Date of Publish: 20/04/2011

Orthopaedic surgery in a patient with metal sensitivity

Adala R, Chakravarthy M, Srinivas V, Pai S. J Cutan Aesthet Surg. 2011 Jan-Apr; 4(1): 67-68.
When patients with hypersensitivity to metals present for surgery where metallic prostheses are required, problems arise about the choice of the prosthesis. We present a case of a patient with proven metal sensitivity to cobalt, chromium, nickel and molybdenum, who required bilateral total knee replacement for osteoarthritis and was successfully managed by a titanium prosthesis. The MELISA® test in the patient revealed strongly positive allergy to nickel and chromium and weakly positive results for cobalt and molybdenum. Based on the MELISA® report, the implant to be used in our patient was chosen to be of titanium and a polyethylene insert was used to avoid the possible metal allergy. Our case demonstrated the need for proper investigation with tests such as MELISA® and also the need for proper history in all such patients.

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