title: Biomaterial hypersensitivity: is it real? Supportive evidence and approach considerations for metal allergic patients following total knee arthroplasty.
abstract: The prospect of biomaterial hypersensitivity developing in response to joint implant materials was first presented more than 30 years ago. Many studies have established probable causation between first-generation metal-on-metal hip implants and hypersensitivity reactions. In a limited patient population, implant failure may ultimately be related to metal hypersensitivity. The examination of hypersensitivity reactions in current-generation metal-on-metal knee implants is comparatively limited. The purpose of this study is to summarize all available literature regarding biomaterial hypersensitivity after total knee arthroplasty, elucidate overall trends about this topic in the current literature, and provide a foundation for clinical approach considerations when biomaterial hypersensitivity is suspected.
authors.affiliation: Division of Orthopaedics and Rehabilitation, Department of Surgery, Southern Illinois University School of Medicine, P.O. Box 19679, Springfield, IL 62794-9679, USA.
authors.forename: Andrew J
authors.identifier: 0000-0001-5348-6495
authors.initials: AJ
authors.lastname: Mitchelson
authors.affiliation: Division of Orthopaedics and Rehabilitation, Department of Surgery, Southern Illinois University School of Medicine, P.O. Box 19679, Springfield, IL 62794-9679, USA.
authors.forename: Craig J
authors.identifier: 0000-0002-5358-7621
authors.initials: CJ
authors.lastname: Wilson
authors.affiliation: Department of Orthopaedic Surgery & Biomedical Engineering, University of Tennessee, Memphis, TN 38017, USA.
authors.forename: William M
authors.initials: WM
authors.lastname: Mihalko
authors.affiliation: Clinic for Orthopaedic Surgery, Campus Grosshadern, Ludwig Maximilians University, 80539 Munich, Germany ; Aesculap AG, Research & Development, 78532 Tuttlingen, Germany.
authors.forename: Thomas M
authors.initials: TM
authors.lastname: Grupp
authors.affiliation: Division of Orthopaedics and Rehabilitation, Department of Surgery, Southern Illinois University School of Medicine, P.O. Box 19679, Springfield, IL 62794-9679, USA.
authors.forename: Blaine T
authors.initials: BT
authors.lastname: Manning
authors.affiliation: Colorado Joint Replacement, Denver, CO 80210, USA.
authors.forename: Douglas A
authors.initials: DA
authors.lastname: Dennis
authors.affiliation: Department of Orthopaedic Surgery, Stanford University School of Medicine, Redwood City, CA 94063, USA.
authors.forename: Stuart B
authors.initials: SB
authors.lastname: Goodman
authors.affiliation: Division of Orthopaedics and Rehabilitation, Department of Surgery, Southern Illinois University School of Medicine, P.O. Box 19679, Springfield, IL 62794-9679, USA.
authors.forename: Tony H
authors.identifier: 0000-0001-7344-0398
authors.initials: TH
authors.lastname: Tzeng
authors.affiliation: Division of Orthopaedics and Rehabilitation, Department of Surgery, Southern Illinois University School of Medicine, P.O. Box 19679, Springfield, IL 62794-9679, USA.
authors.forename: Sonia
authors.identifier: 0000-0003-2115-4984
authors.initials: S
authors.lastname: Vasdev
authors.affiliation: Division of Orthopaedics and Rehabilitation, Department of Surgery, Southern Illinois University School of Medicine, P.O. Box 19679, Springfield, IL 62794-9679, USA.
authors.forename: Khaled J
authors.initials: KJ
authors.lastname: Saleh
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects* / Q000706:statistics & numerical data*; D001672:Biocompatible Materials / Q000009:adverse effects*; D019317:Evidence-Based Medicine; D005260:Female; D006801:Humans; D006967:Hypersensitivity / Q000453:epidemiology* / Q000209:etiology*; D015994:Incidence; D008297:Male; D008670:Metals / Q000009:adverse effects*; D008875:Middle Aged; D012307:Risk Factors; D016896:Treatment Outcome
chemical_list: D001672:Biocompatible Materials; D008670:Metals