Thomas P, Geier J, Dickel H, Diepgen T, Hillen U, Kreft B, Schnuch A, Szliska C, Mahler V
Klinik und Poliklinik für Dermatologie und Allergologie, Ludwig-Maximilians-Universität München, Frauenlobstrasse 9-11, 80337, München, Deutschland.
Informationsverbund Dermatologischer Kliniken (IVDK), Institut an der Universität Göttingen, Göttingen, Deutschland.
Orthopade. 2015 Nov;44(11):905-8. doi: 10.1007/s00132-015-3150-8.
Intolerance reactions to metal implants may be caused by metal allergy. However, prior to implantation, patch testing should not be done in a prophylactic-prophetic approach. Pre-implant patch testing should only be performed to verify or exclude metal allergy in patients with a reported respective history. In the case of implant-in particular arthroplasty-related complications like, for example, pain, effusion, skin changes, reduced range of motion, or loosening, orthopedic-surgical differential diagnostics should be performed first. Allergological workup of suspected metal implant allergy should be done with the DKG baseline series which contains nickel-, cobalt- and chromium-preparations. Various studies assessing the usefulness of metal alloy discs for patch testing proved that this approach does not give reliable information about metal allergy. Positive patch test reactions to the discs cannot be assigned to a specific metal within the disc alloy components. Furthermore, availability of such metal discs might be an invitation to uncritical testing. Accordingly, due to lack of benefit in comparison to patch testing with standardized metal salt preparations, we do not recommend patch testing with metal alloy discs.
对金属植入物的不耐受反应可能由金属过敏引起。然而，在植入前，不应采用预防性预测性方法进行斑贴试验。植入前斑贴试验仅应在有相关病史报告的患者中进行，以验证或排除金属过敏。对于植入物，特别是与关节成形术相关的并发症，如疼痛、积液、皮肤变化、活动范围减小或松动，应首先进行骨科手术鉴别诊断。对疑似金属植入物过敏的变应性检查应使用包含镍、钴和铬制剂的德国接触性皮炎学会（DKG）基线系列进行。各种评估金属合金盘用于斑贴试验有效性的研究证明，这种方法无法提供有关金属过敏的可靠信息。对盘的斑贴试验阳性反应不能归因于盘合金成分中的特定金属。此外，此类金属盘的可得性可能会引发不加批判的检测。因此，由于与使用标准化金属盐制剂进行斑贴试验相比没有益处，我们不建议使用金属合金盘进行斑贴试验。
