Hypersensitivity Reactions to Implantable Devices

Overview:

Metals are a key component of many implantable medical devices. Metal or its alloys can be found in coronary stents, dental fillings, surgical clips, orthopedic, spinal, and gynecological devices to name a few. When metallic biomedical devices are implanted into the body, the metal undergoes corrosion.

This process releases particles and ions into the body that can trigger an immune response known as metal hypersensitivity – a type IV immunological response. This can lead to complications such as slow wound healing, neuropsychiatric problems, and device failure. Reaction to nickel was first reported in 1966 but since this time, the use of metal in implantable devices has increased, with an associated rise in reactions to other metals.

To date, hypersensitivity reactions to chromium, copper, cobalt, iron, magnesium, manganese, molybdenum, nickel, zinc, gold, and titanium have been reported. Gaps in the evidence about the normal behaviour of metal in the body, appropriate diagnostic approaches and treatment options contribute to the difficulties patients encounter when they experience this issue.

In our study on the lived experiences of metal hypersensitivity, participants encountered many healthcare providers, but they were not aware of metal hypersensitivity.

Physiotherapists were among the healthcare workers participants encountered along their journey. Thus, the aim of this educational session is to present the evidence on metal hypersensitivity to physiotherapists so that they can be better prepared to identify and support patients with this condition.

Learning Objectives:

Upon completion of this online course, participants will:

1. Gain an understanding of hypersensitivity to metals in implantable devices
2. Recognize symptoms of metal hypersensitivity
3. Identify areas of opportunities to enhance the detection of metal hypersensitivity

Speaker:

Dzifa Dordunoo, PhD, RN

Dzifa Dordunoo PhD, RN, a native of Dzodze, Ghana, is assistant professor at the University of Victoria, school of nursing. As a clinician, Dzifa has over 20 years of varied clinical practice experience working in general medicine and coronary care units as well as outpatient clinics (Heart failure and Sickle Cell).

As a scholar and researcher, Dzifa worked on several investigator-initiated studies and phase III/IV FDA clinical trials with implantable devices. Her interest in the metal hypersensitivity grew after she was involved in a clinical case of a patient with extensive allergy who experienced stent restenosis. She has completed several projects that has demonstrated lack of awareness among healthcare workers about hypersensitivity reactions and that hypersensitivity reaction is not routinely discussed pre-operatively.

Dr Dordunoo earned her bachelor's degree (with distinction) from University of Victoria(Canada) and holds a master’s degree from Duke University (USA) with post-master's certificate in clinical research management and teaching. She completed her doctoral education at the University of Maryland Baltimore (USA). She is currently the president of the Coalition of African, Caribbean and Black Nurses in British Columbia.