Self-reported nickel allergy may not impact TKA outcomes, implant performance
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Key takeaways:
- Self-reported nickel allergy may not affect outcomes or implant performance for total knee arthroplasty.
- Patients with self-reported nickel allergy had similar improvements vs. patients with no nickel allergy.
Patients with self-reported nickel allergy can expect positive outcomes after total knee arthroplasty with similar improvements compared with patients with no nickel allergy, according to published data.
“Choosing more costly and less familiar hypoallergenic components for primary TKA may not be merited in the setting of nickel allergy,” researchers from Hospital for Special Surgery wrote in the study.
Breana R. Siljander, MD, and colleagues performed a retrospective review of data from 18,019 primary TKAs from a single institution between Feb. 1, 2016, and Dec. 31, 2020. Among the cohort, 284 TKAs were performed on 239 patients with self-reported preoperative nickel allergy.
Outcome measures included survivorship, revision, Knee Injury and Osteoarthritis Outcome Score for Joint Replacement scores, VAS pain scores, lower extremity activity scale (LEAS) scores and Patient-Reported Outcomes Measurement Information System (PROMIS) mental and physical scores.
At 1 year, survivorship free of all-cause revision was 99.5% for patients with self-reported nickel allergy and 99.3% for patients with no nickel allergy (P = .49).
Researchers found no significant differences in KOOS JR, VAS or LEAS scores at 6 weeks or 1 year between the cohorts. However, they noted patients with self-reported nickel allergy had worse PROMIS mental and physical scores at 6 weeks compared with patients without nickel allergy.
After stratifying TKAs by nickel-free vs. cobalt chromium implant types, researchers found no significant differences in KOOS JR scores at 6 weeks or 1 year for patients with self-reported nickel allergy compared with patients without nickel allergy.
“Patients who carry a nickel allergy diagnosis should be advised that their clinical outcome scores will likely improve after primary TKA and may not be affected whether a nickel-free implant is used,” researchers wrote.
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