Allergy in total knee replacement surgery: Is it a real problem?

World Journal of Orthopedics
Maristella F SaccomannoEnrico Pola

Abstract

Total knee arthroplasty is a common procedure, with extremely good clinical results. Despite this success, it produces 20% unsatisfactory results. Among the causes of these failures is metal hypersensitivity. Metal sensitization is higher in patients with a knee arthroplasty than in the general population and is even higher in patients undergoing revision surgery. However, a clear correlation between metal sensitization and symptomatic knee after surgery has not been ascertained. Surely, patients with a clear history of metal allergy must be carefully examined through dermatological and laboratory testing before surgery. There is no globally accepted diagnostic algorithm or laboratory test to diagnose metal hypersensitivity or metal reactions. The patch test is the most common test to determine metal hypersensitivity, though presenting some limitations. Several laboratory assays have been developed, with a higher sensitivity compared to patch testing, yet their clinical availability is not widespread, due to high costs and technical complexity. Symptoms of a reaction to metal implants present across a wide spectrum, ranging from pain and cutaneous dermatitis to aseptic loosening of the arthroplasty. However, although cutaneous ...Continue Reading

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Citations

Oct 19, 2019·Contact Dermatitis·Jørgen SerupInes Schreiver
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Oct 30, 2021·Knee Surgery, Sports Traumatology, Arthroscopy : Official Journal of the ESSKA·Lorenzo BanciAndrea Baldini

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Methods Mentioned

BETA
blood draw
enzyme-linked
ELISA
biopsies

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