A reaction to a knee replacement can appear months or even years after the initial surgery. Health care providers have been known to rely more on staples in performing surgeries. Case Reports and SeriesSystemic Nickel Allergy after Internal Fixation of a Bunionectomy. Nasal congestion. 639644, 2020. sharing sensitive information, make sure youre on a federal Any metal that comes into contact with body tissues will corrode to some degree. Allergic contact dermatitis caused by titanium screws and dental They always include a percentage of nickel, which is a known allergen. Titanium is another type of metal that is utilized extensively in cardiac pacemakers, dental procedures, arthroplasty, body piercing, and spectacle frames [2]. The MELISA test has been known to be a more sensitive test to metal allergy but lacks specificity in the proliferation of lymphocytes [3]. In orthopedic joint surgery, reported metal hypersensitivity reactions include cutaneous rash and erythema to joint pain and aseptic implant loosening [10] . This case highlights the variable presentation of titanium allergy that clinicians should be vigilant for. Contact Allergy to metals such as nickel, cobalt, and chromium is prevalent in the general population. Health care providers should be more vigilant with these cases in order to provide proper diagnosis to patients who suffer from abdominal pain as the most common symptom of allergic reactions to staples and clips. Please enter a Recipient Address and/or check the Send me a copy checkbox. 2023 Mar 20;16(6):2463. doi: 10.3390/ma16062463. Patch-tested at time of stenting and again in 6 mo; 6.9% were nickel allergic, but 37% developed instent restenosis; 1/3 nickel-allergic patients developed diffuse in-stent restenosis. M. Goutam, C. Giriyapura, S. K. Mishra, and S. Gupta, Titanium allergy: a literature review, Indian Journal of Dermatology, vol. Most reactions to knee replacements are hypersensitive reactions. The .gov means its official. Before Many types of metallic implants can cause cutaneous allergic reactions, from orthopedic and dental implants to cardiac stents and pacemakers. Will my hardware set off a metal detector? official website and that any information you provide is encrypted Sinus Issues. document.getElementById( "ak_js_1" ).setAttribute( "value", ( new Date() ).getTime() ); Your Injury:Bladder SlingGadolinium (MRI)Hernia MeshIVC filterNuVasive MAGECParagardStryker HipSurgical StaplerTransvaginal Mesh------AbilifyActosAduhelmBelviqCymbaltaEffexorElmironEssureGranufloDepakoteGeodonInvegaInvokanaLyricaNexiumOpioidsParaquatRisperdalRoundupTestosterone therapyTalcum PowderTaxotereXareltoZantacZofranZoloftZinbryta, State:AL AlabamaAK AlaskaAZ ArizonaAR ArkansasCA CaliforniaCO ColoradoCT ConnecticutDE DelawareFL FloridaGA GeorgiaHI HawaiiID IdahoIL IllinoisIN IndianaIA IowaKS KansasKY KentuckyLA LouisianaME MaineMD MarylandMA MassachusettsMI MichiganMN MinnesotaMS MississippiMO MissouriMT MontanaNE NebraskaNV NevadaNH New HampshireNJ New JerseyNM New MexicoNY New YorkNC North CarolinaND North DakotaOH OhioOK OklahomaOR OregonPA PennsylvaniaRI Rhode IslandSC South CarolinaSD South DakotaTN TennesseeTX TexasUT UtahVT VermontVA VirginiaWA WashingtonWV West VirginiaWI WisconsinWY WyomingOther. Foot & Ankle Problems: Allergy to metal screws - HealthBoards By postoperative day 6, the patients symptoms of abdominal distension resolved and her RLQ pain also diminished. These assessments do not indicate that Dr. Sinicropi has performed these specific surgeries. If you have a known hypersensitivity to metal and are scheduled to undergo a total knee replacement, it is not clear if starting with a ceramic or titanium appliance is the best option. Middleton S, Toms A. doi: 10.7759/cureus.26167. -, Lancet. He served as assistant team physician to Chivas USA (Major League Soccer) and the United States men's and women's national soccer teams. 97100, 2017. Allergy symptoms, which depend on the substance involved, can affect your airways, sinuses and nasal passages, skin, and digestive system. Type I hypersensitivity reaction may manifest as anaphylaxis causing urticarial plaques or papules on the skin [3]. Read our. However, it indeed seems titanium allergy had a significant role in her abdominal discomfort owing to her positive allergy test results further proving titanium hypersensitivity in this patient. Dermatol Ther (Heidelb). Diagnostic laparoscopy evaluation with fluoroscopic guidance was performed to locate the exact positioning of the pigtail catheter within the cecum before surgery (a) and after pigtail catheter removal (b). Dermatitis. Because of this, the symptoms of DHT can get progressively worse as more and more metal ions are released due to corrosion. Many people have known skin sensitivities to various metals. Clipboard, Search History, and several other advanced features are temporarily unavailable. The patient tolerated the procedure well with no postoperative complications. eCollection 2022. Federal government websites often end in .gov or .mil. Polylactide-polyglycolide copolymer an absorbable material that is ideally used for plastic surgeries because of less scarring after healing. The diagnosis of DHT can be difficult, in part because a hypersensitive reaction on the skin doesn't always cause a hypersensitive reaction on internal tissues, or vice versa. Systemic Nickel Allergy after Internal Fixation of a Bunionectomy Hosoki M, Nishigawa K, Tajima T, Ueda M, Matsuka Y. J Prosthodont Res. Signs and symptoms of metal hypersensitivity can range from mild to severe and generalized. Titanium is a known metal used widely in the medical field and can cause allergic reactions with complications. Cite this: Cutaneous and Systemic Hypersensitivity Reactions to Metallic Implants-Medscape-Apr01,2011. Hypersensitivity Reactions to Metallic Implants 2023 Feb 19;14(2):116. doi: 10.3390/jfb14020116. W. S. Towers and K. Kurtom, Rare systemic response to titanium spinal fusion implant: case report, Cureus, vol. Late onset infection can occur in some cases where you have some focus of infection causing bacteremia,and the sign symptoms include, redness. Cardiac stents and patches are often made of Nitinol, a composite of nickel and titanium. The Body's Reaction to a Variety of Foreign Materials - Monib Health Nickel allergy to orthopaedic implants: A review and case series One of the rare complications from the use of staples in surgery is an allergic reaction, mainly because of the components or materials present in the staple. The patient has been recommended to do a close follow-up for a few months to monitor her progress. Cara Beth Lee, MD, is a board-certified orthopedic surgeon and Assistant Medical Director at Comagine Health in Washington. Results may vary from person to person. We describe a 69-year-old male for whom significant pathologic findings around dental implants had never been observed. Dizziness or fainting. After removal of dental implants, the eczema disappeared completely. Basko-Plluska JL, Thyssen JP, Schalock PC. A rash after surgery may be due to contact with irritants or an allergic reaction to a medication. 2013 Jun-Jul;79(4):38-43. 2023 Dotdash Media, Inc. All rights reserved, Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Infrequent complications have been discussed in studies regarding pigtail catheter found on computerized tomography (CT) scan following a procedure. 2011American Contact Dermatitis Society. While the words "hypersensitivity" and "allergy" are often used interchangeably, they're not really the same. The titanium screws used in the orthopedic surgery that he underwent were removed 1 year later, but the eczema remained. You can find out more about our use, change your default settings, and withdraw your consent at any time with effect for the future by visiting Cookies Settings, which can also be found in the footer of the site. In our case, the patients nonspecific symptoms due to the titanium clips were quite different from the symptoms reported in other studies and may not wholly be attributable to titanium hypersensitivity since the patient had known allergic reactions to various other allergens as well. Titanium Rejection Symptoms | Colgate However, in October 2020, the patient started having new symptoms of watery, nonbloody diarrhea associated with her chronic RLQ pain. She was tested for Clostridium difficile infection and showed positive toxin B results confirming the diagnosis. In essence, hypersensitivity reactions become a diagnosis of exclusion for physicians. Our case is about a 28-year-old female presenting with a spectrum of abdominal symptoms with a complicated medical history. Finally, the blood test could be effectively used to diagnose type IV hypersensitivity allergic reactions, including contact dermatitis or eczema reported by few studies on titanium allergy [12]. So a person who has already had spinal hardware put in place can potentially develop an allergy to it years down the line. These cookies will be stored in your browser only with your consent. Metal Allergy to Surgical Plates, Screws, and Implants - Verywell Health Titanium hypersensitivity - MELISA Moreover, metal allergy screening should be considered for patients with past hypersensitivity reactions before any surgery. The Dr really should check it. 2021;9(8):3109-3117.e1. Save my name, email, and website in this browser for the next time I comment. It also sheds light on retained foreign bodies as a possible cause of abdominal pain in patients who have gone through various surgical procedures in the past. With prosthetic knees, stainless steel used to build the appliance contains around 10% nickel. Please see our, You are being redirected to Medscape Education, Advanced Systemic Mastocytosis: Considerations to Optimize Patient Management. She reported a complete resolution of all symptoms one-month postsurgery. 2, 2020. In general, orthopedic implants are alloys, meaning they contain more than one type of metal. However, other metal ions as well as bone cement components can cause such hypersensitivity reactions. It can be challenging to diagnose and discover RFB due to the different manifestations of each case and nonspecific symptoms. With that said, some studies suggest that they may be beneficial for certain groups. 55435 The Opioid Epidemic. 12, no. The information contained herein is subject to change without notice. *List is not exhaustive. = reference; THR = total hip replacement; TKA = total knee arthroplasty; TKR = total knee replacement. Allergic reactions to staples, clips, and other metallic implants may be rare, but it can have adverse health effects on a patient.