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Review Question - QID 213935

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QID 213935 (Type "213935" in App Search)
A 59-year-old female who recently moved to the area presents to your office for evaluation of a painful right total knee arthroplasty that was performed by another surgeon 10 months ago. Infectious workup, including alpha-defensin and synovial fluid analysis, are negative for infection. When asked, she does endorse a history of skin reaction to cheap metal jewelry. What is the pathophysiology of metal hypersensitivity reactions in TKA?