PMID- 37454947 OWN - NLM STAT- MEDLINE DCOM- 20231204 LR - 20231216 IS - 1532-8406 (Electronic) IS - 0883-5403 (Linking) VI - 39 IP - 1 DP - 2024 Jan TI - Do Patients With Hypoallergenic Total Knee Arthroplasty Implants for Metal Allergy Do Worse? An Analysis of Health Care Utilizations and Patient-Reported Outcome Measures. PG - 103-110 LID - S0883-5403(23)00742-8 [pii] LID - 10.1016/j.arth.2023.07.005 [doi] AB - BACKGROUND: Metal allergy is a rare and controversial cause of implant failure and poor outcomes following total knee arthroplasty (TKA). Few studies have investigated clinical and patient-reported outcome measures (PROMs) in patients treated with hypoallergenic implants. This investigation aimed to compare: (1) health care utilizations (eg, hospital length of stay, 90-day readmission rate, and incidence of nonhome discharge) and (2) 1-year PROMs between patients who received hypoallergenic and standard TKA implants. METHODS: This was a retrospective review of prospectively collected data from patients who underwent primary TKA between 2018 and 2019. Propensity score matching (3:1) was used to compare standard TKA patients with those who received hypoallergenic TKA implants, respectively. Knee injury and Osteoarthritis Outcome Score (KOOS) pain, KOOS Physical function Shortform (PS), and Veterans RAND 12-Item Health Survey Mental Component Score were collected preoperatively and at 1-year. After matching, 190 hypoallergenic and 570 standard TKAs were analyzed. RESULTS: No differences were observed in length of stay (P = .98), 90-day readmission (P = .89), and nonhome discharge (P = .82). Additionally, there was no significant difference in change from preoperative to 1-year PROMs (KOOS pain, P = .97; KOOS PS, P = .88; Veterans RAND 12-Item Health Survey Mental Component Score, P = .28). Patient-reported satisfaction was similar at 1-year (P = .23). Patients achieved similar rates of Patient Acceptable Symptom State (PASS) and minimal clinically important difference (MCID) for KOOS pain (PASS, P = .77; MCID, P = .33) and KOOS PS (PASS, P = .44; MCID, P = .65). CONCLUSION: Patients treated with hypoallergenic TKA implants for suspected metal allergy had similar outcomes compared to patients who had standard implants and no metal allergy. CI - Copyright (c) 2023 Elsevier Inc. All rights reserved. FAU - Tidd, Joshua L AU - Tidd JL AD - Department of Orthopaedic Surgery, Cleveland Clinic, Cleveland, Ohio; College of Medicine, Northeast Ohio Medical University, Rootstown, Ohio. FAU - Gudapati, Lakshmi Spandana AU - Gudapati LS AD - Department of Orthopaedic Surgery, Cleveland Clinic, Cleveland, Ohio. FAU - Simmons, Hannah L AU - Simmons HL AD - Department of Orthopaedic Surgery, Cleveland Clinic, Cleveland, Ohio. FAU - Klika, Alison K AU - Klika AK AD - Department of Orthopaedic Surgery, Cleveland Clinic, Cleveland, Ohio. FAU - Pasqualini, Ignacio AU - Pasqualini I AD - Department of Orthopaedic Surgery, Cleveland Clinic, Cleveland, Ohio. CN - Cleveland Clinic Arthroplasty Group AD - Department of Orthopaedic Surgery, Cleveland Clinic, Cleveland, Ohio. FAU - Piuzzi, Nicolas S AU - Piuzzi NS AD - Department of Orthopaedic Surgery, Cleveland Clinic, Cleveland, Ohio; Department of Biomedical Engineering, Cleveland Clinic, Cleveland, Ohio. LA - eng PT - Journal Article DEP - 20230715 PL - United States TA - J Arthroplasty JT - The Journal of arthroplasty JID - 8703515 SB - IM MH - Humans MH - *Arthroplasty, Replacement, Knee/adverse effects MH - *Osteoarthritis, Knee/surgery MH - Patient Satisfaction MH - Patient Acceptance of Health Care MH - Pain/surgery MH - Health Surveys MH - *Hypersensitivity/epidemiology/etiology/surgery MH - Patient Reported Outcome Measures MH - Treatment Outcome OTO - NOTNLM OT - health care utilization OT - metal allergy OT - metal hypersensitivity OT - nickel allergy OT - satisfaction OT - total knee arthroplasty FIR - Higuera, Carlos A IR - Higuera CA FIR - Molloy, Robert M IR - Molloy RM FIR - Murray, Trevor G IR - Murray TG FIR - Bloomfield, Michael R IR - Bloomfield MR FIR - Schaffer, Jonathon L IR - Schaffer JL FIR - McLaughlin, John P IR - McLaughlin JP FIR - Deren, Matthew E IR - Deren ME FIR - Surace, Peter A IR - Surace PA FIR - Krebs, Viktor E IR - Krebs VE EDAT- 2023/07/17 00:42 MHDA- 2023/12/04 12:42 CRDT- 2023/07/16 19:28 PHST- 2023/02/26 00:00 [received] PHST- 2023/07/02 00:00 [revised] PHST- 2023/07/10 00:00 [accepted] PHST- 2023/12/04 12:42 [medline] PHST- 2023/07/17 00:42 [pubmed] PHST- 2023/07/16 19:28 [entrez] AID - S0883-5403(23)00742-8 [pii] AID - 10.1016/j.arth.2023.07.005 [doi] PST - ppublish SO - J Arthroplasty. 2024 Jan;39(1):103-110. doi: 10.1016/j.arth.2023.07.005. Epub 2023 Jul 15.