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The focus of this review are allergic complications following insertion of metallic orthopedic implants. Such potential allergic reactions encompass eczema, impaired wound and fracture healing, infection-mimicking reactions, effusions, pain and loosening. Nickel, cobalt and chromium seem to be the predominant eliciting allergens. Allergy might be considered prior to planned orthopaedic surgery or in patients with complications following arthroplasty We recommend, that differential diagnoses - in particular infection -should always be excluded in cooperation with surgery collegues. The clinical work up of a patient suspected of suffering from metal implant allergy should include a combined evaluation of medical history, clinical findings, patch testing and histology In vitro testing, namely the lymphocyte transformation test (LTT), can indicate metal sensitization, but needs careful interpretation.

About the authors

P. Thomas


Author for correspondence.
Russian Federation

M. Thomsen

DRK Hospital, Orthopedics and Trauma Surgery

Russian Federation

V. Krenn

Center for Histology, Cytology and Molecular Diagnostics

Russian Federation

B. Summer


Russian Federation


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