Understanding immune-mediated cobalt/chromium allergy to orthopaedic implants: a meta-synthetic review.
Arnold ChenAndrew P KurmisPublished in: Arthroplasty (London, England) (2024)
Despite increasing clinical awareness and acknowledgement of true allergy to joint replacement components, this review highlighted that the evidence base underpinning the diagnosis and management of such patients is limited. Both patient-reported metal allergy or skin patch testing are grossly unreliable methods and show almost no correlation with true immune reactivity. Recent studies suggested a potential role for patient-specific in vitro cellular activation testing and/or targeted genetic testing when cobalt/chromium allergy is clinically suspected. However, while likely representing the contemporary "best available" approaches both can be costly undertakings, are not yet universally available, and still require broader validation in non-research settings before wider uptake can be championed.
Keyphrases
- patient reported
- atopic dermatitis
- end stage renal disease
- infectious diseases
- newly diagnosed
- ejection fraction
- chronic kidney disease
- prognostic factors
- soft tissue
- peritoneal dialysis
- pulmonary embolism
- reduced graphene oxide
- drug delivery
- metal organic framework
- carbon nanotubes
- gold nanoparticles
- patient reported outcomes