Duchna H W, Nowack U, Merget R, Muhr G, Schultze-Werninghaus G
Abt. f. Pneumologie, Allergologie und Schlafmedizin, Ruhr-Universität Bochum.
Zentralbl Chir. 1998;123(11):1271-6.
Allergies caused by metallic implants are often thought to be a reason for postoperative complications like bone necrosis or loosening of the prosthesis.
In a prospective study, we investigated allergic sensitivity against components of stainless steel implants, including titanium, in 112 patients shortly before surgical operation. The same tests were then repeated in 100 of these patients exactly one year after operation. There were three different kinds of procedures: 1. titanium implants, mainly total hip replacements, 2. regular steel implants, 3. surgery without any implants (control group). Any differences from the process of regular healing were regarded as postoperative complications.
A sensitivity against nickel (Ni) was diagnosed in three of these 100 patients (3%) before surgery. These patients, of whom two received a nickel-containing implant and one a titanium arthroplasty, did not show any postsurgical complications. Furthermore, three patients (3%) acquired a new sensitivity against metals during the study-interval of one year. Two of these three patients were women, who developed a postsurgical sensitivity against nickel or chrome but got titanium arthroplasties, which did not contain any nickel. These two women wore metal-containing jewelry, which might be the reason for the newly acquired metal-sensitivities, and both showed postsurgical complications. The third patient, who has developed a postsurgical sensitivity against components of his steel arthroplasty, did not reveal any complications.
We conclude that the rate of allergic sensitization against metal-components of arthroplasties is low in our patients. Additionally, skin-sensitivity against components of alloys and platings was not associated with a higher rate of postsurgical complications in our patients. We did not see any sensitivity against titanium. In conclusion, metallic implants are not a cause of allergies to a relevant extent, nowadays.
金属植入物引起的过敏通常被认为是术后并发症（如骨坏死或假体松动）的一个原因。
在一项前瞻性研究中，我们在112例患者手术前不久调查了其对不锈钢植入物成分（包括钛）的过敏敏感性。然后在其中100例患者术后整整一年时重复进行相同测试。有三种不同的手术方式：1. 钛植入物，主要是全髋关节置换；2. 普通钢植入物；3. 无植入物手术（对照组）。与正常愈合过程的任何差异都被视为术后并发症。
在这100例患者中，术前有3例（3%）被诊断对镍（Ni）敏感。这3例患者中，2例接受了含镍植入物，1例接受了钛关节成形术，术后均未出现任何并发症。此外，在一年的研究期间，有3例患者（3%）对金属产生了新的敏感性。这3例患者中有2例为女性，她们术后对镍或铬敏感，但接受的是不含任何镍的钛关节成形术。这两名女性佩戴含金属首饰，这可能是新产生金属敏感性的原因，且两人均出现了术后并发症。第三例患者术后对其钢关节成形术的成分敏感，但未出现任何并发症。
我们得出结论，在我们的患者中，对关节成形术金属成分的过敏致敏率较低。此外，患者对合金和镀层成分的皮肤敏感性与较高的术后并发症发生率无关。我们未发现对钛的任何敏感性。总之，如今金属植入物在很大程度上并非过敏的原因。
