A Perspective Study Concerning The Relationship Between Metal Allergy And Post-surgery Pain Following Total Hip And Knee Arthroplasty

ObjectiveTo detect whether there exists relationship between metal allergy and post-surgery pain in total hip and knee arthroplasty patients, a perspective study was conducted. We hypothesis that some extent relationship does exist between them.MethodsPatients who have undergone total hip and knee arthroplasty surgeries because of suffering serious dysfunction and pain hip and knee diseases were concluded in our study. The excluded criteria included patients who accepted immunosuppressor2weeks preoperatively, skin impairment around patch testing site, and other out of control factors. Each patient accepted patch testing for3days in the left upper back the day before surgery, and images before patch testing,2and3days after patch testing were obtained to evaluate the final incidence of metal allergy. The patch testing products contained12metal elements, including chromium, cobalt, nickel, molybdenum, titanium, aluminium, vanadium, ferric, manganese, stannous, zirconium, opper.2extra-observer took charge of image results evaluation. According to the patch testing results, we divided those patients into non-metal allergy group and metal allergy group. Preoperative and postoperative VAS Score, lymphocyte transforming test, X-rays were collected to detect the relationship between metal allergy and post-surgery pain following total hip and knee arthroplasty.ResultsThere were96patients received preoperative patch testing. The overall metal allergy rate was51.1%(49/96) in our study. Nickel, cobalt, manganese, and stannous were the most common allergic metal elements in our study.9none appropriate cases were excluded out and87patients were finally included our study for detecting relationship between metal allergy and post-surgery following total hip and knee patients. There were36metal allergy and26non-metal allergy patients in the THA group, while11metal allergy and14non-metal allergy patients were in the TKA group. There was no statistical significance of preoperative mean age, mean height, mean weight, mean BMI index, mean preoperative VAS score, lymphocyte transforming test in both groups. We found no relationship existed between metal allergy and post-surgery pain in total hip and knee arthroplasty.ConclusionPain caused by metal allergy usually manifest persistent and recurrent pain. The results of amount of white blood cell and neutrophil, C-reactive protein, erythrocyte sedimentation rate, and postoperative plain X-rays show negative. Currently, patch testing and lymphocyte transforming test are used for metal allergy diagnosis.we deemed that metal allergy may exist some-extent relationship with post-surgery pain in total hip and knee patients. Larger samples and longer follow-up time are essential needed for further study.