Patients with Intolerance Reactions to Total Knee Replacement: Combined Assessment of Allergy Diagnostics, Periprosthetic Histology, and Peri-implant Cytokine Expression Pattern

Table 2

Patch test/LTT results and histology grading, group I.

Patient number	Age, sex	Patch test reaction	LTT-reaction	CD3-infiltrate		KP1	CD20	CD15	Rating (Type I–IV according to [24])
				Qualitative	Quantitative
10	37, m	Ni, Co, Cr	n.d.	Micronodal perivascular	+	++	−	−	Type 4
8	51, f	Ni,	Ni,	Micronodal perivascular	++	+	−	−	Type 4
15	59, f	Ni	n.d.	Micronodal perivascular	++	++	+	−	Type 4
9	74, m	Ni, Co	n.d.	Micronodal perivascular	+++	++	−	−	Type 4
3	51, m	Co	n.d.	Diffuse	−	+	−	−	Type 4
18	58, f	Ni,	Ni	Diffuse	−	−	−	−	Type 1 (Necrosis)
7	75, m	Ni	Ni	Diffuse	+	++	−	−	Type 4
1	63, m	Ni, Co, Ge, Be	Ni	Diffuse	+	++	+	+	Type 4
16	57, m	Ni, Co	Ni	Diffuse	+	+	−	−	Type 4
17	68, m	Ni, Co, Cr,	n.d.	Diffuse	+	+	−	−	Type 4
19	56, f	Ni,	neg	Diffuse	+	++	−	−	Type 1

Findings in 11 patients with CoCrMo based knee arthroplasty with complications and positive patch test reaction. Ni = nickel, Co = cobalt, Cr = chromium, Ge = gentamicin, B = benzoyl peroxide; n.d. = not done; LTT = lymphocyte transformation test.