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  • 2015.06.13 | 求助者 :骨科新手|  人气:538
    文献已找到,AB图书馆

    标题:Evaluation and management of metal hypersensitivity in total joint arthroplasty: a systematic review

    作者:Amini M1, Mayes WH1, Tzeng A2, Tzeng TH3, Saleh KJ3, Mihalko WM4.

    网址:PMID: 24941403

    求助者:骨科新手

    • 求助时间:2015/6/13 16:23:56
    • 求助状态:AB图书馆客服已找到全文,详情咨询在线客服qq 1257749646
    • 文献摘要:
    Metal hypersensitivity has been an identified problem in orthopedics for nearly half a century, but its implications remain unclear. Establishing which total joint arthroplasty (TJA) candidates may do poorly with conventional implants and which patients would benefit from revision to an allergen-free implant remains challenging. Our systematic search of the MEDLINE database identified 52 articles for inclusion in our review. Case reports revealed that half of patients presented with pain and swelling, while only one-third presented with cutaneous symptoms. All patients were symptomatic within the first post-operative year; 90% were symptomatic within 3 months. Reports of patch testing revealed that patients with TJAs were positive for metal sensitivity more often than patients without TJAs (OR 1.3). Those with poorly functioning arthroplasties and those who had already had revisions tested positive more often than those with well-functioning TJAs (OR 1.7) and those without TJAs (OR 3.1). Lymphocyte transformation testing (LTT) shows promise in diagnosing metal allergy, and components of bone cement are also being recognized as potential allergens. Further work is necessary to delineate which patients should be tested for metal allergy and which patients would benefit from allergen-free implants.

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