Advertisement

Metal Allergy pp 249-262 | Cite as

Hypersensitivity to Hip and Knee Implants

  • Lauren N. Ko
  • Peter C. Schalock
Chapter

Abstract

Prosthetic hip and knee implantations rank among the most common elective operations in the United States and Europe. These implants are compositionally complex and have undergone drastic evolutions over the past several decades. Hypersensitivity reactions to hip and knee implant components are well documented in the literature but remain uncommon. They range from localized dermatitis to implant loosening and subsequent failure. Currently, patch testing is the most useful method to evaluate for metal allergy. Preimplantation testing is not necessary unless patients have a significant history of skin rashes after metal contact or previously have experienced device failure. Postoperative complications such as aseptic loosening, chronic pain, or new, unexplained local or regional dermatitis may occasionally benefit from evaluation for metal allergy. Clinical next steps following implantation may be challenging. If the implant is symptomatic, topical or systemic corticosteroids may be tried, but ultimately, the surgeon and patient may need to decide whether replacement with a less allergenic alternative is feasible and safe. Whether pre- or postoperative, clinical decisions should be made by the collaborative efforts of dermatologists, allergists, and surgeons. Prospective trials in this field are still necessary to develop an evidence-based approach to the treatment of patients with allergic reactions to metal, as current clinicians are guided largely by expert opinion.

Abbreviations

AJL

Aseptic joint loosening

ALTR

Adverse local tissue reactions

ALVAL

Aseptic lymphocyte-dominated vasculitis-associated lesion

CoCrMo

Cobalt-chromium-molybdenum

CRP

C-reactive protein

ESR

Erythrocyte sedimentation rate

LTT

Lymphocyte transformation testing

mLST

Modified lymphocyte stimulation test

MoM

Metal-on-metal

MoP

Metal-on-plastic

PTFE

Polytetrafluoroethylene

THA

Total hip arthroplasty

TJR

Total joint replacements

TKA

Total knee arthroplasty

THR

Total hip replacement

References

  1. 1.
    Knight SR, Aujla R, Biswas SP. Total hip arthroplasty - over 100 years of operative history. Orthop Rev. 2001;3(2):e16.Google Scholar
  2. 2.
    Learmonth ID, Young C, Rorabeck C. The operation of the century: total hip replacement. Lancet. 2007;370:1508–19.PubMedGoogle Scholar
  3. 3.
    HCPUnet, Healthcare Cost and Utilization Project. Agency for Healthcare Research and Quality. http://hcupnet.ahrq.gov. Accessed 20 Aug 2016.
  4. 4.
    Benson MK, Goodwin PG, Brostoff J. Metal sensitivity in patients with joint replacement arthroplasties. Br Med J. 1975;15:374–5.Google Scholar
  5. 5.
    Christiansen K, Holmes K, Zilko PJ. Metal sensitivity causing loosened joint prostheses. Ann Rheum Dis. 1980;39(5):476.PubMedPubMedCentralGoogle Scholar
  6. 6.
    Tisley DA, Rostein H. Sensitivity caused by internal exposure to nickel, chrome and cobalt. Contact Dermatitis. 1980;6:175–8.Google Scholar
  7. 7.
    Elves MW, Wilson JN, Scales JT, Kemp HB. Incidence of metal sensitivity in patients with total joint replacements. Br Med J. 1975;15:376–8.Google Scholar
  8. 8.
    Svedman C, Lundh T, Tillman C, et al. Gold concentration in blood in patients with gold-plated stents. Contact Dermatitis. 2006;54(4):221–2.PubMedGoogle Scholar
  9. 9.
    Amstutz HC, Grigoris P. Metal on metal bearings in hip arthroplasty. Clin Orthop Relat Res. 1966;(329 Suppl):S11–34.Google Scholar
  10. 10.
    Basko-Plluska JL, Thyssen JP, Schalock PC. Cutaneous and systemic hypersensitivity reactions to metallic implants. Dermatitis. 2011;22(2):65–79.PubMedGoogle Scholar
  11. 11.
    Halpin DS. An unusual reaction in muscle in association with a Vitallium plate: a report of possible metal hypersensitivity. J Bone Joint Surg (Br). 1975;57:451–3.Google Scholar
  12. 12.
    Nakamura S, Yasunaga Y, Ikuta Y, et al. Autoantibodies to red cells associated with metallosis—a case report. Acta Orthop Scand. 1997;68:495–6.PubMedGoogle Scholar
  13. 13.
    Thyssen JP, Menne T, Schalock PC, et al. Pragmatic approach to the clinical work up of patients with putative allergic disease to metallic orthopaedic implants before and after surgery. Br J Dermatol. 2011;164:473–8.PubMedGoogle Scholar
  14. 14.
    Sugiyama T, Uo M, Wada T, et al. Novel metal allergy patch test using metal nanoballs. J Nanobiotechnol. 2014;3:51.Google Scholar
  15. 15.
    Shimmin A, Beaulé PE, Campbell P. Metal-on-metal hip resurfacing arthroplasty. J Bone Joint Surg Am. 2008;90:637–54.PubMedGoogle Scholar
  16. 16.
    Silverman EJ, Ashley B, Sheth NP. Metal-on-metal total hip arthroplasty: is there still a role in 2016? Curr Rev Musculoskelet Med. 2016;9(1):93–6.PubMedPubMedCentralGoogle Scholar
  17. 17.
    Ridley CM. How relevant is cobalt sensitivity in a patient with unsatisfactory total knee replacement? Clin Exp Dermatol. 1977;2(4):401–4.PubMedGoogle Scholar
  18. 18.
    Munro-Ashman D, Miller AJ. Rejection of metal to metal prosthesis and skin sensitivity to cobalt. Contact Dermatitis. 1976;2(2):65–7.PubMedGoogle Scholar
  19. 19.
    Symeonides PP, Paschaloglo C, Papageorgiou S. An allergic reaction after internal fixation of a fracture using a vitallium plate. J Allergy Clin Immunol. 1973;51(4):251–2.PubMedGoogle Scholar
  20. 20.
    Verma SB, Mody B, Gawkrodger DJ. Dermatitis on the knee following knee replacement: a minority of cases show contact allergy to chromate, cobalt or nickel but a causal association is unproven. Contact Dermatitis. 2006;54(4):228–9.PubMedGoogle Scholar
  21. 21.
    Bergschmidt P, Bader R, Mittelmeier W. Metal hypersensitivity in total knee arthroplasty: revision surgery using a ceramic femoral component–a case report. Knee. 2012;19(2):144–7.PubMedGoogle Scholar
  22. 22.
    Handa S, Dogra S, Prasad R. Metal sensitivity in a patient with a total knee replacement. Contact Dermatitis. 2003;49(5):259–60.PubMedGoogle Scholar
  23. 23.
    Thomsen M, Rozak M, Thomas P. Pain in a chromium- allergic patient with total knee arthroplasty: disappearance of symptoms after revision with a special surface-coated TKA—a case report. Acta Orthop. 2011;82(3):386–8.PubMedPubMedCentralGoogle Scholar
  24. 24.
    Oiso N, Komeda T, Fukai K, et al. Metal allergy to implanted orthopaedic prosthesis after post-operative Staphylococcus aureus infection. Contact Dermatitis. 2004;51(3):151–3.PubMedGoogle Scholar
  25. 25.
    Beecker J, Gordon J, Pratt M. An interesting case of joint prosthesis allergy. Dermatitis. 2009;20(2):E4–9.PubMedGoogle Scholar
  26. 26.
    van Opstal N, Verheyden F. Revision of a tibial baseplate using a customized oxinium component in a case of suspected metal allergy. A case report. Acta Orthop Belg. 2001;77(5):691–5.Google Scholar
  27. 27.
    Dietrich KA, Mazoochian F, Summer B, et al. Intolerance reactions to knee arthroplasty in patients with nickel/cobalt allergy and disappearance of symptoms after revision surgery with titanium-based endoprostheses. J Dtsch Dermatol Ges. 2009;7:410–2.PubMedGoogle Scholar
  28. 28.
    Gao X, He RX, Yan SG, et al. Dermatitis associated with chromium following total knee arthroplasty. J Arthroplast. 2011;26(4):665.Google Scholar
  29. 29.
    Post ZD, Orozco FR, Ong AC. Metal sensitivity after TKA presenting with systemic dermatitis and hair loss. Orthopedics. 2013;36(4):e525–8.PubMedGoogle Scholar
  30. 30.
    Wiley K, Ding K. Incidence of pseudotumor and acute lymphocytic vasculitis associated lesion (ALVAL) reactions in metal-on-metal hip articulations: a meta-analysis. J Arthroplast. 2013;28:1238–45.Google Scholar
  31. 31.
    Berstock JR, Baker RP, Bannister GC, et al. Histology of failed metal-on-metal hip arthroplasty; three distinct sub-types. Hip Int. 2014;24(3):243–8.PubMedGoogle Scholar
  32. 32.
    Chalmers BP, Perry KI, Taunton MJ, et al. Diagnosis of adverse local tissue reactions following metal-on-metal hip arthroplasty. Curr Rev. Musculoskelet Med. 2016;9(1):67–74.PubMedPubMedCentralGoogle Scholar
  33. 33.
    Griffiths HJ, Burke J, Bonfiglio TA. Granulomatous pseudotumors in total joint replacement. Skelet Radiol. 1987;16(2):146–52.Google Scholar
  34. 34.
    Grammatopoulos G, Pandit H, Kwon YM, et al. Hip resurfacings revised for inflammatory pseudotumour have a poor outcome. J Bone Joint Surg (Br). 2009;91:1019–24.Google Scholar
  35. 35.
    Carr AM, DeSteiger R. Osteolysis in patients with a metal-on-metal hip arthroplasty. ANZ J Surg. 2008;78:144–7.PubMedGoogle Scholar
  36. 36.
    Aroukatos P, Repanti M, Repantis T, et al. Immunologic adverse reaction associated with low-carbide metal-on-metal bearings in total hip arthroplasty. Clin Orthop Relat Res. 2010;468:2135–42.PubMedGoogle Scholar
  37. 37.
    Glyn-Jones S, Pandit H, Kwon YM, et al. Risk factors for inflammatory pseudotumour formation following hip resurfacing. J Bone Joint Surg (Br). 2009;91:1566–74.Google Scholar
  38. 38.
    Liow MH, Urish KL, Preffer FI, et al. Metal ion levels are not correlated with histopathology of adverse local tissue reactions in taper corrosion of total hip arthroplasty. J Arthroplast. 2016;31(8):1797–802.Google Scholar
  39. 39.
    Gawkrodger DJ. Metal sensitivities and orthopaedic implants revisited: the potential for metal allergy with the new metal-on-metal joint prostheses. Br J Dermatol. 2003;148:1089–93.PubMedGoogle Scholar
  40. 40.
    von Domarus C, Rosenberg JP, Rüther W, et al. Necrobiosis and T-lymphocyte infiltration in retrieved aseptically loosened metal-on-polyethylene arthroplasties. Acta Orthop. 2011;82(5):596–601.Google Scholar
  41. 41.
    Urban RM, Jacobs JJ, Tomlinson MJ, et al. Dissemination of wear particles to the liver, spleen and abdominal lymph nodes of patients with hip or knee replacement. J Bone Joint Surg Am. 2000;82(4):457–76.PubMedGoogle Scholar
  42. 42.
    Thierse HJ, Gamerdinger K, Junkes C, et al. T cell receptor (TCR) interaction with haptens: metal ions as non-classical haptens. Toxicology. 2005;209(2):101–7.Google Scholar
  43. 43.
    Munch HJ, Jacobsen SS, Olesen JT, et al. The association between metal allergy, total knee arthroplasty and revision: study based on the Danish knee Arthroplasty register. Acta Orthop. 2015;86(3):379–83.Google Scholar
  44. 44.
    Cadosch D, Chan E, Gautschi OP, et al. Metal is not inert: role of metal ions released by biocorrosion in aseptic loosening—current concepts. J Biomed Mater Res. 2009;91(4):1252–62.Google Scholar
  45. 45.
    Wataha JC, Lockwood PE, Marek M, et al. Ability of Ni-containing biomedical alloys to activate monocytes and endothelial cells in vitro. J Biomed Mater Res. 1999;45(3):251–7.PubMedGoogle Scholar
  46. 46.
    Lane A, Tyson A, Thurston E. Providing re-essure-ance to the nickel-allergic patient considering hysteroscopic sterilization. J Minim Invasive Gynecol. 2016;23(1):126–9.PubMedGoogle Scholar
  47. 47.
    Pourzal R, Urban RM, Wimmer MA. What do the retrievals really tell us? In:Metal on metal bearings: a clinical practicum. New York: Springer; 2014. p. 173–93.Google Scholar
  48. 48.
    Cooper HJ, Jacobs JJ. Benign responses to orthopaedic implants: really? In:Metal on metal bearings: a clinical practicum. New York: Springer; 2014. p. 135–51.Google Scholar
  49. 49.
    Brown C, Fisher J, Ingham E. Biological effects of clinically relevant wear particles from metal-on-metal hip prostheses. Proc Inst Mech Eng H. 2006;220:355–69.PubMedGoogle Scholar
  50. 50.
    Catelas I, Wimmer MA. New insights into wear and biological effects of metal-on-metal bearings. J Bone Joint Surg Am. 2011;93(12):1158.Google Scholar
  51. 51.
    Mahendra G, Pandit H, Kliskey K, et al. Necrotic and inflammatory changes in metal-on-metal resurfacing hip arthroplasties. Acta Orthop. 2009;80:653–9.PubMedPubMedCentralGoogle Scholar
  52. 52.
    Simpson JM, Villar RN. Hip resurfacing. Br Med J. 2010;341:3459.Google Scholar
  53. 53.
    Campbell P, Ebramzaddeh E, Nelson S, et al. Histological features of pseudotumor-like tissues from metal-on-metal hips. Clin Orthop Relat Res. 2010;468:2321–7.PubMedPubMedCentralGoogle Scholar
  54. 54.
    Pandit H, Glyn-Jones S, McLardy-Smith P, et al. Pseudotumours associated with metal-on-metal hip resurfacings. J Bone Joint Surg (Br). 2008;90:847–51.Google Scholar
  55. 55.
    Pandit H, Vlychou M, Whitwell D, et al. Necrotic granulomatous pseudotumours in bilateral resurfacing hip arthoplasties: evidence for a type IV immune response. Virchows Arch. 2008;453:529–34.PubMedGoogle Scholar
  56. 56.
    Williams DH, Greidanus NV, Masri BA, et al. Prevalence of pseudotumor in asymptomatic patients after metal-on-metal hip arthroplasty. J Bone Joint Surg Am. 2011;93:2164–71.PubMedGoogle Scholar
  57. 57.
    Holland DJ, Quigley L, Sprague S, et al. Pseudotumors associated with total hip arthroplasty. J Bone Joint Surg Am. 2012;94:86–93.PubMedGoogle Scholar
  58. 58.
    Tallroth K, Eskola A, Santavirta S, et al. Aggressive granulomatous lesions after hip arthroplasty. J Bone Joint Surg (Br). 1989;71:571–5.Google Scholar
  59. 59.
    Santavirta S, Hoikka V, Eskola A, et al. Aggressive granulomatous lesions in cementless total hip arthroplasty. J Bone Joint Surg (Br). 1990;72:980–4.Google Scholar
  60. 60.
    Shin YS, Jung TW, Han SB. Vaginal mass following uncemented total hip arthroplasty. Indian J Orthop. 2014;48(6):628–30.PubMedPubMedCentralGoogle Scholar
  61. 61.
    Aquino M, Mucci T. Systemic contact dermatitis and allergy to biomedical devices. Curr Allergy Asthma Rep. 2013;13:518–27.PubMedGoogle Scholar
  62. 62.
    Scully WF, Teeny SM. Pseudotumor associated with metal-on-polyethylene total hip arthroplasty. Orthopedics. 2013;36:666–70.Google Scholar
  63. 63.
    Carli A, Reuven A, Zukor DJ, et al. Adverse soft-tissue reactions around non-metal-on-metal total hip arthroplasty - a systematic review of the literature. Bull NYU Hosp Jt Dis. 2011;69(1):47–51.Google Scholar
  64. 64.
    Natu S, Sidaginamale RP, Gandhi J, et al. Adverse reactions to metal debris: histopathological features of periprosthetic soft tissue reactions seen in association with failed metal on metal hip arthroplasties. J Clin Pathol. 2012;65:409–18.PubMedGoogle Scholar
  65. 65.
    Briggs TW, Hanna SA, Kayani B, et al. Metal-on-polyethylene versus metal-on-metal bearing surfaces in total hip arthroplasty: a prospective randomised study investigating metal ion levels and chromosomal aberrations in peripheral lymphocytes. Bone Joint J. 2015;97(9):1183–91.PubMedGoogle Scholar
  66. 66.
    Cousen PJ, Gawkrodger DJ. Metal allergy and second-generation metal-on-metal arthroplasties. Contact Dermatitis. 2012;66(2):55–62.PubMedGoogle Scholar
  67. 67.
    Brown GC, Lockshin MD, Salvati EA, et al. Sensitivity to metal as a possible cause of sterile loosening after cobalt-chromium total hip replacement arthroplasty. J Bone Joint Surg Am. 1977;59(2):164–8.PubMedGoogle Scholar
  68. 68.
    Hallab N. Metal sensitivity in patients with orthopedic implants. J Clin Rheumatol. 2001;7(4):215–8.PubMedGoogle Scholar
  69. 69.
    Park YS, Moon YW, Lim SJ, et al. Early osteolysis following second- generation metal-on-metal hip replacement. J Bone Joint Surg Am. 2005;87:1515–21.PubMedGoogle Scholar
  70. 70.
    Deutman R, Mulder TJ, Brian R, et al. Metal sensitivity before and after total hip arthroplasty. J Bone Joint Surg Am. 1977;59:862–5.PubMedGoogle Scholar
  71. 71.
    Antony FC, Holden CA. Metal allergy resurfaces in failed hip endoprostheses. Contact Dermatitis. 2003;48:49–50.PubMedGoogle Scholar
  72. 72.
    Milavec-Puretic V, Orlic D, Marusic A. Sensitivity to metals in 40 patients with failed hip endoprosthesis. Arch Orthop Trauma Surg. 1998;117:383–6.PubMedGoogle Scholar
  73. 73.
    Fang CS, Harvie P, Gibbons CL, et al. The imaging spectrum of periarticular inflammatory masses following metal-on-metal hip resurfacing. Skelet Radiol. 2008;37:715–22.Google Scholar
  74. 74.
    Willert HG, Buchhorn GH, Fayyazi A, et al. Metal-on-metal bearings and hypersensitivity in patients with artificial hip joints. A clinical and histomorphological study. J Bone Joint Surg Am. 2005;87:28–36.PubMedGoogle Scholar
  75. 75.
    Mikhael MM, Hanssen AD, Sierra RJ. Failure of metal-on-metal total hip arthroplasty mimicking hip infection. A report of two cases. J Bone Joint Surg Am. 2009;91:443–6.PubMedGoogle Scholar
  76. 76.
    Campbell P, Shimmin LW, Solomon M. Metal sensitivity as a cause of groin pain in metal-on-metal hip resurfacing. J Arthroplast. 2008;23:1080–5.Google Scholar
  77. 77.
    Jensen P, Thyssen JP, Retpen JB, et al. Cobalt allergy and suspected aseptic lymphocyte-dominated vascular-associated lesion following total hip arthroplasty. Contact Dermatitis. 2009;61:238–9.PubMedGoogle Scholar
  78. 78.
    Counsell A, Heasley R, Arumilli B, et al. A groin mass caused by metal particle debris after hip resurfacing. Acta Orthop Belg. 2008;74:870–4.PubMedGoogle Scholar
  79. 79.
    Korovessis P, Petsinis G, Repanti M, et al. Metallosis after contemporary metal-on-metal total hip arthroplasty. Five to nine-year follow-up. J Bone Joint Surg Am. 2006;88:1183–91.PubMedGoogle Scholar
  80. 80.
    Cancilleri F, De Giorgis P, Verdoia C, et al. Allergy to components of total hip arthroplasty before and after surgery. Ital J Orthop Traumatol. 1992;18(3):407–10.PubMedGoogle Scholar
  81. 81.
    Hallab NJ, Anderson S, Stafford T, et al. Lymphocyte responses in patients with total hip arthroplasty. J Orthop Res. 2005;23(2):384–91.Google Scholar
  82. 82.
    Atanaskova Mesinkovska N, Tellez A, Molina L, et al. The effect of patch testing on surgical practices and outcomes in orthopedic patients with metal implants. Arch Dermatol. 2012;148(6):687–93.PubMedGoogle Scholar
  83. 83.
    Niki Y, Matsumoto H, Otani T, et al. Screening for symptomatic metal sensitivity: a prospective study of 92 patients undergoing total knee arthroplasty. Biomaterials. 2005;26:1019–26.PubMedGoogle Scholar
  84. 84.
    Eben R, Dietrich KA, Nerz C, et al. Contact allergy to metals and bone cement components in patients with intolerance of arthroplasty. Dtsch Med Wochenschr. 2010;135(28–29):1418–22.PubMedGoogle Scholar
  85. 85.
    Krecisz B, Kieć-Swierczyńska M, Bakowicz-Mitura K. Allergy to metals as a cause of orthopedic implant failure. Int J Occup Med Environ Health. 2006;19(3):178–80.Google Scholar
  86. 86.
    Evans EM, Freeman MA, Miller AJ, Vernon-Roberts B. Metal sensitivity as a cause of bone necrosis and loosening of the prosthesis in total joint replacement. J Bone Joint Surg (Br). 1974;56(4):626–42.Google Scholar
  87. 87.
    Zeng Y, Feng W, Li J, et al. A prospective study concerning the relationship between metal allergy and post-operative pain following total hip and knee arthroplasty. Int Orthop. 2014;38(11):2231–6.PubMedGoogle Scholar
  88. 88.
    Granchi D, Cenni E, Trisolino G, et al. Sensitivity to implant materials in patients undergoing total hip replacement. J Biomed Mater Res B Appl Biomater. 2006;77(2):257–64.PubMedGoogle Scholar
  89. 89.
    Waterman AH, Schrik JJ. Allergy in hip arthroplasty. Contact Dermatitis. 1985;13(5):294–301.PubMedGoogle Scholar
  90. 90.
    Carlsson AS, Magnusson B, Möller H. Metal sensitivity in patients with metal-to-plastic total hip arthroplasties. Acta Orthop Scand. 1980;51(1):57–62.PubMedGoogle Scholar
  91. 91.
    Nater JP, Brain RG, Deutman R, et al. The development of metal hypersensitivity in patients with metal-to-plastic hip arthroplasties. Contact Dermatitis. 1976;2(5):259–61.PubMedGoogle Scholar
  92. 92.
    Rooker GD, Wilkinson JD. Metal sensitivity in patients undergoing hip replacement. A prospective study. J Bone Joint Surg (Br). 1980;62(4):502–5.Google Scholar
  93. 93.
    Reed KB, Davis MD, Nakamura K, et al. Retrospective evaluation of patch testing before or after metal device implantation. Arch Dermatol. 2008;144(8):999–1007.PubMedGoogle Scholar
  94. 94.
    Webley M, Kates A, Snaith ML. Metal sensitivity in patients with a hinge arthroplasty of the knee. Ann Rheum Dis. 1978;37:373–5.PubMedPubMedCentralGoogle Scholar
  95. 95.
    Benevenia J, Lee FY, Buechel F, et al. Pathologic supracondylar fracture due to osteolytic pseudotumor of knee following cementless total knee replacement. J Biomed Mater Res. 1998;43:473–7.PubMedGoogle Scholar
  96. 96.
    Thyssen JP, Jakobsen SS, Engkilde K, et al. The association between metal allergy, total hip arthroplasty, and revision. Acta Orthop. 2009;80:646–52.PubMedPubMedCentralGoogle Scholar
  97. 97.
    Innocenti M, Carulli C, Matassi F, et al. Total knee arthroplasty in patients with hypersensitivity to metals. Int Orthop. 2014;38(2):329–33.PubMedPubMedCentralGoogle Scholar
  98. 98.
    Lachiewicz PF, Watters TS, Jacobs JJ. Metal hypersensitivity and total knee arthroplasty. J Am Acad Orthop Surg. 2016;24(2):106–12.PubMedPubMedCentralGoogle Scholar
  99. 99.
    Granchi D, Cenni E, Tigani D, et al. Sensitivity to implant materials in patients with total knee arthroplasties. Biomaterials. 2008;29(10):1494–500.PubMedGoogle Scholar
  100. 100.
    Nam D, Li K, Riegler B, et al. Patient-reported metal allergy: a risk factor for poor outcomes after total joint arthroplasty. J Arthroplast. 2016;5403(16):136–4.Google Scholar
  101. 101.
    Bravo D, Wagner ER, Larson DR, et al. No increased risk of knee arthroplasty failure in patients with positive skin patch testing for metal hypersensitivity: a matched cohort study. J Arthroplast. 2016;31(8):1717–21.Google Scholar
  102. 102.
    Middleton S, Toms A. Allergy in total knee arthroplasty: a review of the facts. Bone Joint J. 2016;98:437–41.PubMedGoogle Scholar
  103. 103.
    Razak A, Ebinesan AD, Charalambous CP. Metal allergy screening prior to joint arthroplasty and its influence on implant choice: a delphi consensus study amongst orthopaedic arthroplasty surgeons. Knee Surg Relat Res. 2013;25(4):186–93.PubMedPubMedCentralGoogle Scholar
  104. 104.
    Thomas P, Schuh A, Ring J, et al. Orthopedic surgical implants and allergies: joint statement by the implant allergy working group (AK 20) of the DGOOC (German Association of Orthopedics and Orthopedic Surgery), DKG (German contact dermatitis research group) and DGAKI (German Society for Allergology and Clinical Immunology) [in German]. Orthopade. 2008;37(1):75–88.PubMedGoogle Scholar
  105. 105.
    Johansen JD, Aalto-Korte K, Agner T, Andersen KE, Bircher A, Bruze M, Cannavó A, Giménez-Arnau A, Gonçalo M, Goossens A, John SM, Lidén C, Lindberg M, Mahler V, Matura M, Rustemeyer T, Serup J, Spiewak R, Thyssen JP, Vigan M, White IR, Wilkinson M, Uter W. European Society of Contact Dermatitis guideline for diagnostic patch testing recommendations on best practice. Contact Dermatitis. 2015;73(4):195–221.Google Scholar
  106. 106.
    Schalock PC, Crawford G, Nedorost S, et al. Patch testing for evaluation of hypersensitivity to implanted metal devices: a perspective from the American contact dermatitis society. Dermatitis. 2016;27(5):241–7.PubMedGoogle Scholar
  107. 107.
    Josefson A, Färm G, Meding B. Validity of self-reported nickel allergy. Contact Dermatitis. 2010;62(5):289–93.PubMedGoogle Scholar
  108. 108.
    Schalock PC, Thyssen JP. Metal hypersensitivity reactions to implants: opinions and practices of patch testing dermatologists. Dermatitis. 2013;24(6):313–20.PubMedGoogle Scholar
  109. 109.
    Honari G, Ellis SG, Wilkoff BL, et al. Hypersensitivity reactions associated with endovascular devices. Contact Dermatitis. 2008;59:7–22.PubMedGoogle Scholar
  110. 110.
    Ko LN, Schalock PC. Prosthetic and Device Surgery Considerations. Current Treatment Options in Allergy 2016;3(4):359–375.Google Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Harvard Medical SchoolBostonUSA
  2. 2.Department of Surgery (Dermatology)Geisel School of Medicine at DartmouthHanoverUSA
  3. 3.FraminghamUSA

Personalised recommendations