ASEPTIC, LOCALIZED AND RECURRENT CELLULITIS AFTER PROSTHESIS IMPLANTATION

Non-infectious dermatites due to orthopedic implants have rarely been reported, except for eczema, We describe the cases of three patients w ho presented, three months after implantation of a total hip prosthesi s (cases 1 and 3) or a unicompartmental knee prosthesis (case 2). a hi ghly febrile cellulitis which was localized in the skin overlying the implant, Histological examination of skin biopsy specimens showed cell ulitis without vasculitis. Bacteriological cultures of blood and skin samples were sterile. Oral provocation tests with nickel, chromium and cobalt resulted in the recurrence of the cellulitis in one of the two patients tested. The cellulitis recurred 8 to 18 times in the three p atients, with no evidence of an infectious process. The eruption and f ever cleared spontaneously in about 10 days, and within 48 hours in pa tients treated with oral corticosteroids. Signs of loosening of the or thopedic material were found in all three patients. These febrile, loc alized and recurrent episodes of cellulitis seem to correspond to a no vel skin disorder, probably caused by hypersensitivity to the implante d prosthetic material.