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Although metal allergy with total joint replacement exists, the prevalence of this condition is unknown, according to Joshua J. Jacobs, MD…
…”In patients with metal-on-metal surface replacements, there is a direct correlation between serum metal levels and metal sensitivity determined by [lymphocyte transformation testing] LTT,” Jacobs said. “Current diagnostic methods, both patch testing and in vitro, do require more robust clinical validation, but it can be useful in preop screening for patients with in vitro metal allergies when there is a history of reaction to jewelry.”
Jacobs JJ. Clinical manifestations of metal allergy. Adverse reactions to byproducts of joint replacements (AAOS/ORSI). Presented at the American Academy of Orthopaedic Surgery 2012 Annual Meeting. Feb. 7-11. San Francisco.