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Biomaterial hypersensitivity: is it real? Supportive evidence and approach considerations for metal allergic patients following total knee arthroplasty.

Mitchelson AJ, Wilson CJ, Mihalko WM, Grupp TM, Manning BT, Dennis DA, Goodman SB, Tzeng TH, Vasdev S, Saleh KJ - Biomed Res Int (2015)

Bottom Line: Many studies have established probable causation between first-generation metal-on-metal hip implants and hypersensitivity reactions.The examination of hypersensitivity reactions in current-generation metal-on-metal knee implants is comparatively limited.The purpose of this study is to summarize all available literature regarding biomaterial hypersensitivity after total knee arthroplasty, elucidate overall trends about this topic in the current literature, and provide a foundation for clinical approach considerations when biomaterial hypersensitivity is suspected.

View Article: PubMed Central - PubMed

Affiliation: Division of Orthopaedics and Rehabilitation, Department of Surgery, Southern Illinois University School of Medicine, P.O. Box 19679, Springfield, IL 62794-9679, USA.

ABSTRACT
The prospect of biomaterial hypersensitivity developing in response to joint implant materials was first presented more than 30 years ago. Many studies have established probable causation between first-generation metal-on-metal hip implants and hypersensitivity reactions. In a limited patient population, implant failure may ultimately be related to metal hypersensitivity. The examination of hypersensitivity reactions in current-generation metal-on-metal knee implants is comparatively limited. The purpose of this study is to summarize all available literature regarding biomaterial hypersensitivity after total knee arthroplasty, elucidate overall trends about this topic in the current literature, and provide a foundation for clinical approach considerations when biomaterial hypersensitivity is suspected.

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Related in: MedlinePlus

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Mentions: Several diagnostic algorithms have been suggested for orthopaedic patients with suspected metal hypersensitivity [5, 61]. Comprehensive diagnosis and treatment algorithm are presented in Figures 1 and 2, respectively. Postoperative intervention should follow positive patch test results only when patients are symptomatic or the implant demonstrates clear evidence of failure [5, 9]. Consideration also should be given to nonmetal allergic reactions after TKA. Benzoyl peroxide found in bone cement may cause delayed hypersensitivity reactions [5, 64, 65].


Biomaterial hypersensitivity: is it real? Supportive evidence and approach considerations for metal allergic patients following total knee arthroplasty.

Mitchelson AJ, Wilson CJ, Mihalko WM, Grupp TM, Manning BT, Dennis DA, Goodman SB, Tzeng TH, Vasdev S, Saleh KJ - Biomed Res Int (2015)

© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4390183&req=5

Mentions: Several diagnostic algorithms have been suggested for orthopaedic patients with suspected metal hypersensitivity [5, 61]. Comprehensive diagnosis and treatment algorithm are presented in Figures 1 and 2, respectively. Postoperative intervention should follow positive patch test results only when patients are symptomatic or the implant demonstrates clear evidence of failure [5, 9]. Consideration also should be given to nonmetal allergic reactions after TKA. Benzoyl peroxide found in bone cement may cause delayed hypersensitivity reactions [5, 64, 65].

Bottom Line: Many studies have established probable causation between first-generation metal-on-metal hip implants and hypersensitivity reactions.The examination of hypersensitivity reactions in current-generation metal-on-metal knee implants is comparatively limited.The purpose of this study is to summarize all available literature regarding biomaterial hypersensitivity after total knee arthroplasty, elucidate overall trends about this topic in the current literature, and provide a foundation for clinical approach considerations when biomaterial hypersensitivity is suspected.

View Article: PubMed Central - PubMed

Affiliation: Division of Orthopaedics and Rehabilitation, Department of Surgery, Southern Illinois University School of Medicine, P.O. Box 19679, Springfield, IL 62794-9679, USA.

ABSTRACT
The prospect of biomaterial hypersensitivity developing in response to joint implant materials was first presented more than 30 years ago. Many studies have established probable causation between first-generation metal-on-metal hip implants and hypersensitivity reactions. In a limited patient population, implant failure may ultimately be related to metal hypersensitivity. The examination of hypersensitivity reactions in current-generation metal-on-metal knee implants is comparatively limited. The purpose of this study is to summarize all available literature regarding biomaterial hypersensitivity after total knee arthroplasty, elucidate overall trends about this topic in the current literature, and provide a foundation for clinical approach considerations when biomaterial hypersensitivity is suspected.

Show MeSH
Related in: MedlinePlus