Transformation in the presence of metals of lymphocytes from patients with total joint prostheses.

A lymphocyte transformation test has been used to study metal sensitivity in patients receiving total joint replacements. In the case of nickel, very significant levels of transformation were obtained with lymphocytes from patients with positive patch tests for this metal. In the case of patch test negative recipients of total joint prosthesis an elevated index of transformation was found in seven out of 15. Transformation in the presence of cobalt was less striking and there was evidence of toxicity of the metal in doses used to obtain stimulation. In eight out of 12 patch test positive individuals a significant level of transformation was obtained. Two of the seven patients carrying joint prostheses who wwere also patch test negative gave an elevated index of transformation. The clinical implications of these results are discussed.