title: Clinical and diagnostic challenges of metal implant allergy using the example of orthopaedic surgical implants: Part 15 of the Series Molecular Allergology.
abstract: 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.
authors.affiliation: Department of Dermatology and Allergology, Ludwig-Maximilians-University Munich, Frauenlobstraße 9-11, 80337 Munich, Germany.
authors.forename: Peter
authors.initials: P
authors.lastname: Thomas
keywords: Allergy; bone cement; chromium; cobalt; lymphocyte transformation test; metal implant; nickel; patch test