Table 6 Main conclusions and recommendations of the included studies
Sensitizing potential of TKA | LE | |
|---|---|---|
TKA may induce metal hypersensitivity. | Kręcisz et al. [27] | III |
Desai et al. [29] | IV | |
Frigerio et al. [30] | IV | |
Granchi et al. [7] | IV | |
Unable to prove an association between TKA and metal hypersensitivity | Verma et al. [39] | IV |
Unable to conclude as patients had received hypoallergenic implants | Kitagawa et al. [26] | III |
Relationship between metal hypersensitivity and adverse clinical outcomes | ||
Metal hypersensitivity may be a cause of complications | Atanaskova Mesinkovska et al. [24] | III |
Kręcisz et al. [27] | III | |
Frigerio et al. [30] | IV | |
Sasseville et al. [33]a | IV | |
Tam et al. [34] | IV | |
Thomas et al. [37] | IV | |
Zeng et al. [41] | IV | |
No relationship between metal hypersensitivity and complications | Carlsson and Möller [25] | III |
Carossino et al. [28] | IV | |
Granchi et al. [7] | IV | |
Treudler and Simon [38] | IV | |
Verma et al. [39] | IV | |
Webley et al. [40] | IV | |
Utility of patch testing | ||
Recommend routine pre-operative testing | Kręcisz et al. [27]b | III |
Desai et al. [29] | IV | |
Frigerio et al. [30] | IV | |
Only perform preoperatively in patients with a history of metal hypersensitivity | Atanaskova Mesinkovska et al. [24] | III |
Kitagawa et al. [26] | III | |
Carossino et al. [28] | IV | |
Guenther et al. [31] | IV | |
Innocenti et al. [32] | IV | |
Sasseville et al. [33] | IV | |
Tam et al. [34] | IV | |
Could be a valuable diagnostic tool postoperatively | Atanaskova Mesinkovska et al. [24] | III |
Carossino et al. [28] | IV | |
Desai et al. [29] | IV | |
Granchi et al. [7] | IV | |
Thomas et al. [35] | IV | |
Thomas et al. [36] | IV | |
Thomas et al. [37] | IV | |
Zeng et al. [41] | IV | |
Lützner et al. [42] | II | |
Did not comment on utility of pre- or postoperative patch testing | Carlsson and Möller [25] | III |
Treudler and Simon [38] | IV | |
Verma et al. [39] | IV | |
Webley et al. [40] | IV | |