The MELISA test in the patient revealed strongly positive allergy to nickel and chromium and weakly positive results for cobalt and molybdenum. A total of 100 patients referred for total hip or total knee arthroplasty were assessed for metal allergy preoperatively and then at 1 year post-implantation by means of patch tests. Stage I (pre-implantation) - 60 patients scheduled for arthroplasty surgery. David R. Lionberger, MD, orthopedic surgeon and assistant professor at Texas A&M University, said for patients to have a metal hypersensitive reaction to an implant, there needs to be a … Request PDF | On Sep 1, 2001, Nadim Hallab published Metal Sensitivity in Patients with Orthopedic Implants | Find, read and cite all the research you need on ResearchGate Sensitization to orthopaedic implant materials is an unpredictable event that might affect implant performance. Routine pre-implant testing in asymptomatic individuals is not indicated. Hallab, Nadim et al. This delayed hypersensitivity to metallic orthopedic implants is more clearly defined and is a contributing factor to implant failure. Innocenti M, Carulli C, Matassi F, Carossino AM, Brandi ML, Civinini R. Total knee arthroplasty in patients with hypersensitivity to metals. Cutaneous metal sensitivity in patients with orthopaedic injuries. Metal sensitivity in patients with orthopaedic implants. Allergo J Int, pp. 273 - 279 CrossRef View Record in Scopus Google Scholar Objectives. On the other hand, there are multiple authors reporting opposite data, though the patient groups are smaller. Vanadium allergy may be underdiagnosed because it is not a standard patch test allergen. The prevalence of dermal sensitivity in patients with a joint replacement device, particularly those with a failed implant, is substantially higher than that in the general population. 28:243–246 2015. 2014;23:179-185., 2014. - The prevalence of dermal sensitivity in patients with a joint replacement device, particularly those with a failed implant, is substantially higher than that in the general population. Metal Sensitivity in Patients with Orthopaedic Implants ... test for the clinical determination of metal hypersensitivity to implanted devices. For this type of highly specialized testing Dr. Kaper will use the Orthopedic Analysis lab in … Materials and methods: The study was conducted in two stages. Because a metal allergy to implant components is currently not commonly considered in the differential for joint failure in the orthopedic literature, there should be improved communication and collaboration between orthopedists and dermatologists when evaluating joint replacement patients with a presentation suggestive of allergy. [12] Thomas P. Clinical and diagnostic challenges of metal implant allergy using the example of orthopaedic surgical implants. Objectives: Evaluation of the allergenic properties of the metal knee or hip joint implants 24 months post surgery and assessment of the relation between allergy to metals and metal implants failure. J Bone Joint Surg Am. Stainless steel, which contains a large percentage of nickel, is often used for screws while Three patient groups were set up: (1) individuals without implants and no history of metal allergy (7 cases), (2) individuals without implants and known history of metal allergy (7 cases), and … of assessment and treatment, particularly in patients with self-reported metal allergies before surgery [30]. Are orthopaedic implants failing due to metal allergy? Metal sensitivity in patients with orthopaedic implants: a prospective study @article{Frigerio2011MetalSI, title={Metal sensitivity in patients with orthopaedic implants: a prospective study}, author={E. Frigerio and Paolo D. Pigatto and G. Guzzi and G. Altomare}, journal={Contact Dermatitis}, year={2011}, volume={64} } The tests were significantly more positive in the patients with knee implants… Prevalence of self-reported metal allergy in patients undergoing primary total knee arthroplasty. Metal Sensitivity in Patients with Orthopaedic Implants, The Journal of Bone & Joint Surgery, Vol 83-A No. Frigerio E, Pigatto PD, Guzzi G, Altomare G. Source Department of Technology for Health, Dermatological Clinic, IRCCS Galeazzi Hospital, University of Milan, Milan 20161, Italy. Unfortunately, this is not definitive. 3 –5 Although THA has a high success rate, implant loosening may occur, with early symptoms including persistent pain and aseptic failure. The most common form of all metal hypersensitivity is allergic contact dermatitis (ACD) caused by nickel. Unfortunately, people who are sensitive can suffer chronic inflammation from the chromium, nickel, or cobalt often used in them. In patients with osteoarthritis, metal-on-metal is the implant of choice because such implants are relatively cheap and have low wear rates. Metal sensitivity in patients with orthopaedic implants: a prospective study. Background. Metal sensitivity in patients with orthopaedic implants: a prospective study Contact Dermatitis , 64 ( 2011 ) , pp. Based on the MELISA report, the implant to be used in our patient was chosen to be of titanium (femoral and tibia component) and a polyethylene insert was used to avoid the possible metal allergy. The prevalence of dermal sensitivity in patients with a ... that in the general population. March 11, 2020 - melisa_wpa. 2011; 64(5):273-9 (ISSN: 1600-0536) Frigerio E; Pigatto PD; Guzzi G; Altomare G. BACKGROUND: Sensitization to orthopaedic implant materials is an unpredictable event that might affect implant … ... Background: Manufactures of orthopaedic fracture implants have turned to titanium in a pure form and an alloy during the past ten to fifteen years. Metal alloy implants cause allergic reactions in sensitive people Metal alloys are used in orthopedic implants for strength and durability. 3, 4 Interestingly, the prevalence of contact skin sensitivity in patients with a joint replacement device is higher than that in the general population. Listen to patient’s concerns about metal allergy if the concern arises. The most common contact allergy in the United States is metal allergy, specifically nickel. The aim of the study was to examine the reactivity of peripheral human leukocytes to various metal ions prior and following hip replacement in order to investigate implant-induced metal sensitivity. The prevalence of contact skin sensitivity in patients with a joint replacement device is higher than that in the general population. 2001 Mar;83-A(3):428-36. Abstract Metal Sensitivity in Patients with Orthopaedic Implants, The Journal of Bone & Joint Surgery, Vol 83-A No. J Knee Surg. Comments are off for this post. This chronic inflammation opens the door to developing skin cancer. The risk must be considered seriously, however, in patients with a history of dermal sensitivity who are undergoing permanent placement of orthopedic implants such as … Contact Dermatitis. The frequency of metal sensitivity in the patients awaiting surgery was similar to that of the general population and the most common sensitizers were nickel, followed by cobalt, chromium and manganese. Metal sensitivity in patients with orthopaedic implants: a prospective study. 3. PHILADELPHIA, Nov. 12 -- When a patient with an orthopedic implant develops a rash or inflammatory symptoms, think metal allergy, suggested researchers here. March 2001 p428-436 (THA) revision in patients with cases with metal allergy, and metal allergy risk was not elevated after THA [26]. Patch testing is probably the best pre- and post-implant screening test. Metal sensitivity as a cause for painful joint replacement has become increasingly prevalent; however, there is a lack of reported clinical outcome data from total knee arthroplasty patients with metal allergies. 5,12,13,15 The scarcity of literature on vanadium allergy seems to suggest that it is a rare entity, but we believe that it may be more common. Information overview • There are multiple reports citing metal allergy as a cause of orthopaedic implant failure1-7 • In addition to Nickel, most patients are allergic to multiple metals.8-9 Cobalt and Chromium have also both been cited as allergens leading to revision.5-6, 17-18 Five 5% >Five 3. It is thought that the use of jewelry is the dominant cause of exposure .Common metal alloys used in orthopedic implants are stainless steel (which contains nickel), titanium, and oxidized zirconium. Although reports are rare, other researchers have found vanadium allergy in patients with metal orthopedic implants. BACKGROUND: Sensitization to orthopaedic implant materials is an unpredictable event that might affect implant performance. Metal allergy testing is readily available to help identify patients with potential allergies or to evaluate patients with previous joint replacements who may be experiencing allergic-type response to their implant. Implant metals. March 2001 p428-436; Hallab, Nadim et al. Metal sensitivity in patients with orthopaedic implants: a prospective study . Reactions to metal orthopedic implants do occur, though rarely, even in those with metal allergy. Orthopedic Implants Orthopedic implants often contain nickel, cobalt, chromium, and/or titanium [31].