@upstatephil The titanium in surgical hardware is an alloy or mixture of titanium and other metals. It is possible that any of the metals used can be a culprit in an immune response.

You might find more information at https://www.orthopedicanalysis.com/ . They test for reactions to materials in implants. When I did a blood test with them, it was not covered by insurance.

Another source of information is the Environmental Health Center Dallas. https://www.ehcd.com/

They test for and treat many environmental immune issues including implant sensitivities and the type of testing they do is how they mix an antigen mixture for allergy shots which is specific to the individual patient. This is the practice that started this field of medicine although the pioneering doctor passed a few years ago. You can also search for other practitioners in this field at https://www.aaemonline.org/

I learned all of this from my doctor who was certified in Environmental Medicine. I had allergy testing and precise mixtures for allergy shots for things I am allergic to.

There is a member on Connect who traveled to the Texas location (moved out of Dallas to a suburb) for testing and treatment. You can find the discussion here.

Joint Replacements - "Is there a hospital or Dr in US who understand metal allergies in TKR?"
https://connect.mayoclinic.org/discussion/is-there-a-hospital-or-dr-in-us-who-understand-metal-allergies-in-tkr/
Jennifer