Summary
The focus of this review are allergic reactions to orthopaedic-surgical metal implants. The spectrum of metal implant associated potential allergic reactions encompasses eczema, impaired wound and fracture healing, infection-mimicking reactions, effusions, pain and loosening. Nickel, cobalt and chromium seem to be the predominant eliciting allergens. Despite the growing number of respective publications the topic „metal implant allergy“ remains a diagnostic challenge. Initially, differential diagnoses should always be excluded in cooperation with surgery collegues. It is recommended to perform a combined evaluation of medical history, clinical findings, patch testing and histology. The lymphocyte transformation test (LTT) can indicate metal sensitization, but it needs careful interpretation. Allergists can provide a substantial contribution to this interdisciplinary topic.
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Abbreviations
- Co:
-
Cobalt
- CoCrMo:
-
Cobalt-chromium-molybdenum
- Cr:
-
Chromium
- FDA U.S.:
-
Food and Drug Administration
- LTT:
-
Lymphocyte transformation test
- MHRA:
-
Medicines and Healthcare Products Regulatory Agency
- Mo:
-
Molybdenum
- M-o-M:
-
Metal-on-metal
- PMMA:
-
Polymerized polymethylmethacrylate
- RKI:
-
Robert Koch-Institute
- SI:
-
Stimulation index
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Prof. Dr. Peter Thomas was appointed as reference allergist by the German Orthopaedic Society as well as by the German Society of Dental Implantology.
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Thomas P. Clinical and diagnostic challenges of metal implant allergy using the example of orthopedic surgical implants. Allergo J Int 2014;23:179–85 DOI: 10.1007/s40629-014-0023-3
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Thomas, P. Clinical and diagnostic challenges of metal implant allergy using the example of orthopaedic surgical implants. Allergo J Int 23, 179–185 (2014). https://doi.org/10.1007/s40629-014-0023-3
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DOI: https://doi.org/10.1007/s40629-014-0023-3