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Titanium Allergy: A Retrospective Review of 166 Patch Tested Patients.
Camila N Fontane Hoyos1,2, Antonia F Chen1,3, Ari M Goldminz1,2
1From the Brigham and Women's Hospital, Boston, Massachusetts, USA.
Dermatitis : Contact, Atopic, Occupational, Drug
|January 8, 2024
Summary
Metal allergy from implants can cause issues. Titanium allergy is often overlooked, but this study found a 15.7% positive patch test rate in patients evaluated for titanium allergy, especially after implantation.
Area of Science:
- Biomaterials Science
- Allergy and Immunology
- Orthopedic Surgery
Background:
- Hypersensitivity reactions to metals in orthopedic implants can cause significant morbidity.
- Titanium implants are frequently used as alternatives for metal-allergic patients, yet titanium allergy is understudied.
- Allergic reactions to titanium in implants may be overlooked in clinical practice.
Purpose of the Study:
- To evaluate titanium allergy and characterize titanium patch testing experiences at a single institution.
- To assess the prevalence and relevance of titanium allergy in patients undergoing pre- and post-implant evaluations.
Main Methods:
- Retrospective review of 166 patients evaluated for titanium contact allergy between January 2018 and August 2023.
- Analysis of patch test results, categorizing patients into pre-implant, post-implant, and unrelated testing groups.
- Statistical comparison of positive titanium patch test (PTP) rates between pre- and post-implant cohorts.
Main Results:
- Overall, 15.7% (26/166) of patients tested positive for titanium allergy.
- The positive titanium patch test rate was significantly higher in the post-implant group (28.1%) compared to the pre-implant group (6.0%) (p=0.002).
- Of the 18 positive titanium patch tests in the post-implant group, 8 were deemed likely relevant and 8 possibly relevant to implant-related symptoms.
Conclusions:
- Titanium allergy is a relevant clinical concern, particularly in patients with post-implant symptoms.
- Higher rates of positive titanium patch tests in the post-implant group suggest a potential role in implant-related issues.
- Further research is needed to determine the incidence of titanium allergy and monitor sensitization trends.
