ArticleActa orthopaedica2015
The association between metal allergy, total knee arthroplasty, and revision: study based on the Danish Knee Arthroplasty Register.
Article in Acta orthopaedica, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 37 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
37 citing papers in PubMed, 2 syntheses or guidelines pooled it, 102 citations in OpenAlex.
- Metal sensitivity in total joint arthroplasty: None of the current diagnostic tests are reliable, sensitive and specific enough to guide treatment decisions!Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2025Pooled it
- "Systematic review and meta-analysis of ceramic coated implants in total knee arthroplasty. Comparable mid-term results to uncoated implants."Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2023Pooled it
- No difference in patient reported outcome and inflammatory response after coated and uncoated total knee arthroplasty - a randomized controlled study.BMC musculoskeletal disorders · 2023Trial
- Increased inflammatory response is associated with less favorable functional results 5 years after total knee arthroplasty.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2023Trial
- [The use of knee prostheses with a hypoallergenic coating is safe in the medium term : A randomized controlled study].Orthopadie (Heidelberg, Germany) · 2022Trial
- Orthopedic implant allergies: a review of current knowledge on metal hypersensitivity and prosthesis failure.EFORT open reviews · 2026Article
- Metal Sensitization in Patients That Underwent Patch Test Pre and Post-Implant Exposure.Contact dermatitis · 2026Article
- Outcomes of Metal Hypersensitivity in Knee Arthroplasty: A Systematic Review of the Literature.Arthroplasty today · 2026Article
- Mid-Term Results of a Cemented Titanium-Niobium Nitride-Coated Mobile Knee in Primary Total Knee Arthroplasty.Journal of clinical medicine · 2025Article
- Metal Hypersensitivity in Patients With Failure of Joint Prosthesis Treatment.Journal of immunology research · 2025Article
- Existing and Novel Assessment Methods for Metal Sensitivity in Elective Lower-Limb Arthroplasty-A Scoping Review.Arthroplasty today · 2024Article
- Understanding immune-mediated cobalt/chromium allergy to orthopaedic implants: a meta-synthetic review.Arthroplasty (London, England) · 2024Review
- Review
- Hypersensitivity and lymphocyte activation after total hip arthroplasty.Orthopadie (Heidelberg, Germany) · 2023Review
- An interleukin-1 polymorphism additionally intensified by atopy as prognostic factor for aseptic non-mechanical complications in metal knee and hip arthroplasty.Frontiers in immunology · 2022Article
- No Clinical or Radiographic Differences Between Cemented Cobalt-Chromium and Titanium-Niobium Nitride Mobile-Bearing Unicompartmental Knee Arthroplasty.Indian journal of orthopaedics · 2021Article
- Metal allergy in primary and revision total knee arthroplasty : a scoping review and evidence-based practical approach.Bone & joint open · 2021Article
- Metal Hypersensitivity in Joint Arthroplasty.Journal of the American Academy of Orthopaedic Surgeons. Global research & reviews · 2021Review
- Self-reported metal hypersensitivity in patients undergoing unicondylar knee arthroplasty.Journal of clinical orthopaedics and trauma · 2021Article
- Article
Corrections and comments
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Authors and funding
7 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
background and purposeIt is unclear whether delayed-type hypersensitivity reactions against implanted metals play a role in the etiopathogenesis of malfunctioning total knee arthroplasties. We therefore evaluated the association between metal allergy, defined as a positive patch test reaction to common metal allergens, and revision surgery in patients who underwent knee arthroplasty. PATIENTS AND
methodsThe nationwide Danish Knee Arthroplasty Register, including all knee-implanted patients and revisions in Denmark after 1997 (n = 46,407), was crosslinked with a contact allergy patch test database from the greater Copenhagen area (n = 27,020).
results327 patients were registered in both databases. The prevalence of contact allergy to nickel, chromium, and cobalt was comparable in patients with and without revision surgery. However, in patients with 2 or more episodes of revision surgery, the prevalence of cobalt and chromium allergy was markedly higher. Metal allergy that was diagnosed before implant surgery appeared not to increase the risk of implant failure and revision surgery.
interpretationWhile we could not confirm that a positive patch test reaction to common metals is associated with complications and revision surgery after knee arthroplasty, metal allergy may be a contributor to the multifactorial pathogenesis of implant failure in some cases. In cases with multiple revisions, cobalt and chromium allergies appear to be more frequent.
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