Allergy Tests Needed Before New Knee or Hip (MedPageToday)
Preoperative skin patch testing for metal allergy influenced treatment planning in two-thirds of a small cohort of patients scheduled to receive metal-containing prosthetic devices, a retrospective chart review showed.
All 21 patients with positive tests received allergen-free prostheses and had no complications associated with hypersensitivity.
Post-implantation patch testing led to prosthesis removal in 10 additional patients, and six had resolution of hypersensitivity-associated symptoms.
"The findings of this study support a role for patch testing in patients with a clinical history of metal hypersensitivity before prosthetic device implantation," Natasha Atanaskova Mesinkovska, MD, PhD, of the Cleveland Clinic, and co-authors wrote in an article published online in Archives of Dermatology.
"The decision of 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," they said.
The author of an accompanying editorial cautioned that "the patch test is a cutaneous test that does not recreate the environment in which the metal reside...
