Knee Surg Relat Res.  2013 Dec;25(4):186-193. 10.5792/ksrr.2013.25.4.186.

Metal Allergy Screening Prior to Joint Arthroplasty and Its Influence on Implant Choice: A Delphi Consensus Study Amongst Orthopaedic Arthroplasty Surgeons

• Razak A
• Ebinesan A
• Charalambous CP

• KMID: 2230733
• DOI: http://doi.org/10.5792/ksrr.2013.25.4.186

Abstract

PURPOSE
This study was undertaken to obtain a consensus amongst joint arthroplasty experts with regards to metal allergy screening prior to joint arthroplasty and the choice of implant in patients with potential metal allergy.
MATERIALS AND METHODS
A web based Delphi consensus study was used including orthopaedic surgeons that had previously published on the topic of knee, hip or shoulder arthroplasty. Two rounds of questionnaires were sent via electronic mail. Consensus was considered reached if agreement was 60% or higher.
RESULTS
Eighteen surgeons responded to the first and 17 to the second round of questionnaires. There was consensus that patients having metal arthroplasty surgery should not be routinely questioned about metal allergy prior to surgery. There was consensus that patch testing is not necessary even if metal allergy is suspected. Most respondents agreed in proceeding with cobalt chromium or stainless steel implant in patients suspected of metal allergy regardless of the results of cutaneous patch testing.
CONCLUSIONS
This consensus study suggests that routine metal allergy screening prior to joint arthroplasty is not essential. The use of traditional cobalt chromium/stainless steel implants is recommended regardless of the patient's metal allergy status based on expert opinion through this study.

Keyword

Arthroplasty; Metal allergy; Delphi study

MeSH Terms

Arthroplasty*
Chromium
Cobalt
Consensus*
Surveys and Questionnaires
Delphi Technique
Electronic Mail
Expert Testimony
Hip
Humans
Hypersensitivity*
Joints*
Knee
Mass Screening*
Patch Tests
Shoulder
Stainless Steel
Steel
Chromium
Cobalt
Stainless Steel
Steel