Pain in a chromium-allergic patient with total knee arthroplasty: disappearance of symptoms after revision with a special surface-coated TKA ­— a case report

In 2005, a 60-year-old woman suffering from osteoarthritis received a total knee replacement (TKA) (e.motion, BBraun Aesculap, Tuttlingen, Germany) in another hospital. The prosthesis was implanted using antibiotic-loaded cement. Postoperatively, she suffered reduced mobility (E/F 0/10/60°) and her knee pain did not get better. In 2006, since the pain continued, a cemented retropatellar replacement was implanted. Radiological examination did not reveal any sign of a mechanical complication, but the pain still persisted and the patient was admitted to our hospital. Now, she complained of partly eczematous reactions (local itching, partial oozing, eczematous rashes), which appeared about half a year after the primary surgery (Figure 1). Blood counts including C-reactive protein test and bacteriological tests after joint aspiration virtually excluded a low-grade infection. A lymphocyte transformation test showed no increased values for metal ions (chromium, cobalt, nickel).