Orthopedic Implant Hypersensitivity Reactions

Innes, Matthew; Atwater, Amber Reck

doi:10.1016/j.det.2020.02.005

Cited by 12 publications

(5 citation statements)

References 52 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…However, unlike traditional allergic contact dermatitis, the sensitization phase of OIH occurs in different microenvironments other than the skin. The release of metal ions and wear particles into the soft tissue or joint space may activate both innate and acquired immune responses [ 5 ]. This may also explain the reasons for delayed onset (>3 years) of OIH while the metal implant gradually wears over time with subsequent and persistent releasing metal ions.…”

Section: Discussionmentioning

confidence: 99%

Orthopedic implant hypersensitivity: Characterization of clinical presentation and effects of photobiomodulation therapy

Chang

Wu²

2023

Tzu Chi Medical Journal

View full text Add to dashboard Cite

A BSTRACT Objectives: Orthopedic implants have improved the quality of life in aging society but also induces several kinds of tissue reactions, referred to as orthopedic implant hypersensitivity (OIH). The aim of our study is to report the clinical characteristics of OIH and the effects of photobiomodulation therapy (PBMT) on these groups of patients. Materials and Methods: We collected cases that complained of skin rashes with pruritus after orthopedic implants from January 2017 to June 2022 at the Dermatology clinic in Hualien Tzu Chi Hospital. We recorded the sites and material of orthopedic implants, skin lesions onset time, symptoms, location after implantation, and the disease duration. Laboratory tests were measured, including complete blood count, differential count, serum immunoglobulin E (IgE) level, as well as inflammatory and autoimmune markers. PBMT, including UVB311 nm or low-level laser therapy 808 nm, was performed. Dose, duration, and response were documented. Results: Fourteen patients were diagnosed with OIH; twelve presented with localized eczema at the implant sites, and two with generalized eczema. Eleven patients (78.6%) had either elevated eosinophils percentage (>6%) or IgE level (>200 U/mL) or both. Seven patients (50%) had favorable outcome after PBMT and successfully withdrew from systemic steroid. Conclusion: In our case series, localized eczema at implant sites was a common cutaneous presentation in OIH. Hence, a surgical scar at the eczema site or long-term waxing and waning generalized eczema should prompt physicians on the possibility of OIH. Blood eosinophils percentage and serum IgE level can be reference biomarkers for OIH. PBMT provides a noninvasive and effective treatment strategy for immune regulation and tissue regeneration.

show abstract

Section: Discussionmentioning

confidence: 99%

Orthopedic implant hypersensitivity: Characterization of clinical presentation and effects of photobiomodulation therapy

Chang

Wu²

2023

Tzu Chi Medical Journal

View full text Add to dashboard Cite

show abstract

“…Immunologically, implant allergy results from autoimmunity/inflammatory reactions and type 4 delayed hypersensitivity reactions [15][16][17]. The triggering of these autoimmune reactions, hypersensitivity, or inflammatory reactions are attributed to metal-bound proteins recognized by the immune system or by free…”

Section: Discussionmentioning

confidence: 99%

“…radical formations produced by metal binding to sulfur in mitochondria, enzymes, and cell proteins [15][16][17].…”

Section: Discussionmentioning

confidence: 99%

Cervical Implant Allergy With Chronic Neck Pain: A Case Report

Aoyama¹,

Anazawa²,

Hotta³

et al. 2022

Cureus

View full text Add to dashboard Cite

A 57-year-old woman underwent cervical implant surgery for a dislocated cervical spine fracture, and she complained of continuous intractable neck pain after surgery. Eight years later, she developed a plantar skin rash, subsequently diagnosed as a metal allergy, and metal dentures were replaced with ceramic ones. The skin rash, however, persisted for four more years after that and was eventually treated with cervical implant removal. Subsequently, her skin rash and her neck pain improved simultaneously. This synchronous improvement strongly suggested that the neck pain could have been caused by a cervical implant allergy. We discuss a case of posterior cervical implant allergy that presented with neck pain and plantar skin rash years after surgery.

show abstract

“…Total joint arthroplasty (TJA) is mainly used to treat end-stage joint diseases. The surgery involves removing part or all of the damaged joint and fitting hardware—orthopaedic prostheses made of metal, plastic, ceramic or a combination of these materials ( Innes and Atwater, 2020 ) to allow movement without pain or restriction and it can relieve joint pain, correct joint deformity, restore joint function and enhance the quality of life. Because of these advantages, TJA is widely used around the world.…”

Section: Introductionmentioning

confidence: 99%

Recent advances in prevention, detection and treatment in prosthetic joint infections of bioactive materials

Xie

Liu

et al. 2022

Front. Bioeng. Biotechnol.

View full text Add to dashboard Cite

Prosthetic joint infection (PJI) is often considered as one of the most common but catastrophic complications after artificial joint replacement, which can lead to surgical failure, revision, amputation and even death. It has become a worldwide problem and brings great challenges to public health systems. A small amount of microbe attaches to the graft and forms a biofilm on its surface, which lead to the PJI. The current standard methods of treating PJI have limitations, but according to recent reports, bioactive materials have potential research value as a bioactive substance that can have a wide range of applications in the field of PJI. These include the addition of bioactive materials to bone cement, the use of antibacterial and anti-fouling materials for prosthetic coatings, the use of active materials such as bioactive glasses, protamine, hydrogels for prophylaxis and detection with PH sensors and fluorescent-labelled nanoparticles, and the use of antibiotic hydrogels and targeting delivery vehicles for therapeutic purposes. This review focus on prevention, detection and treatment in joint infections with bioactive materials and provide thoughts and ideas for their future applications.

show abstract

Orthopedic Implant Hypersensitivity Reactions

Cited by 12 publications

References 52 publications

Orthopedic implant hypersensitivity: Characterization of clinical presentation and effects of photobiomodulation therapy

Orthopedic implant hypersensitivity: Characterization of clinical presentation and effects of photobiomodulation therapy

Cervical Implant Allergy With Chronic Neck Pain: A Case Report

Recent advances in prevention, detection and treatment in prosthetic joint infections of bioactive materials

Contact Info

Product

Resources

About