Acta Chir Orthop Traumatol Cech. 2023; 90(2):85-91 | DOI: 10.55095/achot2023/012

Type IV Titanium Hypersensitivity: Rare, or Rarely Detected?Current concepts review

J. VOVES1,2,*, O. MĚRKA1,2, K. ČABANOVÁ3,4, J. JANO©EK5, G. BAJOR6
1 University of Ostrava, Faculty of Medicine, Institute of Emergency Medicine, Ostrava, Czech Republic
2 University Hospital Ostrava, Department of Trauma Surgery, Ostrava, Czech Republic
3 V©B-Technical University of Ostrava, Centre of Advanced Innovation Technologies, Ostrava, Czech Republic
4 V©B-Technical University of Ostrava, Faculty of Mining and Geology, Ostrava, Czech Republic
5 University of Ostrava, Faculty of Medicine, Ostrava, Czech Republic
6 Institute of Anatomy, University of Silesia in Katowice, Poland

The presented review aims to summarize the current knowledge of hypersensitivity to titanium - a material widely used in medical applications thanks to its exceptional chemical stability, resistance to corrosion, low specific weight and high strength. The hypersensitivity to metals is usually caused by the Type IV immunopathological reaction. Case reports on allergic reactions to titanium are rare but the actual occurrence can be expected to be much higher, especially due to its problematic detection. Although cutaneous patch tests are widely accepted and used for the diagnosis of hypersensitivity of numerous metals (e.g. Ni), it is notoriously unreliable in case of allergies to titanium, which may be associated with the low percutaneous transport of titanium and its salts. The Lymphocyte Transformation Test has superior sensitivity but it remains mostly unknown among clinicians and there are not many laboratories capable of performing it. This review presents numerous case reports indicating, in combination with the above-mentioned facts, that hypersensitivity to titanium should be considered as a possible cause also in non-specific problems associated with titanium implant failure.

Keywords: titanium, allergy, patch test, lymphocyte transformation test

Published: April 1, 2023  Show citation

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VOVES J, MĚRKA O, ČABANOVÁ K, JANO©EK J, BAJOR G. Type IV Titanium Hypersensitivity: Rare, or Rarely Detected? Acta Chir Orthop Traumatol Cech. 2023;90(2):85-91. doi: 10.55095/achot2023/012. PubMed PMID: 37155996.
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