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Need TKR and had positive allergy testing / Bone Cement and Metals
Joint Replacements | Last Active: Jun 7, 2023 | Replies (157)Comment receiving replies
Hello @okieshan1. This must be a frustrating choice facing you. I did some research because I was curious myself and was able to find an article from the NIH website that you may find interesting, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4726476/. In particular, there are a few passages from the abstract of this study that you may find relevant:
"Given the limitations of current testing methods, the widespread screening of patients for metal allergies before TKA is not warranted."
"Anecdotal reports suggest that, if metal hypersensitivity is suspected and nonsurgical measures have failed, then revision to components fabricated of titanium alloy or zirconium coating can be successful in relieving symptoms. Revision should be considered as a last resort, however, and patients should be informed that no evidence-based medicine is available to guide the management of these conditions, particularly for decisions regarding revision."
@okieshan1, I see that the above mentioned alternatives also showed mildly reactive in your test results, but it does suggest that there are alternative metals and coatings out there for replacements. If you don't mind sharing, did your surgeon discuss with you any other options for knees? I would have to imagine that they have more access to resources regarding devices.
Replies to "Hello @okieshan1. This must be a frustrating choice facing you. I did some research because I..."
thank you for posting, very informative!!!!
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@JustinMcClanahan to answer your question, original surgeon did suggest a coated knee to ensure no metal allergy issues. But then when he saw my bone cement allergy scores as 'Reactive' he referred me to surgeon who did cement-less knee. That 2nd surgeon sent me for an MRI for a custom built 'Biomet Vanguard Knee Replacement' which is cement-less. But then he did say there were metals in it, so suggested I hold off until I was too miserable before going for it, because he said if you do have allergy, there will be nothing I can do after the fact.
I asked does anyone make a 'coated cement-less knee' and he was not aware of one. I also asked someone in the medical supply field and they didn't have any info of that either. Do you think that is even an option? I joke and say I guess I'll have to wait until they come up with a ceramic joint.
Given your findings above, do you think my mild reaction to metal would warrant not even worrying about it?