Further clear evidence that ‘being allergic to a knee replacement prosthesis’ is just NOT actually a real thing!

A Comparison of Clinical Outcomes After Total Knee Arthroplasty in Patients Who Have and Do Not Have Self-Reported Nickel Allergy: Matched and Unmatched Cohort Comparisons
Siljander et al.
J Arthroplasty 2024; 39(10): 2490-2495. doi: 10.1016/j.arth.2024.05.029. Epub 2024 May 15.

There has been some debate for number of years now about whether or not the tiny amounts of nickel that can be found in a cobalt-chrome knee replacement prosthesis could potentially cause an allergic reaction to the prosthesis in those patients with nickel sensitivity / allergy…

I’ve posted about this before: https://sportsortho.co.uk/blog/is-there-really-such-as-thing-as-metal-allergy-with-knee-replacement-prostheses/

… and the answer back then was a fairly convincing ‘No’!

Well, Siljander et al have now recently published another important study that lends even more weight to this answer…

In this latest study, the team from The Hospital for Special Surgery, in New York, looked at 284 patients undergoing knee replacement surgery with a self-reported nickel allergy, and they compared their outcomes to those of over 17,000 patients without a self-reported nickel allergy. The researchers used a wide variety of different patient-reported outcome measures, as well as looking at revision rates (with a 5-year follow-up). The results…

NO differences in outcome were seen!

This large high-quality study simply adds further weight to the argument that nickel allergy / sensitivity does not make any difference when it comes to choosing what knee replacement prosthesis a patient might have, and hence there is still no place whatsoever for so-called ‘hypoallergenic’ implants or for changing one’s choice of knee replacement from a cobalt-chrome prosthesis to a titanium prosthesis.