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Metalik implantlar alerji yapar mı?

Year 2019, Volume: 58 Issue: 1, 92 - 102, 14.03.2019

Fatma Düşünür Günsen Aytül Zerrin Sin Semih Aydoğdu

Abstract

Metal hipersensitivitesi, özellikle nikel duyarlılığı, toplumda sık görülen bir tablodur. İmplante metaller biyolojik sıvılarla temas ettiğinde aşınır ve demir, krom, nikel, alüminyum ve molibden gibi metalik iyonlar salınır. Bu metal iyonları lokal veya sistemik etkilerle hipersensitivite reaksiyonlarına neden olabilir. İmplante materyale karşı gelişen cilt lezyonları primer olarak T hücre aracılı tip 4 gecikmiş tip hipersensitivite reaksiyonudur. Yama testi metal duyarlılığını göstermede altın standarttır. Rutin olarak operasyon öncesi yama testi önerilmemekte olup, hastanın öyküsünde kişisel metal duyarlılığı öyküsü var ise yapılmalıdır. Hastaların preoperatif değerlendirmesi sırasında kimin hipersensitivite reaksiyonu geliştireceğini önceden belirleyen bir test yöntemi yoktur. Metal hipersensitivitesi; psödotümör formasyonu, kronik ağrı, eklem efüzyonu ve hatta protez başarısızlığı ve değiştirilmesine neden olabileceğinden ortopedide önemli bir sorundur.

Keywords

Metalik implantlar alerji yama testi.

References

  • Zug KA, Warshaw EM, Fowler JF Jr, et al. Patch-test results of the North American Contact Dermatitis Group 2005-2006 [published correction appears in Dermatitis. 2009;20(5):300]. Dermatitis. 2009;20(3):149-160
  • Thyssen J P, Linneberg A, Menn´e T, Nielsen N H, Johansen J D. Contact allergy to allergens of the TRUE-test (panels 1 and 2) has decreased modestly in the general population. Br J Dermatol 2009: 161: 1124–1129
  • Aquino M, Mucci T. Systemic contact dermatitis and allergy to biomedical devices. Curr Allergy Asthma Rep. 2013; 13: 518-27
  • Merritt K, Rodrigo JJ. Immune response to synthetic materials: sensitization of patients receiving orthopaedic implants. Clin Orthop Relat Res. 1996;326(326): 71-79
  • Niki Y, Matsumoto H, Otani T et al. Screening for symptomatic metal sensitivity: a prospective study of 92 patients undergoing total knee arthroplasty. Biomaterials 2006: 26: 1019–1026.
  • Thyssen J P, Johansen J D, Menn´e T, Lid´en C, Bruze M,White I R. Hypersensitivity reactions from metallic implants: a future challenge that needs to be addressed. Br J Dermatol 2010: 162: 235–236
  • Roberts TT, Haines CM, Uhl RL. Allergic or Hypersensitivity Reactions to Orthopaedic Implants. J Am Acad Orthop Surg. 2017 Oct;25(10):693-702.
  • Tezer M, Kuzgun U, Hamzaoglu A, Ozturk C, Kabukcuoglu F, Sirvanci M. Intraspinal metalloma resulting in late paraparesis. Arch Orthop Trauma Surg 2005: 125: 417–421.
  • Dorr L D, Bloebaum R, Emmanual J, Meldrum R. Histologic, biochemical and ion analysis of tissue and fluids retrieved during total hip arthroplasty. Clin Orthop Relat Res 1990: 261: 82–95
  • Urban R M, Jacobs J J, Tomlinson M J, Gavrilovic J, Black J, Peoc’h M. Dissemination of wear particles to the liver, spleen, and abdominal lymph nodes of patients with hip or knee replacement. J Bone Joint Surg Am 2000: 82: 457–47
  • Halwani D O, Anderson P G, Lemons J E, Jordan WD, Anayiotos A S, Brott B C. In-vivo corrosion and local release of metallic ions from vascular stents into surrounding tissue. J Invasive Cardiol 2010: 22: 528–535
  • Schalock P, Mennѐ T et al. Hypersensitivity reactions to metalic implants- diagnostic algorithm and suggested patch test series for clinical use. Contact Dermatitis 2011; 66:4-19
  • Cadosch D, Chan E, Gautschi O P, Filgueira L. Metal is not inert: role of metal ions released by biocorrosion in aseptic loosening – current oncepts. J Biomed Mater Res A 2009: 91: 1252–1262
  • Hallab N J, Caicedo M, Finnegan A, Jacobs J J. Th1 type lymphocyte reactivity to metals in patients with total hip arthroplasty. J Orthop Surg 2008: 3: 6.
  • Thomas P, Summer B, Sander C A, Przybilla B, Thomas M, Naumann T. Intolerance of osteosynthesis material: evidence of dichromate contact allergy with concomitant oligoclonal T-cell infiltrate and TH1-type cytokine expression in the peri-implantar tissue. Allergy 2000: 55: 969–972
  • Bircher A, Niklaus F. Friederich, Walter Seelig, Kathrin Scherer. Allergic complications from orthopaedic joint implants: the role of delayed hypersensitivity to benzoyl peroxide in bone cement. Contact Dermatitis. 2012 Jan;66(1):20-6
  • Lohmann CH, Hameister R, Singh G. Allergies in orthopaedic and trauma surgery. Orthop Traumatol Surg Res. 2017 Feb;103(1S):S75-S81.
  • Cadosch D, Gautschi O P, Chan E, Simmen H P, Filgueira L. Titanium induced production of chemokines CCL17/TARC and CCL22/MDC in humanosteoclasts and osteoblasts. J BiomedMater Res A 2010: 92: 475–483
  • Basko-Plluska J L, Thyssen J P, Schalock P C. Cutaneous and systemic hypersensitivity reactions to metallic implants – an update. Dermatitis 2011: 22: 65–79
  • Hallab N J, Jacobs J J. Biologic effects of implant debris. Bull NYU Hosp Jt Dis 2009: 67: 182–188
  • Faschingbauer M, Renner L, Boettner F. Allergy in Total Knee Replacement. Does It Exist?: Review Article. HSS J. 2017 Feb;13(1):12-19
  • Köster R, Vielıf D, Kiehn M, et al. Nickel and molybdenum contact allergies in patients with coronary in-stent restenosis. Lancet 2000; 356:1895
  • Thyssen J P, Engkilde Menn´e K, Johansen T,Hansen J D, Gislason P R. G H No association between metal allergy and cardiac in-stent restenosis in patients with dermatitis – results from a linkage study. Contact Dermatitis 2011: 64: 138–141
  • D´ery J P, Gilbert M, O’Hara G et al. Pacemaker contact sensitivity: case report and review of the literature. Pacing Clin Electrophysiol 2002: 25: 863–865
  • Paragard. Product description. Available at: http://www.paragard.com/hcp/aboutparagard/ product-description (last accessed 3 December 2010)
  • Essure. Instructions for use. Available at: http://www.essuremd.com/portals/ essuremd/PDFs/TopDownloads/L3002% 2009_09_09%20smaller.pdf (last accessed 28 January 2011)
  • Julander A, Hinds´en M, Skare L, Lid´en C. Cobalt-containing alloys and their ability to release cobalt and cause dermatitis. Contact Dermatitis 2009; 60: 165–170
  • Christensen TJ, Samant SA, Shin AY. Making Sense of Metal Allergy and Hypersensitivity to Metallic Implants in Relation to Hand Surgery. J Hand Surg Am. 2017 Sep;42(9):737-746.
  • Carlsson A, M¨oller H. Implantation of orthopaedic devices in patients with metal allergy. Acta Derm Venereol 1989: 69: 62–66.
  • Bruze M. Thoughts on implants and contact allergy. Arch Dermatol 2008: 144: 1042–1044
  • Bravo D, Wagner ER, Larson DR, Davis MP, Pagnano MW, Sierra RJ. No Increased Risk of Knee Arthroplasty Failure in Patients With Positive Skin Patch Testing for Metal Hypersensitivity: A Matched Cohort Study. J Arthroplasty. 2016; 31(8):1717-21.
  • Kurtis B. Reed, MD; Mark D. P. Davis, MD et al. Retrospective Evaluation of Patch Testing Before or After Metal Device Implantation. Arch Dermatol. 2008;144(8):999-1007
  • Natasha Atanaskova Mesinkovska, MD, PhD; Alejandra Tellez et al. The Effect of Patch Testing on Surgical Practices and Outcomes in Orthopedic Patients With Metal Implants. Arch Dermatol. 2012;148(6):687-693
  • Dejobert Y, Piette F, Thomas P. Contact dermatitis from benzoyl peroxide in dental prostheses. Contact Dermatitis 2002: 46: 177–178
  • Geier J, Lessmann H, Becker D, Thomas P. Allergologische Diagnostik bei Verdacht auf Implantatunvertr¨aglichkeit: Hinweise f ¨ ur die Praxis. Hautarzt 2008: 59: 594–597
  • Ockenfels H-M, UterW, Lessmann H, Schnuch A, Geier J. Patch testing with benzoyl peroxide: reaction profile and interpretation of positive patch test reactions. Contact Dermatitis 2009: 61: 209–216
  • Muller K E, Valentine-Thon E. Hypersensitivity to titanium: clinical and laboratory evidence. Neuro Endocrinol Lett 2006: 27: 311–313.
  • Hallab N J, Epstein R, McAllister K, Jacobs J J. In vitro reactivity to implant metals demonstrates a person-dependent association with both T-cell and B-cell activation. J BiomedMaterRes A 2010: 92: 667–682

Do metallic implants make allergies?

Year 2019, Volume: 58 Issue: 1, 92 - 102, 14.03.2019

Fatma Düşünür Günsen Aytül Zerrin Sin Semih Aydoğdu

Abstract

Sensitivity to metals is very common, especially to nickel. Implanted metals corrode when in contact with biological fluids and release iron, chromium, nickel, aluminium, molybdenum etc. metallic ions. These metal ions may cause local or systemic effects and induce hypersensitivity reactions. Cutaneous reactions over the implanted device are primarily T-cell mediated type 4 delayed-type reactions. Patch test evaluation is the gold standard for searching metal hypersensitivity. Routine pre-implant patch testing is not recommended; if the patient has a personal metal allergy history, it should be performed before operation. Currently available testing methods cannot predict which patients will develop hypersensitivity reactions following insertion of metalic implants. Metal hypersensitivity is an important problem in orthopedics, because of its potential role in formation of pseudotumors, ,chronic pain, joint effusion and also prosthetic joint failure and revision need.

Keywords

Metalic implants allergy patch test.

References

  • Zug KA, Warshaw EM, Fowler JF Jr, et al. Patch-test results of the North American Contact Dermatitis Group 2005-2006 [published correction appears in Dermatitis. 2009;20(5):300]. Dermatitis. 2009;20(3):149-160
  • Thyssen J P, Linneberg A, Menn´e T, Nielsen N H, Johansen J D. Contact allergy to allergens of the TRUE-test (panels 1 and 2) has decreased modestly in the general population. Br J Dermatol 2009: 161: 1124–1129
  • Aquino M, Mucci T. Systemic contact dermatitis and allergy to biomedical devices. Curr Allergy Asthma Rep. 2013; 13: 518-27
  • Merritt K, Rodrigo JJ. Immune response to synthetic materials: sensitization of patients receiving orthopaedic implants. Clin Orthop Relat Res. 1996;326(326): 71-79
  • Niki Y, Matsumoto H, Otani T et al. Screening for symptomatic metal sensitivity: a prospective study of 92 patients undergoing total knee arthroplasty. Biomaterials 2006: 26: 1019–1026.
  • Thyssen J P, Johansen J D, Menn´e T, Lid´en C, Bruze M,White I R. Hypersensitivity reactions from metallic implants: a future challenge that needs to be addressed. Br J Dermatol 2010: 162: 235–236
  • Roberts TT, Haines CM, Uhl RL. Allergic or Hypersensitivity Reactions to Orthopaedic Implants. J Am Acad Orthop Surg. 2017 Oct;25(10):693-702.
  • Tezer M, Kuzgun U, Hamzaoglu A, Ozturk C, Kabukcuoglu F, Sirvanci M. Intraspinal metalloma resulting in late paraparesis. Arch Orthop Trauma Surg 2005: 125: 417–421.
  • Dorr L D, Bloebaum R, Emmanual J, Meldrum R. Histologic, biochemical and ion analysis of tissue and fluids retrieved during total hip arthroplasty. Clin Orthop Relat Res 1990: 261: 82–95
  • Urban R M, Jacobs J J, Tomlinson M J, Gavrilovic J, Black J, Peoc’h M. Dissemination of wear particles to the liver, spleen, and abdominal lymph nodes of patients with hip or knee replacement. J Bone Joint Surg Am 2000: 82: 457–47
  • Halwani D O, Anderson P G, Lemons J E, Jordan WD, Anayiotos A S, Brott B C. In-vivo corrosion and local release of metallic ions from vascular stents into surrounding tissue. J Invasive Cardiol 2010: 22: 528–535
  • Schalock P, Mennѐ T et al. Hypersensitivity reactions to metalic implants- diagnostic algorithm and suggested patch test series for clinical use. Contact Dermatitis 2011; 66:4-19
  • Cadosch D, Chan E, Gautschi O P, Filgueira L. Metal is not inert: role of metal ions released by biocorrosion in aseptic loosening – current oncepts. J Biomed Mater Res A 2009: 91: 1252–1262
  • Hallab N J, Caicedo M, Finnegan A, Jacobs J J. Th1 type lymphocyte reactivity to metals in patients with total hip arthroplasty. J Orthop Surg 2008: 3: 6.
  • Thomas P, Summer B, Sander C A, Przybilla B, Thomas M, Naumann T. Intolerance of osteosynthesis material: evidence of dichromate contact allergy with concomitant oligoclonal T-cell infiltrate and TH1-type cytokine expression in the peri-implantar tissue. Allergy 2000: 55: 969–972
  • Bircher A, Niklaus F. Friederich, Walter Seelig, Kathrin Scherer. Allergic complications from orthopaedic joint implants: the role of delayed hypersensitivity to benzoyl peroxide in bone cement. Contact Dermatitis. 2012 Jan;66(1):20-6
  • Lohmann CH, Hameister R, Singh G. Allergies in orthopaedic and trauma surgery. Orthop Traumatol Surg Res. 2017 Feb;103(1S):S75-S81.
  • Cadosch D, Gautschi O P, Chan E, Simmen H P, Filgueira L. Titanium induced production of chemokines CCL17/TARC and CCL22/MDC in humanosteoclasts and osteoblasts. J BiomedMater Res A 2010: 92: 475–483
  • Basko-Plluska J L, Thyssen J P, Schalock P C. Cutaneous and systemic hypersensitivity reactions to metallic implants – an update. Dermatitis 2011: 22: 65–79
  • Hallab N J, Jacobs J J. Biologic effects of implant debris. Bull NYU Hosp Jt Dis 2009: 67: 182–188
  • Faschingbauer M, Renner L, Boettner F. Allergy in Total Knee Replacement. Does It Exist?: Review Article. HSS J. 2017 Feb;13(1):12-19
  • Köster R, Vielıf D, Kiehn M, et al. Nickel and molybdenum contact allergies in patients with coronary in-stent restenosis. Lancet 2000; 356:1895
  • Thyssen J P, Engkilde Menn´e K, Johansen T,Hansen J D, Gislason P R. G H No association between metal allergy and cardiac in-stent restenosis in patients with dermatitis – results from a linkage study. Contact Dermatitis 2011: 64: 138–141
  • D´ery J P, Gilbert M, O’Hara G et al. Pacemaker contact sensitivity: case report and review of the literature. Pacing Clin Electrophysiol 2002: 25: 863–865
  • Paragard. Product description. Available at: http://www.paragard.com/hcp/aboutparagard/ product-description (last accessed 3 December 2010)
  • Essure. Instructions for use. Available at: http://www.essuremd.com/portals/ essuremd/PDFs/TopDownloads/L3002% 2009_09_09%20smaller.pdf (last accessed 28 January 2011)
  • Julander A, Hinds´en M, Skare L, Lid´en C. Cobalt-containing alloys and their ability to release cobalt and cause dermatitis. Contact Dermatitis 2009; 60: 165–170
  • Christensen TJ, Samant SA, Shin AY. Making Sense of Metal Allergy and Hypersensitivity to Metallic Implants in Relation to Hand Surgery. J Hand Surg Am. 2017 Sep;42(9):737-746.
  • Carlsson A, M¨oller H. Implantation of orthopaedic devices in patients with metal allergy. Acta Derm Venereol 1989: 69: 62–66.
  • Bruze M. Thoughts on implants and contact allergy. Arch Dermatol 2008: 144: 1042–1044
  • Bravo D, Wagner ER, Larson DR, Davis MP, Pagnano MW, Sierra RJ. No Increased Risk of Knee Arthroplasty Failure in Patients With Positive Skin Patch Testing for Metal Hypersensitivity: A Matched Cohort Study. J Arthroplasty. 2016; 31(8):1717-21.
  • Kurtis B. Reed, MD; Mark D. P. Davis, MD et al. Retrospective Evaluation of Patch Testing Before or After Metal Device Implantation. Arch Dermatol. 2008;144(8):999-1007
  • Natasha Atanaskova Mesinkovska, MD, PhD; Alejandra Tellez et al. The Effect of Patch Testing on Surgical Practices and Outcomes in Orthopedic Patients With Metal Implants. Arch Dermatol. 2012;148(6):687-693
  • Dejobert Y, Piette F, Thomas P. Contact dermatitis from benzoyl peroxide in dental prostheses. Contact Dermatitis 2002: 46: 177–178
  • Geier J, Lessmann H, Becker D, Thomas P. Allergologische Diagnostik bei Verdacht auf Implantatunvertr¨aglichkeit: Hinweise f ¨ ur die Praxis. Hautarzt 2008: 59: 594–597
  • Ockenfels H-M, UterW, Lessmann H, Schnuch A, Geier J. Patch testing with benzoyl peroxide: reaction profile and interpretation of positive patch test reactions. Contact Dermatitis 2009: 61: 209–216
  • Muller K E, Valentine-Thon E. Hypersensitivity to titanium: clinical and laboratory evidence. Neuro Endocrinol Lett 2006: 27: 311–313.
  • Hallab N J, Epstein R, McAllister K, Jacobs J J. In vitro reactivity to implant metals demonstrates a person-dependent association with both T-cell and B-cell activation. J BiomedMaterRes A 2010: 92: 667–682
There are 38 citations in total.

Details

Primary Language Turkish
Journal Section Reviews
Authors

Fatma Düşünür Günsen 0000-0001-8107-1561

Aytül Zerrin Sin 0000-0002-9199-1991

Semih Aydoğdu 0000-0002-2149-3225

Publication Date March 14, 2019
Submission Date February 7, 2018
Published in Issue Year 2019Volume: 58 Issue: 1

Cite

Vancouver Düşünür Günsen F, Sin AZ, Aydoğdu S. Metalik implantlar alerji yapar mı?. EJM. 2019;58(1):92-102.
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