The role of metal patch testing in evaluating patients for metallic prosthetic joint failure
| Autor: | Alan L. Schocket, Levi Keller, Craig Hogan |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Male
Pulmonary and Respiratory Medicine Prosthetic joint medicine.medical_treatment Immunology Dentistry Context (language use) Sensitivity and Specificity Prosthesis Metal allergy Patch testing 03 medical and health sciences 0302 clinical medicine Hypersensitivity Humans Immunology and Allergy Medicine In patient 030212 general & internal medicine Arthroplasty Replacement Retrospective Studies business.industry Middle Aged Patch Tests Prosthesis Failure 030228 respiratory system Metals Cohort Female Revision status business |
| Zdroj: | Annals of Allergy, Asthma & Immunology. 126:542-547.e1 |
| ISSN: | 1081-1206 |
| DOI: | 10.1016/j.anai.2021.02.018 |
| Popis: | Background Metal allergy may be an uncommon cause of prosthetic joint failure. There exist little data on patch testing to metals in this context and its impact on outcomes of joint revision in these patients. Objective To explore the use and indications for metal patch testing in the evaluation of patients suspected of having metal allergy as a cause of failed joint replacements and to clarify the outcomes of patients revised with alternative metallic joints because of positive patch testing result. Methods A retrospective analysis from January 2016 to April 2020 was completed on a patient cohort referred for evaluation of metal hypersensitivity. Charts were reviewed for age, biological sex, referring specialty, patch testing results, joint, revision status, and outcome measures. Biostatistical analysis and descriptive statistics were performed to determine patch testing performance and functional outcome trends among this patient cohort. Results The sensitivity and specificity of patch testing, in general, are limited when evaluating patients with metallic joint replacements. However, the predictive value of testing seemed to improve with strongly positive patch testing results. Functional outcomes in patients when positive results were used to guide revision prosthesis revealed clinical improvement. Conclusion The attribution of metal allergy or hypersensitivity as a cause of failure in metal prosthetic joint replacement remains unproven. Some patients with positive histories and patch testing results that were used to modify the implanted prosthesis had improved functional outcomes. These results suggest that patch testing may be useful in patients with history of metal sensitivity and prosthetic failure. |
| Databáze: | OpenAIRE |
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