Primary ArthroplastyNo Increased Risk of Knee Arthroplasty Failure in Patients With Positive Skin Patch Testing for Metal Hypersensitivity: A Matched Cohort Study
Section snippets
Materials and Methods
We reviewed all TKAs performed at 1 institution between 1997 and 2009. Within this period, 127 patients underwent 161 knee arthroplasties after SPT for a described history of metal allergy. These patients were initially identified by cross-referencing the Mayo Clinic total joint registry and the Mayo Clinic dermatology skin patch test database. The most common metal alloys used in orthopedic surgery are cobalt-chromium, stainless steel, and titanium-aluminum-vanadium alloys [6]. A SPT was
Results
Patients with a preoperative SPT+ to metals did not have a higher complication rate as compared to SPT− patients or compared to matched controls as shown in Table 2 for arthrofibrosis and for instability. There was a statistically significant difference in survivorship free from arthrofibrosis between SPT− and SPT− controls, with a lower survivorship seen in patients who carried a diagnosis of metal allergy but tested negative for it based on a SPT− results.
Patients with a preoperative SPT+ did
Discussion
It is not known whether a SPT+ for metal hypersensitivity is associated with higher failure rates after TKA. The objective of this article is to report the complications, reoperation, revisions, and functional outcomes of TKA in patients with SPT+ for metal hypersensitivity compared to SPT− and a matched control group. This article did not show any significant differences in outcomes between these groups, negating the association between a SPT+ and the results of TKA.
According to Nationwide
Acknowledgments
The authors recognize Ana I. Velazquez, MD, for her help with this study.
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2022, Arthroplasty TodayCitation Excerpt :Studies reporting clinical outcomes after TKAs with hypoallergenic implants for confirmed or suspected metal hypersensitivities have produced conflicting data [5,12–14,17–19]. Patients with hypersensitivity confirmed by contact SPT have been shown to have equivalent outcomes to patients with negative SPT receiving the same TKA implants [14]. Hypersensitive patients have also been shown to do worse after TKAs even if hypoallergenic implants were used [13,17].
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One or more of the authors of this paper have disclosed potential or pertinent conflicts of interest, which may include receipt of payment, either direct or indirect, institutional support, or association with an entity in the biomedical field which may be perceived to have potential conflict of interest with this work. For full disclosure statements refer to http://dx.doi.org/10.1016/j.arth.2016.01.024.
Each author certifies that his or her institution approved the reporting of this study and all investigations were conducted in conformity with ethical principles of research. The Mayo Clinic Institutional Review Board has approved this study, and consent from all patients was granted. This work was performed at Mayo Clinic Rochester, MN.
No external source of funding played a role in the investigation.