[Adverse reactions to metal orthopedic implants after knee arthroplasty].
Based on several clinical examples, the range of adverse or hypersensitive reactions to metal implants especially after total knee replacement are presented. In general, we found the patients to generally be women who present with pain, swelling, and local or generalized eczema. Some also present with early aseptic loosening mainly in the first 4 years after implantation. For these patients, a detailed allergy-specific history should be taken and a patch test should be performed; if necessary, blood ion levels should be evaluated to exclude cobaltism. Before revision surgery and exchange of the implant we always perform arthroscopic inspection to obtain biopsies for microbiology and histopathology. Using the Consensus Classification a good evaluation for planning revision with the different implant options is possible.
Klinik für Orthopädie und Unfallchirurgie, Klinikum Mittelbaden Baden-Baden, Balger Str. 50, 76532, Baden-Baden, Deutschland. m.thomsen@klinikum-mittelbaden.de.
M
M
Thomsen
Zentrum für Histologie, Zytologie und Molekulare Diagnostik, Max-Planck-Str. 5, 54296, Trier, Deutschland.
V
V
Krenn
Klinik und Poliklinik für Dermatologie und Allergologie, Ludwig-Maximilians-Universität München, Frauenlobstr. 9-11, 80337, München, Deutschland.
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P
Thomas
D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects* / Q000295:instrumentation; D019317:Evidence-Based Medicine; D006801:Humans; D006967:Hypersensitivity / Q000175:diagnosis* / Q000209:etiology* / Q000517:prevention & control; D007720:Knee Prosthesis / Q000009:adverse effects*; D008670:Metals / Q000009:adverse effects*; D010328:Patch Tests / Q000379:methods*; D012086:Reoperation
D008670:Metals
Allergy; Chromium; Cobalt; Joint prosthesis implantation; Patch test