The aims of this study were to evaluate the incidence of local
argyria in patients with
silver-coated megaprostheses and to identify a possible association between
argyria and elevated levels of
silver both locally and in the blood. Between 2004 and 2011, 32 megaprostheses with
silver coatings were implanted in 20 female and 12 male patients following revision
arthroplasty for
infection or resection of a malignant tumour, and the levels of
silver locally in drains and
seromas and in the blood were determined. The mean age of the patients was 46 years (10 to 81); one patient died in the immediate post-operative period and was excluded. Seven patients (23%) developed local
argyria after a median of 25.7 months (interquartile range 2 to 44.5). Patients with and without local
argyria had comparable levels of
silver in the blood and aspiration fluids. The length of the implant did not influence the development of local
argyria. Patients with clinical evidence of local
argyria had no neurological symptoms and no evidence of renal or
hepatic failure. Thus, we conclude that the short-term surveillance of blood
silver levels in these patients is not required.