Fatma Düşünür GÜNSEN, Aytül Zerrin SİN, Semih AYDOĞDU

Metalik implantlar alerji yapar mı?

Metal hipersensitivitesi, özellikle nikel duyarlılığı, toplumda sık görülen bir tablodur. İmplante metaller biyolojik sıvılarla temas ettiğinde aşınır ve demir, krom, nikel, alüminyum ve molibden gibi metalik iyonlar salınır. Bu metal iyonları lokal veya sistemik etkilerle hipersensitivite reaksiyonlarına neden olabilir. İmplante materyale karşı gelişen cilt lezyonları primer olarak T hücre aracılı tip 4 gecikmiş tip hipersensitivite reaksiyonudur. Yama testi metal duyarlılığını göstermede altın standarttır. Rutin olarak operasyon öncesi yama testi önerilmemekte olup, hastanın öyküsünde kişisel metal duyarlılığı öyküsü var ise yapılmalıdır. Hastaların preoperatif değerlendirmesi sırasında kimin hipersensitivite reaksiyonu geliştireceğini önceden belirleyen bir test yöntemi yoktur. Metal hipersensitivitesi; psödotümör formasyonu, kronik ağrı, eklem efüzyonu ve hatta protez başarısızlığı ve değiştirilmesine neden olabileceğinden ortopedide önemli bir sorundur.

Do metallic implants make allergies?

Sensitivity to metals is very common, especially to nickel. Implanted metals corrode when in contact with biological fluids and release iron, chromium, nickel, aluminium, molybdenum etc. metallic ions. These metal ions may cause local or systemic effects and induce hypersensitivity reactions. Cutaneous reactions over the implanted device are primarily T-cell mediated type 4 delayed-type reactions. Patch test evaluation is the gold standard for searching metal hypersensitivity. Routine pre-implant patch testing is not recommended; if the patient has a personal metal allergy history, it should be performed before operation. Currently available testing methods cannot predict which patients will develop hypersensitivity reactions following insertion of metalic implants. Metal hypersensitivity is an important problem in orthopedics, because of its potential role in formation of pseudotumors, ,chronic pain, joint effusion and also prosthetic joint failure and revision need.

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