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International Orthopaedics

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01-11-2014 | Original Paper

A prospective study concerning the relationship between metal allergy and post-operative pain following total hip and knee arthroplasty

Authors: Yirong Zeng, Wenjun Feng, Jie Li, Lu Lu, Chuntao Ma, Jianchun Zeng, Feilong Li, Xinyu Qi, Yueguang Fan

Published in: International Orthopaedics | Issue 11/2014

Abstract

Purpose

A prospective study was conducted to detect whether a relationship exists between metal allergy and post-operative pain in total hip and knee arthroplasty patients. We postulated that to some extent a relationship does exist between them.

Materials and methods

Patients who had undergone total hip and knee arthroplasty surgery because of hip and knee disease were included. The exclusion criteria were patients who were treated with immunosuppressor two weeks pre-operatively, skin conditions around the patch testing site, and other uncontrollable factors. Each patient agreed to patch testing for three days before surgery. Photographic images before patch testing, two and three days after patch testing were obtained to evaluate the final incidence of metal allergy. The patch tests contained 12 metal elements; chromium, cobalt, nickel, molybdenum, titanium, aluminium, vanadium, iron, manganese, tin, zirconium, and copper. Two independent observers evaluated the images. The results were divided into a non-metal allergy group and a metal allergy group. Pre-operative and postoperative VAS score, lymphocyte transforming test, and X-rays were collected to detect the relationship between metal allergy and post-operative pain following total hip and knee arthroplasty.

Results

There were 96 patients who underwent pre-operative patch testing. The overall metal allergy rate was 51.1 % (49/96) in our study. Nickel, cobalt, manganese, and tin were the most common allergic metal elements in our study. Nine inappropriate cases were excluded, and 87 patients were finally included in our study. There were 36 metal allergy and 26 non-metal allergy patients in the THA group, while 11 metal allergy and 14 non-metal allergy patients were found in the TKA group. We found no relationship existed between metal allergy and post-surgery pain in total hip and knee arthroplasty.

Conclusion

Pain caused by metal allergy usually presents as persistent and recurrent pain. The white cell count, C-reactive protein, erythrocyte sedimentation rate and postoperative radiographs were not affected. Currently, patch testing and lymphocyte transforming tests are used for metal allergy diagnosis. We deemed that a relationship between post-surgery pain and metal allergy in total hip and knee patients may exist to some extent. Larger samples and longer follow-up time are essential for further study.

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Title: A prospective study concerning the relationship between metal allergy and post-operative pain following total hip and knee arthroplasty
Authors: Yirong Zeng
Wenjun Feng
Jie Li
Lu Lu
Chuntao Ma
Jianchun Zeng
Feilong Li
Xinyu Qi
Yueguang Fan
Publication date: 01-11-2014
Publisher: Springer Berlin Heidelberg
Published in: International Orthopaedics / Issue 11/2014
Print ISSN: 0341-2695
Electronic ISSN: 1432-5195
DOI: https://doi.org/10.1007/s00264-014-2367-1

At a glance: The STEP trials

Springer Medicine

A prospective study concerning the relationship between metal allergy and post-operative pain following total hip and knee arthroplasty

Abstract

Purpose

Materials and methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose

Materials and methods

Results

Conclusion

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