Abstract
Summary Statement
Routine metal allergy screening prior to joint arthroplasty is not essential and the use of cobalt chromium or stainless steel implants is recommended regardless of the patient's metal allergy status.
Introduction
This study was undertaken to obtain a consensus amongst joint arthroplasty experts with regards to metal allergy screening prior to joint arthroplasty and the choice of implant in patients with potential metal allergy.
Patients & Methods
A web based Delphi consensus study was used including orthopaedic surgeons that had previously published on the topic of knee, hip or shoulder arthroplasty. Two rounds of questionnaires were sent via electronic mail. Consensus was considered if agreement was 60% or higher.
Results
18 surgeons responded to the first and 17 to the second round of questionnaires. There was consensus that patients having metal arthroplasty surgery should not be routinely questioned about metal allergy prior to surgery. There was consensus that patch testing is not necessary even if metal allergy is suspected. Most respondents agreed in proceeding with cobalt chromium or stainless steel implant in patients suspected of metal allergy regardless of the results of cutaneous patch testing.
Discussion/Conclusion
This consensus study suggests that routine metal allergy screening prior to joint arthroplasty is not essential. The use of traditional cobalt chromium/stainless steel implants is recommended regardless of the patient's metal allergy status.
