ArticleArthroplasty today2026
Outcomes of Metal Hypersensitivity in Knee Arthroplasty: A Systematic Review of the Literature.
Article in Arthroplasty today, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
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
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Metal implant hypersensitivity remains a subject of ongoing debate in the orthopaedic community. With the global rise in total knee arthroplasty (TKA) procedures per annum and an increasing prevalence of reported metal allergies in the general population, understanding the clinical relevance of metal implant hypersensitivity in knee arthroplasty patients is essential. This systematic review evaluates the relationship between metal hypersensitivity, diagnostic testing, and postoperative outcomes following TKA. Methods: A literature search was conducted using the Ovid, MEDLINE, and Embase databases for studies published between 1990 and December 2024. Studies assessing diagnosis, management, or outcomes of metal hypersensitivity in TKA were included. Both prospective and retrospective studies were considered. The search yielded 554 records, with an additional 25 studies identified through manual reference screening. Following full-text assessment of 58 articles and application of predefined inclusion and exclusion criteria, 24 studies were included. Data extraction focused on study design, patient demographics, implicated metals, diagnostic methods, interventions, and outcomes. Patient Reporting Items for Systematic Reviews & Meta Analysis (PRISMA) guidelines were followed. Results: A pooled cohort of 5615 knee arthroplasty cases was analyzed, with a mean patient age of 65.35 years and a female predominance (60.55%). Among these, 1165 patients had a documented history of metal hypersensitivity. Twenty studies reported follow-up durations, with a mean follow-up of 27.59 months. Patient symptoms, diagnostic test results, patient-reported outcome measures, and revision rates were evaluated. Conclusions: The available literature demonstrates significant heterogeneity and limited comparability across studies. Current evidence suggests that self-reported metal allergy or positive skin patch/lymphocyte transformation tests do not reliably predict poorer pain or functional outcomes following TKA. The clinical significance of metal hypersensitivity remains uncertain, highlighting the need for standardized diagnostic criteria and further high-quality research.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.