TY - JOUR

T1 - The association between metal allergy, total hip arthroplasty, and revision

AU - Thyssen, Jacob Pontoppidan

AU - Jakobsen, Stig Storgaard

AU - Engkilde, Kåre

AU - Johansen, Jeanne Duus

AU - Søballe, Kjeld

AU - Menné, Torkil

N1 - Keywords: Adolescent; Adult; Arthroplasty, Replacement, Hip; Case-Control Studies; Child; Chromium; Cobalt; Denmark; Dermatitis, Allergic Contact; Female; Hip Prosthesis; Humans; Male; Metals; Middle Aged; Nickel; Patch Tests; Prevalence; Prosthesis Design; Prosthesis Failure; Registries; Reoperation; Risk Factors; Young Adult

PY - 2009

Y1 - 2009

N2 - BACKGROUND AND PURPOSE: It has been speculated that the prevalence of metal allergy may be higher in patients with implant failure. We compared the prevalence and cause of revisions following total hip arthroplasty (THA) in dermatitis patients suspected to have contact allergy and in patients in general with THA. Furthermore, we compared the prevalence of metal allergy in dermatitis patients with and without THA. MATERIALS AND METHODS: The Danish Hip Arthroplasty Registry (DHAR) contained detailed information on 90,697 operations. The Gentofte patch-test database contained test results for patients suspected of having allergic contact dermatitis (n = 18,794). Cases (n = 356) were defined as patch-tested dermatitis patients who also had primary THA performed. Two age- and sex-matched controls (n = 712) from the patch-test database were sought for each case. RESULTS: The prevalence of revision was similar in cases (12%) and in patients from the DHAR (13%). The prevalence of metal allergy was similar in cases and controls. However, the prevalence of metal allergy was lower in cases who were patch-tested after operation (6%) than in those who were patch-tested before operation (16%) (OR = 2.9; 95% CI = 1-8). INTERPRETATION: We found that the risk of surgical revision was not increased in patients with metal allergies and that the risk of metal allergy was not increased in cases who were operated, in comparison to controls. Despite some important study limitations, our observations add to the evidence that the risk of complications in metal allergic patients seems limited.

AB - BACKGROUND AND PURPOSE: It has been speculated that the prevalence of metal allergy may be higher in patients with implant failure. We compared the prevalence and cause of revisions following total hip arthroplasty (THA) in dermatitis patients suspected to have contact allergy and in patients in general with THA. Furthermore, we compared the prevalence of metal allergy in dermatitis patients with and without THA. MATERIALS AND METHODS: The Danish Hip Arthroplasty Registry (DHAR) contained detailed information on 90,697 operations. The Gentofte patch-test database contained test results for patients suspected of having allergic contact dermatitis (n = 18,794). Cases (n = 356) were defined as patch-tested dermatitis patients who also had primary THA performed. Two age- and sex-matched controls (n = 712) from the patch-test database were sought for each case. RESULTS: The prevalence of revision was similar in cases (12%) and in patients from the DHAR (13%). The prevalence of metal allergy was similar in cases and controls. However, the prevalence of metal allergy was lower in cases who were patch-tested after operation (6%) than in those who were patch-tested before operation (16%) (OR = 2.9; 95% CI = 1-8). INTERPRETATION: We found that the risk of surgical revision was not increased in patients with metal allergies and that the risk of metal allergy was not increased in cases who were operated, in comparison to controls. Despite some important study limitations, our observations add to the evidence that the risk of complications in metal allergic patients seems limited.

U2 - 10.3109/17453670903487008

DO - 10.3109/17453670903487008

M3 - Journal article

C2 - 19995314

VL - 80

SP - 646

EP - 652

JO - Acta Orthopaedica

JF - Acta Orthopaedica

SN - 1745-3674

IS - 6

ER -