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Tivanium posterior-stabilized (PS) total knee arthroplasty (TKA) for nickel intolerance
ESSKA Academy. Canata G. Nov 8, 2019; 284367; epEKA-27 Topic: Joint Replacement
Dr. Gian Luigi Canata
Dr. Gian Luigi Canata
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Tivanium posterior-stabilized (PS) total knee arthroplasty (TKA) for nickel intolerance

ePoster - epEKA-27

Topic: TKA

Canata G.L.1, Casale V.2
1Koelliker Hospital, Centre of Sport Traumatology, Torino, Italy, 2Koelliker Hospital, Torino, Italy

The importance of allergic reactions to implant materials in TKA is still controversial. In case of suspect nickel intolerance a different material must be used.
Metal orthopedic implants may be the primary cause of allergies, leading to implant failure. Patch tests screening should be obligatory for patients with symptoms of metal dermatitis to provide implants free from allergenic metals.
The goal of this retrospective study is to compare the results of Tivanium PS for Nickel intolerance to Nex Gen Cruciate Retaining (CR) TKA.
Between 2013 and 2017 the same surgeon performed 17 Tivanium PS implants. Patients who died prior to a two-years follow up (=2) were excluded. 29 patients with a diagnosis of osteoarthritis undergoing a primary TKA were enrolled in this study. In Group A, personal interview, dermatological examination and patch testing with 2.0% cadmium sulphate, 1% cobaltous chloride hexahydrate, 1% chromium (III) chloride, 5% nickel sulfate hexahydrate,1% palladium chloride, 2% copper sulphate pentahydrate, 0.1% titanium (IV) oxide were performed on patients with suspected metal allergy. Tivanium PS Nickel free components were implanted in 14 patients (15 knees) allergic to Nickel, mean age 69 years (r.56-84). Patients of Group B were selected according to close temporal proximity with Group A: 15 Nex Gen CR TKA (1 cemented, 14 uncemented), mean age 68 years (r.45-79). Mean follow up: 36 months (r.13-75). Pre- and postoperative evaluation performed with the Knee injury and Osteoarthritis Outcome Score (KOOS), the Visual Analogue Scale (VAS) and the postoperative Range Of Motion (ROM). Statistics performed with the Student t-test, the Kolmogorov - Smirnov test and the Mann-Whitney U test.
Group A: mean preoperative KOOS score 39,8 (SD 15,8), postoperative 81,3 (SD 18,9). Mean preoperative VAS score 7,0 (r.4-9), postoperative 1,3 (r.0-7). Mean postoperative ROM 0-0-126 (flexion r.90°-140°). Group B: mean preoperative KOOS score 42,1 (SD 22,3), postoperative 89,1 (SD 16,3). Mean preoperative VAS score 7,0 (r.1-10), postoperative 1,4 (r.0-8). Mean postoperative ROM 0-0-122 (flexion r.80°-140°). 2 patients reporting a BMI>25.0 showed residual symptoms in group A, 1 patient with a BMI>25 in group B. No revision surgery needed in the two groups. Outcomes between the two groups are not statistically significant (p>0.05).
The use of Tivanium PS implants in patients with nickel sensitivities shows results as good as Nex Gen CR prostheses.
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