We have located links that may give you full text access.
The effect of patch testing on surgical practices and outcomes in orthopedic patients with metal implants.
Archives of Dermatology 2012 June
OBJECTIVE: To determine the effect of patch testing on surgical decision making and outcomes in patients evaluated for suspected metal hypersensitivity related to implants in bones or joints.
DESIGN: Medical chart review.
SETTING: Tertiary care academic medical center.
PARTICIPANTS: All patients who had patch testing for allergic contact dermatitis related to orthopedic implants.
INTERVENTION: Patch testing.
MAIN OUTCOME MEASURES: The surgeon's preoperative choice of metal implant alloy compared with patch testing results and the presence of hypersensitivity complications related to the metal implant on postsurgical follow-up.
RESULTS: Patients with potential metal hypersensitivity from implanted devices (N = 72) were divided into 2 groups depending on timing of their patch testing: preimplantation (n = 31) and postimplantation (n = 41). History of hypersensitivity to metals was a predictor of positive patch test results to metals in both groups. Positive patch test results indicating metal hypersensitivity influenced the decision-making process of the referring surgeon in all preimplantation cases (n = 21). Patients with metal hypersensitivity who received an allergen-free implant had surgical outcomes free of hypersensitivity complications (n = 21). In patients who had positive patch test results to a metal in their implant after implantation, removal of the device led to resolution of associated symptoms (6 of 10 patients).
CONCLUSIONS: The findings of this study support a role for patch testing in patients with a clinical history of metal hypersensitivity before prosthetic device implantation. The decision on whether to remove an implanted device after positive patch test results should be made on a case-by-case basis, as decided by the surgeon and patient.
DESIGN: Medical chart review.
SETTING: Tertiary care academic medical center.
PARTICIPANTS: All patients who had patch testing for allergic contact dermatitis related to orthopedic implants.
INTERVENTION: Patch testing.
MAIN OUTCOME MEASURES: The surgeon's preoperative choice of metal implant alloy compared with patch testing results and the presence of hypersensitivity complications related to the metal implant on postsurgical follow-up.
RESULTS: Patients with potential metal hypersensitivity from implanted devices (N = 72) were divided into 2 groups depending on timing of their patch testing: preimplantation (n = 31) and postimplantation (n = 41). History of hypersensitivity to metals was a predictor of positive patch test results to metals in both groups. Positive patch test results indicating metal hypersensitivity influenced the decision-making process of the referring surgeon in all preimplantation cases (n = 21). Patients with metal hypersensitivity who received an allergen-free implant had surgical outcomes free of hypersensitivity complications (n = 21). In patients who had positive patch test results to a metal in their implant after implantation, removal of the device led to resolution of associated symptoms (6 of 10 patients).
CONCLUSIONS: The findings of this study support a role for patch testing in patients with a clinical history of metal hypersensitivity before prosthetic device implantation. The decision on whether to remove an implanted device after positive patch test results should be made on a case-by-case basis, as decided by the surgeon and patient.
Full text links
Related Resources
Get seemless 1-tap access through your institution/university
For the best experience, use the Read mobile app
All material on this website is protected by copyright, Copyright © 1994-2024 by WebMD LLC.
This website also contains material copyrighted by 3rd parties.
By using this service, you agree to our terms of use and privacy policy.
Your Privacy Choices
You can now claim free CME credits for this literature searchClaim now
Get seemless 1-tap access through your institution/university
For the best experience, use the Read mobile app