The association between metal allergy, total knee arthroplasty, and revision: Study based on the Danish Knee Arthroplasty Register

BACKGROUND AND PURPOSE: It is unclear whether delayed-type hypersensitivity reactions against implanted metals play a role in the etiopathogenesis of malfunctioning total knee arthroplasties. We therefore evaluated the association between metal allergy, defined as a positive patch test reaction to c...

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Autores principales: Münch, Henrik J, Jacobsen, Stig S, Olesen, Jens T, Menné, Torkil, Søballe, Kjeld, Johansen, Jeanne D, Thyssen, Jacob P
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Informa Healthcare 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4443448/
https://www.ncbi.nlm.nih.gov/pubmed/25582229
http://dx.doi.org/10.3109/17453674.2014.999614
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author Münch, Henrik J
Jacobsen, Stig S
Olesen, Jens T
Menné, Torkil
Søballe, Kjeld
Johansen, Jeanne D
Thyssen, Jacob P
author_facet Münch, Henrik J
Jacobsen, Stig S
Olesen, Jens T
Menné, Torkil
Søballe, Kjeld
Johansen, Jeanne D
Thyssen, Jacob P
author_sort Münch, Henrik J
collection PubMed
description BACKGROUND AND PURPOSE: It is unclear whether delayed-type hypersensitivity reactions against implanted metals play a role in the etiopathogenesis of malfunctioning total knee arthroplasties. We therefore evaluated the association between metal allergy, defined as a positive patch test reaction to common metal allergens, and revision surgery in patients who underwent knee arthroplasty. PATIENTS AND METHODS: The nationwide Danish Knee Arthroplasty Register, including all knee-implanted patients and revisions in Denmark after 1997 (n = 46,407), was crosslinked with a contact allergy patch test database from the greater Copenhagen area (n = 27,020). RESULTS: 327 patients were registered in both databases. The prevalence of contact allergy to nickel, chromium, and cobalt was comparable in patients with and without revision surgery. However, in patients with 2 or more episodes of revision surgery, the prevalence of cobalt and chromium allergy was markedly higher. Metal allergy that was diagnosed before implant surgery appeared not to increase the risk of implant failure and revision surgery. INTERPRETATION: While we could not confirm that a positive patch test reaction to common metals is associated with complications and revision surgery after knee arthroplasty, metal allergy may be a contributor to the multifactorial pathogenesis of implant failure in some cases. In cases with multiple revisions, cobalt and chromium allergies appear to be more frequent.
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spelling pubmed-44434482015-06-08 The association between metal allergy, total knee arthroplasty, and revision: Study based on the Danish Knee Arthroplasty Register Münch, Henrik J Jacobsen, Stig S Olesen, Jens T Menné, Torkil Søballe, Kjeld Johansen, Jeanne D Thyssen, Jacob P Acta Orthop Knee BACKGROUND AND PURPOSE: It is unclear whether delayed-type hypersensitivity reactions against implanted metals play a role in the etiopathogenesis of malfunctioning total knee arthroplasties. We therefore evaluated the association between metal allergy, defined as a positive patch test reaction to common metal allergens, and revision surgery in patients who underwent knee arthroplasty. PATIENTS AND METHODS: The nationwide Danish Knee Arthroplasty Register, including all knee-implanted patients and revisions in Denmark after 1997 (n = 46,407), was crosslinked with a contact allergy patch test database from the greater Copenhagen area (n = 27,020). RESULTS: 327 patients were registered in both databases. The prevalence of contact allergy to nickel, chromium, and cobalt was comparable in patients with and without revision surgery. However, in patients with 2 or more episodes of revision surgery, the prevalence of cobalt and chromium allergy was markedly higher. Metal allergy that was diagnosed before implant surgery appeared not to increase the risk of implant failure and revision surgery. INTERPRETATION: While we could not confirm that a positive patch test reaction to common metals is associated with complications and revision surgery after knee arthroplasty, metal allergy may be a contributor to the multifactorial pathogenesis of implant failure in some cases. In cases with multiple revisions, cobalt and chromium allergies appear to be more frequent. Informa Healthcare 2015-06 2015-05-13 /pmc/articles/PMC4443448/ /pubmed/25582229 http://dx.doi.org/10.3109/17453674.2014.999614 Text en Copyright: © Nordic Orthopaedic Federation http://creativecommons.org/licenses/by-nc-nd/3.0/ This is an open-access article distributed under the terms of the CC-BY-NC-ND 3.0 License which permits users to download and share the article for non-commercial purposes, so long as the article is reproduced in the whole without changes, and provided the original source is credited.
spellingShingle Knee
Münch, Henrik J
Jacobsen, Stig S
Olesen, Jens T
Menné, Torkil
Søballe, Kjeld
Johansen, Jeanne D
Thyssen, Jacob P
The association between metal allergy, total knee arthroplasty, and revision: Study based on the Danish Knee Arthroplasty Register
title The association between metal allergy, total knee arthroplasty, and revision: Study based on the Danish Knee Arthroplasty Register
title_full The association between metal allergy, total knee arthroplasty, and revision: Study based on the Danish Knee Arthroplasty Register
title_fullStr The association between metal allergy, total knee arthroplasty, and revision: Study based on the Danish Knee Arthroplasty Register
title_full_unstemmed The association between metal allergy, total knee arthroplasty, and revision: Study based on the Danish Knee Arthroplasty Register
title_short The association between metal allergy, total knee arthroplasty, and revision: Study based on the Danish Knee Arthroplasty Register
title_sort association between metal allergy, total knee arthroplasty, and revision: study based on the danish knee arthroplasty register
topic Knee
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4443448/
https://www.ncbi.nlm.nih.gov/pubmed/25582229
http://dx.doi.org/10.3109/17453674.2014.999614
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