Allergic Sensitization to Nickel and Implanted Metal Devices: A Perspective.

Area of Science:

• Medical device safety
• Allergology
• Biomaterials science

Background:

• Growing interest in the link between metal allergens, implants, and adverse reactions.
• Focus on nickel sensitization from implanted devices.
• Difficulty distinguishing nickel from other metal allergens in devices.

Purpose of the Study:

• To review if nickel from implants causes new sensitization.
• To determine if nickel sensitization causes adverse health effects.
• To assess the need for pre-operative metal allergy testing.

Main Methods:

• Literature review of studies on metal implants and sensitization.
• Analysis of various devices: hip implants, stents, filters, Essure.
• Consideration of pre-existing and newly acquired sensitization.

Main Results:

• Nickel sensitization from implants is possible but uncommon.
• Metal sensitization rarely causes adverse implant reactions.
• Pre-operative testing for nickel allergy is generally not required.

Conclusions:

• Acquisition of nickel sensitization from implants is infrequent.
• Metal allergy is seldom the cause of implant-related adverse events.
• Routine preoperative patch testing for nickel allergy is unnecessary without a relevant clinical history.