Resumo

PINHO, Romeu et al. Falência de artroplastia total do joelho primária e sua revisão: um caso extremo de hipersensibilidade aos metais. Rev. Port. Ortop. Traum. [online]. 2015, vol.23, n.2, pp.177-184. ISSN 1646-2122.

The prevalence of dermal hypersensitivity to metals in the population varies between 10 and 15%, being the nickel the most frequently involved metal. Nevertheless, it is estimated that allergy / hypersensitivity to metals is involved in only 0.1% of orthopedic implant failures. Except for a minority of highly predisposed patients, in most patients it is not clear how the hypersensitivity responses to metallic biomaterials affect the orthopedic implants performance. There is no test or procedure unanimously accepted to confirm the diagnosis of hypersensitivity to an orthopedic implant. A careful history will be the first and most important step in this approach. The risk for the population is low and consequently there is no indication for the use of routine screening tests. The authors present a very rare case of metal hypersensitivity that not only resulted in the failure of the primary knee arthroplasty and the revision arthroplasty in oxidized zirconium (Oxinium®), but also to the development of an allergic reaction to external fixators, with consequent impairment in the clinical result. The risk for the population is low and consequently there is no indication for the use of routine screening tests. Future studies are needed to define possible predictors with clinical impact.

Palavras-chave : Arthroplasty; hypersensitivity; allergy; metal; failure; prothesis; implant; knee.

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