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Patellofemoral Joint Replacement and Nickel Allergy: An Unusual Presentation
Metal allergy is an unusual complication of joint replacement that may cause aseptic loosening and necessitate joint revision surgery. We present the case of nickel allergy causing aseptic loosening following patellofemoral joint replacement (PFJR) in a 54-year-old male. Joint revision surgery to a...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Hindawi Publishing Corporation
2015
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4620392/ https://www.ncbi.nlm.nih.gov/pubmed/26543657 http://dx.doi.org/10.1155/2015/635082 |
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author | Syed, Farhan Jenner, Edward Faisal, Mohammad |
author_facet | Syed, Farhan Jenner, Edward Faisal, Mohammad |
author_sort | Syed, Farhan |
collection | PubMed |
description | Metal allergy is an unusual complication of joint replacement that may cause aseptic loosening and necessitate joint revision surgery. We present the case of nickel allergy causing aseptic loosening following patellofemoral joint replacement (PFJR) in a 54-year-old male. Joint revision surgery to a nickel-free total knee replacement was performed with good results. Our literature review shows that there is no evidence to guide the management of metal allergy in PFJR. The evidence from studies of total knee replacement is limited to retrospective case series and case reports and gives contradictory recommendations. The optimal management strategy for metal allergy in PFJR is not clear. We recommend allergy testing in patients with history of metal allergy and use of an allergen-free implant in those with positive tests. As there is no gold standard test to establish metal allergy, the choice of test should be guided by availability and recommendation from the local unit of dermatology and allergy testing. We recommend investigation for metal allergy in patients with implant loosening where other causes have been excluded. |
format | Online Article Text |
id | pubmed-4620392 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2015 |
publisher | Hindawi Publishing Corporation |
record_format | MEDLINE/PubMed |
spelling | pubmed-46203922015-11-05 Patellofemoral Joint Replacement and Nickel Allergy: An Unusual Presentation Syed, Farhan Jenner, Edward Faisal, Mohammad Case Rep Orthop Case Report Metal allergy is an unusual complication of joint replacement that may cause aseptic loosening and necessitate joint revision surgery. We present the case of nickel allergy causing aseptic loosening following patellofemoral joint replacement (PFJR) in a 54-year-old male. Joint revision surgery to a nickel-free total knee replacement was performed with good results. Our literature review shows that there is no evidence to guide the management of metal allergy in PFJR. The evidence from studies of total knee replacement is limited to retrospective case series and case reports and gives contradictory recommendations. The optimal management strategy for metal allergy in PFJR is not clear. We recommend allergy testing in patients with history of metal allergy and use of an allergen-free implant in those with positive tests. As there is no gold standard test to establish metal allergy, the choice of test should be guided by availability and recommendation from the local unit of dermatology and allergy testing. We recommend investigation for metal allergy in patients with implant loosening where other causes have been excluded. Hindawi Publishing Corporation 2015 2015-10-12 /pmc/articles/PMC4620392/ /pubmed/26543657 http://dx.doi.org/10.1155/2015/635082 Text en Copyright © 2015 Farhan Syed et al. https://creativecommons.org/licenses/by/3.0/ This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Case Report Syed, Farhan Jenner, Edward Faisal, Mohammad Patellofemoral Joint Replacement and Nickel Allergy: An Unusual Presentation |
title | Patellofemoral Joint Replacement and Nickel Allergy: An Unusual Presentation |
title_full | Patellofemoral Joint Replacement and Nickel Allergy: An Unusual Presentation |
title_fullStr | Patellofemoral Joint Replacement and Nickel Allergy: An Unusual Presentation |
title_full_unstemmed | Patellofemoral Joint Replacement and Nickel Allergy: An Unusual Presentation |
title_short | Patellofemoral Joint Replacement and Nickel Allergy: An Unusual Presentation |
title_sort | patellofemoral joint replacement and nickel allergy: an unusual presentation |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4620392/ https://www.ncbi.nlm.nih.gov/pubmed/26543657 http://dx.doi.org/10.1155/2015/635082 |
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