Recent alarming joint registry data highlighting increased revision rates has prompted further research into the area of metal-on-metal hip replacements and resurfacings. This review article examines the latest literature on the topic of adverse reactions to metal debris and summarises the most up-to-date guidelines on patient management. Adverse reactions to metal debris can cause significant damage to soft tissue and bone if not diagnosed early. Furthermore, not every patient with an adverse reaction to metal debris will be symptomatic. As such, clinicians must remain vigilant when assessing and investigating these patients in order to detect failing implants and initiate appropriate management.
Keywords: adverse reactions; aseptic lymphocyte-dominated vasculitis-associated lesion (ALVAL); hip arthroplasty; hip replacement; hip resurfacing; metal-on-metal; patient management; pseudotumour; revision surgery.