{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,30]],"date-time":"2025-10-30T03:59:58Z","timestamp":1761796798534,"version":"build-2065373602"},"reference-count":28,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2025,6,23]],"date-time":"2025-06-23T00:00:00Z","timestamp":1750636800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100009727","name":"Hospital Research Foundation","doi-asserted-by":"publisher","award":["C\u2010PJ\u201011\u20102018\u2010All PJ"],"award-info":[{"award-number":["C\u2010PJ\u201011\u20102018\u2010All PJ"]}],"id":[{"id":"10.13039\/100009727","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["ANZ Journal of Surgery"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>Immune\u2010mediated adverse local tissue reactions (ALTRs) to implanted metallic devices are an increasingly recognised orthopaedic concern. Recent research has identified a critical HLA genotype associated with increased risk of ALTR development around in\u00a0situ arthroplasty implants. Carriage imparts a &gt;\u2009700% increased relative\u2010risk of high\u2010grade peri\u2010prosthetic lesion development, associated with pain and joint dysfunction and likely contributing to an increased burden of complex revision surgery. Despite being first reported in 2017, the \u2018at risk\u2019 genotype has only subsequently been described in selected metal\u2010on\u2010metal and revision arthroplasty cohorts and no population\u2010level prevalence data has been reported. This novel epidemiologic pilot investigation aimed to explore allele\u2010variant carriage frequencies of the previously\u2010described \u2018at risk\u2019 HLA genotype in an undifferentiated orthopaedic population to inform larger screening investigations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>One hundred consecutive patients were prospectively recruited. Targeted HLA class II genotyping was performed using a medium\u2010resolution Luminex\u2010based approach, and secondary screening was performed to identify the presence of four specific alleles previously\u2010associated with immune\u2010mediated reactions to implanted metal devices.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Our findings, in a non\u2010differentiated orthopaedic cohort, suggest a carrier rate of the previously\u2010defined \u2018at risk\u2019 allele of 38%, with 29% of those sampled carrying the defined \u2018at risk\u2019 genotype.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Our results show a higher\u2010than\u2010anticipated incidence of the \u2018at risk\u2019 gene and genotype. As genotype\u2010associated ALTRs may contribute to patient dissatisfaction following primary joint replacements, the impact of this result may be greater than had previously been considered. While acknowledging the preliminary nature of these data, they may guide future screening applications of the genotyping analysis and will provide a foundation contribution\u2010to\u2010knowledge for future endeavours in diverse populations.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ans.70232","type":"journal-article","created":{"date-parts":[[2025,6,23]],"date-time":"2025-06-23T06:54:14Z","timestamp":1750661654000},"page":"2171-2177","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Establishing the Frequency of the\n                    <scp>HLA<\/scp>\n                    Class\n                    <scp>II<\/scp>\n                    Pseudotumour \u2018at Risk\u2019 Genotype: A Pilot Epidemiologic Analysis"],"prefix":"10.1111","volume":"95","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9951-1374","authenticated-orcid":false,"given":"Andrew P.","family":"Kurmis","sequence":"first","affiliation":[{"name":"College of Medicine &amp; Public Health Flinders University  Bedford Park South Australia Australia"},{"name":"Discipline of Medical Specialties University of Adelaide  Adelaide South Australia Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kimberley F.","family":"Kurmis","sequence":"additional","affiliation":[{"name":"School of Psychology University of Adelaide  Adelaide South Australia Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,6,23]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1126\/science.abi8207"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(15)70187-7"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1200\/PO.16.00066"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11999.0000000000000028"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/iid3.416"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.4049\/jimmunol.1201891"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00402-023-05075-7"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.3928\/01477447-20150804-07"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1302\/2633-1462.31.BJO-2021-0159.R1"},{"issue":"12","key":"e_1_2_12_11_1","article-title":"Pseudotumours and High Grade ALVALs Around Total Knee Arthroplasties: A Large\u2010Scale Histopathologic Review","volume":"100","author":"Garbuz D. S.","year":"2018","journal-title":"Orthopaedic Proceedings"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.otsr.2019.05.019"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.3389\/fbioe.2019.00176"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arth.2021.05.018"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arth.2020.09.014"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arth.2022.04.031"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.artd.2022.04.014"},{"issue":"3","key":"e_1_2_12_18_1","first-page":"214","article-title":"Patient and Radiographic Factors Help to Predict Metal\u2010on\u2010Metal Hip Resurfacings With Evidence of a Pseudotumor","volume":"99","author":"Matharu G. S.","year":"2017","journal-title":"Journal of Bone and Joint Surgery (American Volume)"},{"key":"e_1_2_12_19_1","doi-asserted-by":"publisher","DOI":"10.1302\/2633-1462.43.BJO-2023-0003.R1"},{"key":"e_1_2_12_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arth.2023.06.024"},{"key":"e_1_2_12_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arth.2019.05.025"},{"issue":"4","key":"e_1_2_12_22_1","article-title":"Pseudotumors in Total Joint Arthroplasty","volume":"9","author":"Merwe J. 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