Guenther Daniel, Thomas Peter, Kendoff Daniel, Omar Mohamed, Gehrke Thorsten, Haasper Carl
Orthopaedic Department, Helios-Endo Klinik Hamburg, Holstenstraße 9, 22767, Hamburg, Germany.
Trauma Department, Hannover Medical School (MHH), Carl-Neuberg-Str. 1, 30625, Hannover, Germany.
Int Orthop. 2016 Feb;40(2):239-44. doi: 10.1007/s00264-015-3001-6. Epub 2015 Nov 2.
The purpose of this study was to determine the prevalence of sensitisation to chromium, cobalt, nickel, or a cement component in patients who received endoprosthetic surgery at our institution. Also, we aimed to assess the portion related to allergic reactions in endoprosthetic revisions and to follow-up those patients after allergic reaction related revisions.
We selected patients with a pre-operative known sensitisation to chromium, cobalt, nickel, or a cement component for a post-operative allergic reaction. All patients who received revision surgery because of a potential allergic reaction were followed up post revision surgery.
Eight hundred fifty-five patients were pre-operative known to have a sensitisation to chromium, cobalt, nickel, or a cement component. Six hundred eighty-two patients (79.8 %) received a primary arthroplasty, and 173 patients (20.2 %) received a revision surgery. Seventeen patients (2.0 %) were revised because of allergic reactions. Allergic reactions were the cause for approximately 0.2 % of all endoprosthetic revisions and for 9.8 % of revisions in patients with sensitisation to one of the reviewed components. Potential allergens were strictly avoided in the replaced prosthesis. Outcome scores improved post-operatively.
The allergic patient should be thoroughly informed about potential reactions resulting from implant choice. Our study can serve as risk assessments by quantifying the incidence of allergic reactions due to endoprosthetic treatment.
本研究的目的是确定在我们机构接受假体植入手术的患者中对铬、钴、镍或骨水泥成分致敏的患病率。此外，我们旨在评估假体翻修术中与过敏反应相关的比例，并对因过敏反应进行翻修的患者进行随访。
我们选择术前已知对铬、钴、镍或骨水泥成分致敏且术后发生过敏反应的患者。所有因潜在过敏反应接受翻修手术的患者在翻修手术后均进行随访。
855例患者术前已知对铬、钴、镍或骨水泥成分致敏。682例患者（79.8%）接受了初次关节置换术，173例患者（20.2%）接受了翻修手术。17例患者（2.0%）因过敏反应进行了翻修。过敏反应约占所有假体翻修术的0.2%，在对所评估成分之一致敏的患者翻修术中占9.8%。在置换的假体中严格避免潜在过敏原。术后结果评分有所改善。
应向过敏患者充分告知因植入物选择可能产生的反应。我们的研究可通过量化假体治疗引起的过敏反应发生率来进行风险评估。
