medRxiv PreprintsInternational13 October 2026
HLA Genotype is Associated with Patient Reported Outcomes and Adverse Reactions to Metal Debris in Patients with Cobalt-Chrome Knee Arthroplasties
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Purpose: To determine whether a cobalt-chrome genetic reactivity (CoGR) score - originally developed to identify patients at greater risk of developing adverse reaction to metal-on-metal hips - is associated with poorer patient-reported outcomes after knee arthroplasty (KA). Methods: In a prospective multicentre study, patients at a minimum two years post all cobalt-chrome KA were invited to research clinics. Participants provided samples for blood metal ion measurements and DNA sequencing and completed Forgotten Joint Scores (FJS). Component alignment was assessed on AP and lateral plain radi
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