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Engineering

Patellofemoral Joint Replacement and Nickel Allergy: An Unusual Presentation

Farhan Syed¹, Edward Jenner¹, Mohammad Faisal¹

¹Trauma & Orthopaedics, Warwick Hospital, Lakin Road, Warwick CV34 5BW, UK.

Case Reports in Orthopedics|November 7, 2015

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View abstract on PubMed

Summary

Metal allergy can cause joint replacement failure, necessitating revision surgery. Allergy testing and using nickel-free implants are recommended for patients with a history of metal allergy undergoing joint replacement surgery.

Area of Science:

Orthopedic Surgery
Allergy and Immunology
Biomaterials Science

Background:

Metal allergy is an uncommon complication following joint replacement surgery.
It can lead to aseptic loosening and the need for revision surgery.
Specific guidance for managing metal allergy in patellofemoral joint replacement (PFJR) is lacking.

Purpose of the Study:

To report a case of nickel allergy causing aseptic loosening after PFJR.
To review existing literature on metal allergy management in PFJR.
To propose recommendations for managing metal allergy in PFJR.

Main Methods:

Case presentation of a 54-year-old male with nickel allergy and PFJR.
Literature review of metal allergy in joint replacement, focusing on PFJR and total knee replacement (TKR).
Surgical intervention involving revision to a nickel-free total knee replacement.

Main Results:

The patient experienced successful outcomes after revision surgery with a nickel-free implant.
Literature review revealed limited and contradictory evidence for managing metal allergy in PFJR.
Evidence from TKR studies is primarily from retrospective case series and reports.

Conclusions:

Optimal management for metal allergy in PFJR remains unclear.
Recommend allergy testing for patients with a history of metal allergy before joint replacement.
Suggest using allergen-free implants for patients with confirmed metal allergy.

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Mechanical Engineering

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Patellofemoral Joint Replacement And Nickel Allergy: An Unusual Presentation

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