| Abstrakt: |
Purpose of Review: Metal implants play a significant role in modern medicine. This review summarizes the current literature regarding metal implant hypersensitivity reactions and their workup and management. Recent Findings: Hypersensitivity reactions have been reported to various metal implants, including orthopedic, cardiovascular, dental, gynecologic, neurologic, and oculoplastic devices, and the Nuss procedure. We have consolidated recent expert consensus recommendations to create a proposed management algorithm. Although there is a paucity of data, expert consensus suggests that pre-implant patch testing (PT) may be considered in patients with a history of suspected metal allergy, and all patients prior to the Nuss procedure. Post-implant PT should be considered after all other plausible diagnoses have been ruled out. Summary: There is limited evidence establishing causality between metal allergy and implant-related complications; although PT results may be helpful in guiding discussion and counseling, PT cannot reliably predict any specific outcome. A thorough risk-benefit analysis should be undertaken prior to making any management decisions. There is a need for further prospective controlled studies. |
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