Metal Hypersensitivity and Contact Dermatitis in Orthopedic Hardware and Biocompatible Implants

¹Touro College of Osteopathic Medicine, Middletown, NY, USA

²Valley Consortium for Medical Education, Modesto, CA, USA

³Edward Via College of Osteopathic Medicine, Blacksburg, VA, USA

⁴Touro College of Osteopathic Medicine, Middletown, NY, USA

⁵University of North Texas Health Science Center Fort Worth - Texas College of Osteopathic Medicine, USA

⁶Touro College of Osteopathic Medicine, CA, USA

⁷A.T. Still University School of Osteopathic Medicine in Arizona, Mesa, AZ, USA

⁸Department of Dermatology, Northwell Health, New Hyde Park, NY, USA

*Corresponding author: Kelly Frasier, DO, MS, Department of Dermatology, Northwell Health, New Hyde Park, NY, USA, Phone: 3105956882, Email: [email protected]

Received Date: April 12, 2025

Publication Date: April 29, 2025

Citation: Cevetello A, et al. (2025). Metal Hypersensitivity and Contact Dermatitis in Orthopedic Hardware and Biocompatible Implants. Dermis. 5(3):37.

Copyright: Cevetello A, et al. © (2025).

ABSTRACT

Metal hypersensitivity is a type IV hypersensitivity reaction, which can affect hardware used in orthopedic procedures, such as total joint arthroplasty and fracture fixation using open reduction and internal fixation (ORIF). Metal hypersensitivity reactions are typically seen in orthopedic hardware containing nickel, titanium, cobalt, or chromium, as these metals have often been associated with allergies. Metal hypersensitivity reactions may present as dermatitis on the skin or as edema, which can hinder a patient’s range of motion, typically localized to the affected area or joint. Often, individuals with periprosthetic joint infections or other orthopedic-related infections can present with similar dermatologic symptoms to metal hypersensitivity. Therefore, diagnosis of metal hypersensitivity is one of exclusion and has a rare reported occurrence. Treatment options for metal hypersensitivity from orthopedic hardware depends on the symptoms, types of hardware utilized (e.g. hardware utilized in fracture fixation that can be removed once the fracture heals) ranging from topical treatments for dermatitis, steroids for inflammation, and hardware removal or arthroplasty revisions. This literature review aims to further investigate reported metal hypersensitivity reactions from orthopedic hardware following total joint arthroplasty and ORIF procedures.

Keywords: Metal Hypersensitivity, Dermatitis, Orthopedic Hardware, Implants, Total Joint Arthroplasty