The Significance of Metal Sensitivity Testing in Instrumented Orthopaedic Surgery

• Published in: Journal of orthopedics for physician assistants Vol. 8; no. 3; p. e19.00039
• Main Authors: Peterkin, Brian A., Reiter, Mitchell F., Drzala, Mark R.
• Format: Journal Article
• Language: English
• Published: 2020
• ISSN: 2470-1122; 2470-1122
• DOI: 10.2106/JBJS.JOPA.19.00039

» A review of the incidence and clinical significance of metal hypersensitivity to better understand the role for testing in the detection and prevention of allergic reactions to orthopedic implants.
» Orthopedic procedures involving metallic implants are increasingly common with projected future growth.
» Allergic reactions to metallic implants have been extensively reported, but debate remains regarding the clinical impact of metal induced allergic reactions following orthopedic device implantation.
» There is no generally accepted standard for testing to detect metal hypersensitivity in patients who are considering implantation of a prosthetic device or who already have a device in place.
» Available testing options to detect metal hypersensitivity typically include skin patch testing and the lymphocyte transformation, which differ in sensitivity, cost, and convenience.
» Current research suggests that preoperative testing may be a safe and cost-effective way to improve outcomes in select patients and reduce the need for revision surgery.