Bone Cement Hypersensitivity in Patients With a Painful Total Knee Arthroplasty: A Case Series of Revision Using Custom Cementless Implants

Little is known about patients with bone cement hypersenstivity after total knee arthroplasty (TKA). We present 7 patients implanted with 8 TKAs with clinical failure and a cement hypersensitivity diagnosis. All demonstrated hypersensitivity to bone cement via skin patch and/or lymphocyte transforma...

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Autores principales:	Sheila Pahlavan, BS, Vishal Hegde, MD, Daniel N. Bracey, MD, PhD, Jason M. Jennings, MD, DPT, Douglas A. Dennis, MD
Formato:	article
Lenguaje:	EN
Publicado:	Elsevier 2021
Materias:	Cement allergy TKA allergy TKA hypersensitivity Orthopedic surgery RD701-811
Acceso en línea:	https://doaj.org/article/709ead3ad5b545e99f6d4113a0c03d01
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id	oai:doaj.org-article:709ead3ad5b545e99f6d4113a0c03d01
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spelling	oai:doaj.org-article:709ead3ad5b545e99f6d4113a0c03d012021-11-14T04:33:41ZBone Cement Hypersensitivity in Patients With a Painful Total Knee Arthroplasty: A Case Series of Revision Using Custom Cementless Implants2352-344110.1016/j.artd.2021.06.001https://doaj.org/article/709ead3ad5b545e99f6d4113a0c03d012021-10-01T00:00:00Zhttp://www.sciencedirect.com/science/article/pii/S2352344121000984https://doaj.org/toc/2352-3441Little is known about patients with bone cement hypersenstivity after total knee arthroplasty (TKA). We present 7 patients implanted with 8 TKAs with clinical failure and a cement hypersensitivity diagnosis. All demonstrated hypersensitivity to bone cement via skin patch and/or lymphocyte transformation testing. All 7 patients also showed hypersensitivity to metal, most commonly nickel. Patients underwent custom cementless TKA revision. Prerevision and postrevision outcome measures, radiographs, intraoperative findings, and postrevision complications are reported. Functional scores improved after revision except Veterans RAND-12 mental component scores, which declined. Four patients continue to exhibit symptoms postoperatively, while one patient has had 3 additional surgical procedures. Patients presenting with bone cement hypersensitivity after TKA are particularly challenging. Evidence-based guidelines are lacking, and revision surgery may not relieve the presenting symptoms.Sheila Pahlavan, BSVishal Hegde, MDDaniel N. Bracey, MD, PhDJason M. Jennings, MD, DPTDouglas A. Dennis, MDElsevierarticleCement allergyTKA allergyTKA hypersensitivityOrthopedic surgeryRD701-811ENArthroplasty Today, Vol 11, Iss , Pp 20-24 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Cement allergy TKA allergy TKA hypersensitivity Orthopedic surgery RD701-811
spellingShingle	Cement allergy TKA allergy TKA hypersensitivity Orthopedic surgery RD701-811 Sheila Pahlavan, BS Vishal Hegde, MD Daniel N. Bracey, MD, PhD Jason M. Jennings, MD, DPT Douglas A. Dennis, MD Bone Cement Hypersensitivity in Patients With a Painful Total Knee Arthroplasty: A Case Series of Revision Using Custom Cementless Implants
description	Little is known about patients with bone cement hypersenstivity after total knee arthroplasty (TKA). We present 7 patients implanted with 8 TKAs with clinical failure and a cement hypersensitivity diagnosis. All demonstrated hypersensitivity to bone cement via skin patch and/or lymphocyte transformation testing. All 7 patients also showed hypersensitivity to metal, most commonly nickel. Patients underwent custom cementless TKA revision. Prerevision and postrevision outcome measures, radiographs, intraoperative findings, and postrevision complications are reported. Functional scores improved after revision except Veterans RAND-12 mental component scores, which declined. Four patients continue to exhibit symptoms postoperatively, while one patient has had 3 additional surgical procedures. Patients presenting with bone cement hypersensitivity after TKA are particularly challenging. Evidence-based guidelines are lacking, and revision surgery may not relieve the presenting symptoms.
format	article
author	Sheila Pahlavan, BS Vishal Hegde, MD Daniel N. Bracey, MD, PhD Jason M. Jennings, MD, DPT Douglas A. Dennis, MD
author_facet	Sheila Pahlavan, BS Vishal Hegde, MD Daniel N. Bracey, MD, PhD Jason M. Jennings, MD, DPT Douglas A. Dennis, MD
author_sort	Sheila Pahlavan, BS
title	Bone Cement Hypersensitivity in Patients With a Painful Total Knee Arthroplasty: A Case Series of Revision Using Custom Cementless Implants
title_short	Bone Cement Hypersensitivity in Patients With a Painful Total Knee Arthroplasty: A Case Series of Revision Using Custom Cementless Implants
title_full	Bone Cement Hypersensitivity in Patients With a Painful Total Knee Arthroplasty: A Case Series of Revision Using Custom Cementless Implants
title_fullStr	Bone Cement Hypersensitivity in Patients With a Painful Total Knee Arthroplasty: A Case Series of Revision Using Custom Cementless Implants
title_full_unstemmed	Bone Cement Hypersensitivity in Patients With a Painful Total Knee Arthroplasty: A Case Series of Revision Using Custom Cementless Implants
title_sort	bone cement hypersensitivity in patients with a painful total knee arthroplasty: a case series of revision using custom cementless implants
publisher	Elsevier
publishDate	2021
url	https://doaj.org/article/709ead3ad5b545e99f6d4113a0c03d01
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Bone Cement Hypersensitivity in Patients With a Painful Total Knee Arthroplasty: A Case Series of Revision Using Custom Cementless Implants

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