From the Departments of *Dermatology and †Orthopaedics, Milton S. Hershey Medical Center, Penn State Health, Hershey PA.
Dermatitis. 2017 Jan/Feb;28(1):76-80. doi: 10.1097/DER.0000000000000236.
There is no clear consensus among orthopedic surgeons concerning metal hypersensitivity screening and orthopedic implants.
This study investigated practices and opinions about metal hypersensitivity and orthopedic implants via a survey administered to practicing orthopedists.
A questionnaire was sent to members of the Pennsylvania Orthopaedic Society electronically. Respondents were asked about preoperative and postoperative screening habits concerning metal hypersensitivity and implants.
Forty-four physicians completed the survey. Only 11% of respondents reported that they always or often screen patients for metal hypersensitivity. Fifty percent of respondents stated that they only rarely refer patients for patch testing (and the remainder never do). If, however, patients were found to have a positive patch test, most providers were very likely to use a different implant. Other respondents were skeptical of the relationship between metal hypersensitivity and implant failure. Dermatitis, pain, and loosening were common reasons for postoperative testing. Seventy percent of respondents said that patch testing rarely or never changed their decision making.
This study is reflective of the lack of consensus between orthopedists regarding patch testing. It demonstrates the diversity of opinions among orthopedists, the need for additional dialogue between orthopedic and dermatology specialties, and the need for larger studies investigating outcomes and metal hypersensitivity.
骨科医生对于金属过敏筛查和骨科植入物的看法并不一致。
本研究通过对骨科医生进行问卷调查，调查他们在金属过敏和骨科植入物方面的实践和看法。
向宾夕法尼亚骨科协会的成员发送了一份电子问卷。调查对象被问到有关金属过敏和植入物的术前和术后筛查习惯。
44 名医生完成了这项调查。只有 11%的受访者表示他们经常或总是筛查患者是否存在金属过敏。50%的受访者表示，他们只是偶尔（其余的则从不）将患者转介进行斑贴试验。然而，如果患者的斑贴试验呈阳性，大多数医生很可能会使用不同的植入物。其他医生对金属过敏和植入物失败之间的关系持怀疑态度。皮炎、疼痛和松动是术后检测的常见原因。70%的受访者表示，斑贴试验很少或从未改变他们的决策。
本研究反映了骨科医生在斑贴试验方面缺乏共识。它表明了骨科医生之间意见的多样性，需要在骨科和皮肤科之间进行更多的对话，以及需要进行更大规模的研究来调查结果和金属过敏。
