LYMPHORETICULAR DISSEMINATION OF METAL PARTICLES AFTER PRIMARY JOINT REPLACEMENTS

Twenty-three patients with a history of primary joint replacement foll owed by lymph node dissection procedure were studied, These specimens included pelvic, gastric, paraaortic, inguinal, retroduodenal, and axi llary node chains, The lymph node specimens were sectioned, processed for scanning electron microscopic study, and viewed with backscattered electron imaging to identify metal particles, On detection of a metal particle, energy dispersive xray microanalysis was conducted to deter mine its elemental composition, Seven of 23 patients had metal alloy p articles within the lymph node specimens, Metal particles were identif ied in the pelvic and axillary node chains, In each case, the metal al loy identified corresponded with the implanted type of alloy, The shor test interval between joint implantation and dissemination of metal to a lymph node chain was 6 months, These data suggest the need for cont inued followup to determine long term effects, if any, of this distrib ution of metal particles through the lymphatic system.