@steveinarizona
Thank you for that excellent summary of your research in answer to @mab1226 .
I had a TKR 4 months ago and have been wondering, albeit belatedly, about metal allergies. For such a serious procedure, one would think they might test for metal sensitivities before surgery, as many folks who don’t wear much jewelry wouldn’t necessarily know if they had a history of reaction.

Revision surgery is a pretty high price to pay for something that could be tested for in advance. After wondering if the governing boards for surgical specialties keep any sort of data on revisions necessitated by metal allergies, I looked it up. Preliminary browser search indicates “Metal allergy accounts for less than 1% of in total knee arthroplasty (TKA) revisions.”

Unfortunately, “there is no single definitive test for implant-related metal allergy.” Many symptoms of a reaction to metals are also caused by other variables. Many times the ONLY way they knew for sure that a patient had a specific metal allergy, is when the person’s symptoms completely disappeared after revision. This difficulty in diagnosing metal allergies is not especially encouraging.

Recalling years-ago instances of inflamed ear lobes after wearing inexpensive earrings, and wondering if metal allergy or some other variable played a part, I’m kind of kicking myself (with my new knee 😂) for not asking my surgeon in advance what type of replacements he uses. I still have quite a bit of swelling, warmth and poor flexion, but my surgeon said it’s not surprising in my particular case, as he had to remove way more tissue than in the usual TKR - several damaged ligaments and tissue necrosis from an old injury. A longer healing curve. Well, time will tell.

Anecdotally, while in an emergency room last year accompanying an ill friend, the man on the next stretcher had come in with extreme pain radiating from his hip replacement, in addition to pain throughout his body. He had been having big problems since immediately after his surgery. The man was scheduled for a revision in just 2 weeks, but his pain had become so unbearable he was seriously worried about internal bleeding. Once he was triaged & got a pain med, he felt talkative and I asked him about what symptoms he’d had after the surgery. They ran the gamut, and I was privately thinking “surgeon error,” or perhaps, gross error or negligence by any member of the surgical team. When I asked him if anyone had mentioned metal allergies as a possible factor in his pain and inflammation issues, he said no, it was never brought up. Maybe there are more people out there with metal sensitivities than they know about, but they’re not testing for it. I’m not suggesting this man had metal allergies; I was just surprised his doctor didn’t ask about it.

Thanks for your considerate browser search, it was truly appreciated.