Abstract
Total knee arthroplasty is a common procedure, with extremely good clinical results. Despite this success, it produces 20% unsatisfactory results. These patients complained pain in otherwise well implanted and aligned prostheses. Metal hypersensitivity (MHS) is a rare complication of total joint arthroplasty that has been linked to prosthetic device failure when other potential causes have been ruled out. It has been described as a type IV hypersensitivity reaction to the metals comprising prosthetic implants, often nickel and cobalt-chromium. Patients suffering from this condition have reported periprosthetic joint pain and swelling as well as cutaneous, eczematous dermatitis. Although MHS is rare, hypersensitivity to metals in the general population has an incidence of about 15%, and in rising also for the higher number of joint replacements in the last decades. The purpose of this review was to conduct an analysis of existing literature in order to get a better understanding of the pathophysiology, clinical syndromes diagnosis, detection method, management of MHS and “hypersensitivity-friendly” implants
