Is There an Association Between Contact Allergy and Orthopedic Metal Implants? – a Systematic Review

Introduction Allergic contact dermatitis is a common disease. Common contact allergens are nickel, cobalt and chromium. The Swedish contact dermatitis research group (SCDRG) made a statement on metal implants and contact allergy stating: “it is a known problem, but there is uncertainty as to what extent”. A systematic review could help finding more information on the subject. Aim This study assesses whether there is a known association between contact allergy and orthopedic implants through a systematical review of articles on the subject. Materials and Method A search was made using PubMed and it was systematically documented. The search was built from the defined “PICO”. A relevance assessment was made from pre-defined exclusion criteria in two steps; the first from titles and abstracts and the second from full text articles. A quality assessment graded five articles, inspired by GRADE. Result The search resulted in 95 articles. The first step of the assessment excluded 79 articles, leaving 16. The second step of the assessment excluded ten articles, one was not acquired leaving five. No significant association was shown in any article. Conclusion This study cannot show any association between contact allergy and orthopedic implants. The phenomenon is likely rare. Further research is needed