Metal Implant Allergy

Metal allergy after first metatarsophalangeal total joint replacement – Case report

“…The testing on metal hypersensitivity can be carried out in vivo as in our case report or in vitro with the T-lymphocyte transformation test which is more specific than dermal patch testing [4]. When a patient is referred for a suspected allergy following implantation of a metal implant, dermal patch testing is recommended [1].…”

“…systemic overlying dermatitis [1,7] or less commonly a systemic allergic reaction which was described when using stainless steel instruments for intravenous injections [8]. However, metal I. Schmidt / Foot and Ankle Surgery xxx (2015) e1-e3 e2 hypersensitivity does not automatically lead to relevant symptoms or implant failure, up to 25% of patients with well-functioning hip arthroplasties may be hypersensitive, and upward of 60% of patients with failed or problematic implants may have hypersensitivity [4].…”

“…If the removal of implant is a reasonable option, it should be pursued for definitive treatment [1]. If it is not safe or reasonable at a particular time but the dermatitis is symptomatic, a 3-week course of tapered prednisone is an option [9].…”

“…Metal sensitivity remains unpredictable and a poorly understood aspect of surgical implants, and it is not limited to hip and knee arthroplasty [1]. The prevalence of metal sensitivity in the general population is reported to be up to 25% for nickel, up to 9% for cobalt, up to 6% for chromium, and up to 3% for titanium [2,3].…”

A Delayed Allergic Reaction to Polypropylene Suture Used in Flexor Tendon Repair: Case Report

“…This entity has not received much attention in the hand surgery literature. 3 We report a patient who developed a delayed hypersensitivity reaction to a polypropylene suture used in flexor pollicis longus repair. We also aim to review the literature on this entity and increase the awareness of hand surgeons to the presentation, diagnosis, and management of these rare cases.…”