Acta Scientific Orthopaedics (ISSN: 2581-8635)

Review Article Volume 6 Issue 4

Metal Hypersensitivity in Total Joint Arthroplasty

Keith Kotecki1, John Walsh1, Gary Ulrich2*, Jim Christensen1,3 and Ronald Hillock1,4

1Valley Hospital Orthopedic Surgery Residency Program, Valley Hospital Medical Center, Las Vegas, NV, USA
2Department of Orthopedic Surgery, University of Kentucky College of Medicine, Lexington, KY, USA
3Department of Allergy and Immunology, Optum Care, Las Vegas, NV, USA
4Department of Orthopedic Surgery, Nevada Orthopedic and Spine Center, Las Vegas, NV, USA

*Corresponding Author: Gary Ulrich, Department of Orthopedic Surgery, University of Kentucky College of Medicine, Lexington, KY, USA.

Received: January 23, 2023; Published: March 13, 2023


Background: Failed total joint arthroplasty (TJA) is a multifactorial problem and one potential cause of failed TJA has been attributed to allergic reaction to the metallic components of the implants. The pathophysiology of implant function failure due to allergy has been postulated but is poorly understood. This review explores recent literature on the topic of metal hypersensitivity in TJA and human implantation in general to clarify the current state of understanding on this topic.

Methods: A literature search was completed via PubMed for all articles published related to implant failure in TJA due to metallic allergic reaction. The information was then sorted for relevance on basic science as well as clinical outcomes attributed to metal allergy in TJA.

Results: This review found that previous works attribute 5% of failed TJA to metal hypersensitivity reactions, no single test or finding has been found to be predictive of patients who will experience a failed TJA due to metal hypersensitivity, and there is no clear relationship between metal hypersensitivity and poor clinical outcomes in TJA although many theories have been presented.

Discussion: While evidence-based evaluation and management is desired for metal hypersensitivity, no clear consensus exists. Even routine pre-implantation testing has not shown to be of benefit. Furthermore, no test or finding has been shown to be diagnostic of metal allergy as a cause of failed TJA after implantation. Based on review of the published literature, this review article finds no objective evidence of metal allergy as a cause of TJA failure and therefore cannot conclude that metal allergic reaction is a mode of failure in TJA.

Keywords: Metal Hypersensitivity; Metal Allergy; Metal Ions; Allergic Reaction; Joint Arthroplasty


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Citation: Gary Ulrich., et al. “Metal Hypersensitivity in Total Joint Arthroplasty”.Acta Scientific Orthopaedics 6.4 (2023): 44-52.


Copyright: © 2023 Gary Ulrich., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.


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