Allergy in total knee arthroplasty: a review of the facts. Implantation of cross-linked polyethylene bearing surface led to symptom resolution in 3 mo. However, several studies have reported cases of metal allergy caused by titanium-containing materials. When you visit the site, Dotdash Meredith and its partners may store or retrieve information on your browser, mostly in the form of cookies. On the other hand, another rare case of a female patient was also the topic of one case report. Food and Drug Administration. HHS Vulnerability Disclosure, Help But sometimes issues do arise. This patient is concurrently found to have a retained pigtail catheter in the cecum discovered incidentally through radiology. But sometimes a child can have what's known as anaphylaxis . It may be necessary to remove the spinal hardware to avoid any further complications. This website also contains material copyrighted by 3rd parties. Allergic contact dermatitis caused by titanium screws and dental Total knee arthroplasty (TKA) is generally a very successful surgery, and the vast majority of people who undergo it are satisfied with the results. The patient has been recommended to do a close follow-up for a few months to monitor her progress. Shortness of breath. FOIA 2000 Jul;43(1):35-40 Lachiewicz PF, Watters TS, Jacobs JJ. 2001 Apr 14;357(9263):1205-6; author reply 1206-7 However, these medical devices have been associated with certain injuries and complications lately. A more severe hypersensitivity reaction is usually due to prolonged exposure to a metal allergen, which is possible through metal implants used in surgeries or metal ions that are ingested or inhaled. Dermatitis. Between 10% and 15% of the general population is sensitive or allergic to nickel. Because this can involve another surgery that may be quite complicated, it should not be done without a thorough review of the pros and cons. Disclaimer. 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. Our website is not intended to be a substitute for professional medical advice, diagnosis, or treatment. This causes type IV hypersensitivity reaction through sensitization of T lymphocytes and macrophages. Patient satisfaction after total knee replacement: a systematic review. problems with wound healing. 2022 Nov 28;13:1050315. doi: 10.3389/fimmu.2022.1050315. Middle Back Pain Oftentimes Tied To Heavy Electronics Use, What to Do if Your Back Hurts When Bending Over, Preventing Back Pain When Training For A Triathlon, Titanium & metal alloys (the most common). Before Food allergies: You may feel tingling in your mouth . Juliana L. Basko-Plluska; Jacob P. Thyssen; Peter C. Schalock. Severe skin rashes. A decision was made to remove all the metal surgical clips laparoscopically via fluoroscopic guidance (Figure 1). P. H. Wu, J. H. Chen, and K. E. Chu, Successful endoscopic management of double iatrogenic perforations induced by endoscopic retrograde cholangiopancreatography and computed tomography-guided colon drainage, Case Reports in Gastroenterology, vol. The management of any metal allergy including titanium involves removing specific offending agents and avoiding potential triggers to hypersensitivity reactions. When they do occur, titanium allergy symptoms can range from mild to severe and can include: loosening of the implants (or implant failure) rash or hives. 2019;10(2):63-70. doi:10.5312/wjo.v10.i2.63, Kahlenberg CA, Nwachukwu BU, McLawhorn AS, Cross MB, Cornell CN, Padgett DE. She reported a complete resolution of all symptoms one-month postsurgery. 1, pp. MeSH It can be challenging to diagnose and discover RFB due to the different manifestations of each case and nonspecific symptoms. Staples are used to hold skin together in order to clsoe a surgical incision or wound that is too big or complex to close with traditional sutures or stitches. National Library of Medicine We obtained written informed consent from the patient for the publication of this case report and accompanying images. 35, no. Can You Have an Allergic Reaction to Surgical Staples? The authors declare that they have no competing interests. The patients social history is insignificant, with no smoking or alcohol consumption. We describe a 69-year-old male for whom significant pathologic findings around dental implants had never been observed. = reference; THA = total hip arthroplasty; THR = total hip replacement. Sneezing. Home / Surgical Stapler Lawsuit / Can You Have an Allergic Reaction to Surgical Staples? Allergic reactions can range from mild to severe. The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). It helps to understand what happens when your body comes in contact with a metal to which you're allergic. 1, pp. Prosthetic joints containing metals nickel, chromium, and cobalt are most likely to cause a reaction. Symptoms reported have included: Having a skin sensitivity to a particular metal is not thought to correlate well to having sensitivities to implanted metals. The CT impressions showed no signs of bowel obstruction or colitis; however, it was evident that a portion of a pigtail drainage catheter was lodged within the cecum (Figure 2). Out of these, the cookies that are categorized as necessary are stored on your browser as they are essential for the working of basic functionalities of the website. All of which have resulted in complications that may either occur during the surgical procedure, or may only show up days after the surgery. Eleven months prior, the patient underwent cholecystectomy, or surgery to remove the gallbladder, where six titanium surgical clips were used. The Opioid Epidemic. The titanium screws used in the orthopedic surgery that he underwent were removed 1 year later, but the eczema remained. Verywell Health's content is for informational and educational purposes only. Contact Dermatitis. 2016;24(2):106112. doi:10.5435/JAAOS-D-14-00290, Saccomanno MF, Sircana G, Masci G, et al. 15, 2020. T. Okamura, M. Morimoto, D. Fukushima, and G. Yamane, A skin patch test for the diagnosis of titanium allergy, Journal of Dental Research, vol. Metal Allergy to Surgical Plates, Screws, and Implants. Complications of Biodegradable Materials: Anchors and Interference Screws Nickel is one of the most common allergens, and can cause local contact dermatitis characterized by itching and skin reddening. Titanium is used not only for medical applications such as plastic surgery and/or dental implants, but also for paints, white pigments, photocatalysts, and various types of everyday goods. Usually retained foreign bodies are found after complaints such as pain, infections and a palpable mass. Staged revision resulted in pain relief, but nerve palsy did not recover. A case by Little et al. Allergic contact dermatitis caused by titanium screws and dental Keywords: 2007 Jan;42(1):93-7. doi: 10.1016/j.jpedsurg.2006.09.056. Cobalt and chromium may be found not only in the appliance but also in bone cements used to set the prosthetic. Your email address will not be published. M. Tu and Y. Wu, Multiple allergies to metal alloys, Dermatologica Sinica, vol. FOIA Disclaimer. All of her symptoms were initially suspected due to the infections mentioned above, and she was placed on various antibiotic therapy regimens consisting of ciprofloxacin, amoxicillin/clavulanate potassium, and sulfamethoxazole/trimethoprim. Highest odds ratio for restenosis (5.41) were in nickel positives. The catheter was removed surgically which resolved the patients RLQ abdominal pain and accompanying symptoms. Infrequent complications have been discussed in studies regarding pigtail catheter found on computerized tomography (CT) scan following a procedure. National Library of Medicine It may be necessary to remove the spinal hardware to avoid any further complications. The patient recovered well with no significant intraoperative or postoperative complications. After all, surgical staplers, along with staples, have been heavily marketed as time savers and are said to be more convenient compared to stitches when it comes to wound closure. An interleukin-1 polymorphism additionally intensified by atopy as prognostic factor for aseptic non-mechanical complications in metal knee and hip arthroplasty. Despite repeated attempts by researchers and clinicians to further understand this difficult area of medicine, the association between metal sensitivity and cutaneous allergic reactions remains to be fully understood. fibromyalgia (widespread pain without known cause). Patients can present with atopic dermatitis, pruritus, edema, urticaria, impaired healing fractures, pain, and necrosis of implants [ 3 ]. Department of Medicine, Section of Dermatology, The University of Chicago, Chicago, IL; the National Allergy Research Centre, Department of Dermato-Allergology, Gentofte Hospital, University of Copenhagen, Denmark; and the Department of Dermatology, Massachusetts General Hospital, Harvard Medical School, Boston, MA. That said, in the discussion of metal implants in the body, these words are often used in the same discussion. AAAAI 2009: Half of Physicians Fail to Prescribe EpiPen for Patients With History of Anaphylaxis, Contact Allergens Lurk in Diabetes Devices, New Guidance on Alpha-Gal Syndromes GI Implications: What to Know. 12, no. -, Lancet. The use of these implants is considered experimental and should be done with extreme caution. G. Forte, F. Petrucci, and B. Bocca, Metal allergens of growing significance: epidemiology, immunotoxicology, strategies for testing and prevention, Inflammation & Allergy Drug Targets, vol. Health care providers have been known to rely more on staples in performing surgeries. 1. This site needs JavaScript to work properly. 2023 Feb 2;11:1140393. doi: 10.3389/fbioe.2023.1140393. Any metal that comes into contact with body tissues will corrode to some degree. 2, pp. There is no data to support the routine use of ceramic (zirconium) or titanium implants, even in people with concerns about metal hypersensitivity. ", < 1% develop cutaneous reactions versus 2025% of patients who develop implant-induced metal sensitivity without any allergic skin manifestations. In the past, it was believed that people who experienced an allergic reaction to substances containing iodine were allergic to the nutrient. Jonathan Cluett, MD, is a board-certified orthopedic surgeon with subspecialty training in sports medicine and arthroscopic surgery. These cookies do not store any personal information. Itchy eyes, nose or roof of mouth. 155162, 1999. Most skin reactions are eczematous and allergic in nature, although urticarial, bullous, and vasculitic eruptions may occur. Epub 2016 Mar 29. 2016 Sep;31(9):1910-5. She was tested for Clostridium difficile infection and showed positive toxin B results confirming the diagnosis. Eleven months prior, the patient had undergone cholecystectomy due to acute cholecystitis complicated by a liver abscess.
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