Allergies to Implants Allergic reactions to implanted plates or stents are increasing in prevalence. Orthopedic or neurosurgical implants for stabilizing bones are occasionally rejected by cell mediated immunologic reactions. Recently lymphocytic reactions to implanted cardiac arterial stents have been reported. These can be difficult to confirm as the stents are also designed to elude drugs.

We have long known about atypical reactions to breast implants. Toxicity to contents of certain breast implants have been largely dismissed These reactions are indeed immune mediated; however, they are not IgE mediated. They are analogous to contact sensitivities (like reactions to cheap jewelry). Nickel sensitivities have largely been implicated. Non reacting metals such as titanium are preferred. The testing for such issues is performed by adhering the substance in question to the patient’s skin.

Nickel and other metal ions are small, but are thought to act as haptens by reacting to other proteins in the skin. The easiest thing to do would be to obtain a piece of the material, and perform a patch test by taping the metal to her back for two days. Then, remove the metal and monitor the skin for any delayed reactions (1, 3, 5, and 7 days out from removal for example). Dormer Labs and True Test provide patch testing kits that even include titanium.