Allergy in total knee arthroplasty: a review of the facts

Bone Joint J. 2016 Apr;98-B(4):437-41. doi: 10.1302/0301-620X.98B4.36767.


We explored the literature surrounding whether allergy and hypersensitivity has a clinical basis for implant selection in total knee arthroplasty (TKA). In error, the terms hypersensitivity and allergy are often used synonymously. Although a relationship is present, we could not find any evidence of implant failure due to allergy. There is however increasing basic science that suggests a link between loosening and metal ion production. This is not an allergic response but is a potential problem. With a lack of evidence logically there can be no justification to use 'hypoallergenic' implants in patients who have pre-existing skin sensitivity to the metals used in TKA.

Keywords: Total knee arthroplasty; allergy; metal hypersensitivity.

Publication types

  • Review

MeSH terms

  • Arthroplasty, Replacement, Knee / adverse effects*
  • Humans
  • Hypersensitivity / etiology*
  • Knee Prosthesis / adverse effects*
  • Prosthesis Design