved from her pain. We report the radiological signs that enabled early diagnosis and treatment allowing favorable outcome.

References

Oct 10, 2009·Biomaterials·Thomas M GruppVolkmar Jansson
May 12, 2010·Clinical Orthopaedics and Related Research·Pat CampbellHarlan C Amstutz
Sep 14, 2010·Orthopaedics & Traumatology, Surgery & Research : OTSR·C DelaunayP A Vendittoli
Jun 28, 2011·The Spine Journal : Official Journal of the North American Spine Society·S Raymond Golish, Paul A Anderson
Jul 9, 2013·Journal of Neurosurgery. Spine·Fahed ZairiRichard Assaker
Mar 17, 2015·The Orthopedic Clinics of North America·Keith A Fehring, Thomas K Fehring

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