Need TKR and had positive allergy testing / Bone Cement and Metals

Posted by okieshan1 @okieshan1, Sep 13, 2018

Does anyone have any suggestions on any medical replacement joints on the market my orthopedic surgeon might not know about? I was scheduled for total knee replacement and my surgeon MADE me take a blood allergy test from Orthopedic Analysis.. Test showed "reactive" to Bone Cement monomer so surgeon referred me to a colleague who could do a cement-less knee. Upon his review of my results however, he also stated I was "mildly-reactive" to Chromium, Molybdenum, Nickel, Vanadium, Zirconium and Iron. (Screenshot of levels attached). I'm also 'mildly reactive' to Cobalt Alloy and Titanium Alloy Particles.

My surgeon said, "I recommend you exhaust all other options, because I can do the cement-less knee, but if the metal allergy bothers you, there will be nothing I can do." Very hard to hear as I'm only 55 and active. In the meantime, I've gotten Genicular nerve burn in both knees which helped reduce pain level from 7 to a 4, but I'm trying to find out if there are any other surgical implant options that might work for someone with Bone cement and certain Metal allergies? Also, wondering will this even affect me as I can wear any type of cheap costume jewelry without ever having a reaction? If I have no issue with metal touching my skin, will it bother me if I have it in my joint for TKR?

Thanks in advance for ANY advice!

Interested in more discussions like this? Go to the Joint Replacements Support Group.

I think anyone with ANY allergies should be fully tested for metals and bone cement, as I have been through a nightmare because no one thought to test me and I had no idea I should be tested. I have recent onset in 2013 of food allergies to nightshades, gluten, coffee, my surgeon was aware, but didn't mention testing and I didn't think about it at the time. Now the hardware is loose per XRays, constant swelling, pain 1 1/2 yrs post op. It all has to come out. It is an autoimmune disease and I hope anyone with a hint of an allergy gets tested first. It should be a mainstream discussion with all the allergic reactions we are experiencing in our world. It is not rare to have allergies anymore. I am hoping to get the revision, but there is a limit per the FDA on how many a surgeon can do per year because the surgery is a financial loss for the hospital- I was told this by my surgeon. I am in the Denver area. National Jewish Hospital is were I had the 40 patch testing done. My best to anyone out there going through this. I hope this helps.

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<p>I have a known titanium allergy, doctor diagnosed who also advised I have my metal tooth fillings removed, which I did. With my knee, it went from no issues to suddenly needing a TRK starting in April. I also have a promixal tibial stress fracture with bone marrow involvement, according to the MRI. I am bone on bone with bone spurs and am still on crutches and my life is in shambles. I am sofa bound. I’m also getting all out of alignment since I’m trying to deal with not using my right knee at all. (Aside from the 9/10 pain, it’s like it doesn’t work any more).</p><p>My understanding is in the US, there is no 100% metal free implant. I’m looking into stem cell procedures. I refuse currently to get an implant with metal since I believe it would open the portal to hell.</p><p>Any ideas?</p>

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@jennla

<p>I have a known titanium allergy, doctor diagnosed who also advised I have my metal tooth fillings removed, which I did. With my knee, it went from no issues to suddenly needing a TRK starting in April. I also have a promixal tibial stress fracture with bone marrow involvement, according to the MRI. I am bone on bone with bone spurs and am still on crutches and my life is in shambles. I am sofa bound. I’m also getting all out of alignment since I’m trying to deal with not using my right knee at all. (Aside from the 9/10 pain, it’s like it doesn’t work any more).</p><p>My understanding is in the US, there is no 100% metal free implant. I’m looking into stem cell procedures. I refuse currently to get an implant with metal since I believe it would open the portal to hell.</p><p>Any ideas?</p>

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Hi @jennia - Welcome to Connect! I've had two TKRs and I'm happy to say both went pretty smoothly - although not without a certain level of pain, frustration and worry. So I can imagine why you are feeling concerned with your titanium allergy. Here are some threads you might find interesting:
https://connect.mayoclinic.org/discussion/stem-cell-therapy-2/?pg=1#comment-301639
https://connect.mayoclinic.org/discussion/stem-cell-therapy-for-arthritic-knees/
https://connect.mayoclinic.org/discussion/need-tkr-and-had-positive-allergy-testing-bone-cement-and-metals/

I'm also going to tag a few people who might have insight: @denver, @okieshan1, @gutthookd, and @johnbishop
Meantime, have you talked to your doctor about stem cell availability where you are located?

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@jennla

<p>I have a known titanium allergy, doctor diagnosed who also advised I have my metal tooth fillings removed, which I did. With my knee, it went from no issues to suddenly needing a TRK starting in April. I also have a promixal tibial stress fracture with bone marrow involvement, according to the MRI. I am bone on bone with bone spurs and am still on crutches and my life is in shambles. I am sofa bound. I’m also getting all out of alignment since I’m trying to deal with not using my right knee at all. (Aside from the 9/10 pain, it’s like it doesn’t work any more).</p><p>My understanding is in the US, there is no 100% metal free implant. I’m looking into stem cell procedures. I refuse currently to get an implant with metal since I believe it would open the portal to hell.</p><p>Any ideas?</p>

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Hi @jennia, I would like to add my welcome to Connect along with @debbraw. I had a TKR in April and before I had the surgery I had several blood tests and one was checking for metal allergies which didn't find I had a metal allergy. I would definitely be concerned if I had an allergy. I found some information on ceramic joint replacements. I would talk with your surgeon to see if they have recommendations and then discuss any risks.

CeramTec - Patient Information on BIOLOX® Ball Heads and Cup Inserts:
-- https://www.ceramtec.com/biolox/patient-information/

PubMed - Alternative materials and solutions in total knee arthroplasty for patients with metal allergy
-- https://www.ncbi.nlm.nih.gov/pubmed/18210089

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@jennla

<p>I have a known titanium allergy, doctor diagnosed who also advised I have my metal tooth fillings removed, which I did. With my knee, it went from no issues to suddenly needing a TRK starting in April. I also have a promixal tibial stress fracture with bone marrow involvement, according to the MRI. I am bone on bone with bone spurs and am still on crutches and my life is in shambles. I am sofa bound. I’m also getting all out of alignment since I’m trying to deal with not using my right knee at all. (Aside from the 9/10 pain, it’s like it doesn’t work any more).</p><p>My understanding is in the US, there is no 100% metal free implant. I’m looking into stem cell procedures. I refuse currently to get an implant with metal since I believe it would open the portal to hell.</p><p>Any ideas?</p>

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It is wonderful to see all the links to read about non-metal materials and stem cell therapy! I have always believed stem cell therapy to be so expensive? (at least on Medicare). My husband had a hip replaced over a year ago - he had a known allergy to nickel and after the replacement found out he also had an allergy to titanium!!! He is now on Dupixent, since Jan., and it is questionable whether or not that will prevent symtoms. Our allergist says she is trying to get the word out that there is a test for heavy metals that should be used when there is a question about allergies. You need to find out all you can before the replacement Knowing you already have a titanium allergy, to me, would be a red flag!!!!!!

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@jennla

<p>I have a known titanium allergy, doctor diagnosed who also advised I have my metal tooth fillings removed, which I did. With my knee, it went from no issues to suddenly needing a TRK starting in April. I also have a promixal tibial stress fracture with bone marrow involvement, according to the MRI. I am bone on bone with bone spurs and am still on crutches and my life is in shambles. I am sofa bound. I’m also getting all out of alignment since I’m trying to deal with not using my right knee at all. (Aside from the 9/10 pain, it’s like it doesn’t work any more).</p><p>My understanding is in the US, there is no 100% metal free implant. I’m looking into stem cell procedures. I refuse currently to get an implant with metal since I believe it would open the portal to hell.</p><p>Any ideas?</p>

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My wife is needing a reverse shoulder replacement. She is allergic to cobalt and nickel. Her doctor has not run across this in their 20 years of practice. He seems to not know how to handle this. Has anyone had this issue? Are there any alternatives to the metal implants available? The doctor states no company will guarantee the implants are free of nickel or cobalt.

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@grandpacb

My wife is needing a reverse shoulder replacement. She is allergic to cobalt and nickel. Her doctor has not run across this in their 20 years of practice. He seems to not know how to handle this. Has anyone had this issue? Are there any alternatives to the metal implants available? The doctor states no company will guarantee the implants are free of nickel or cobalt.

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Hi @grandpacb, welcome to Connect. You'll notice that I moved your message to this existing discussion about metal allergies and joint replacements that @jennla started a few days ago. Click VIEW & REPLY to see the past messages.

I think both of you will appreciate the information shared by members in this related discussion
Need TKR and had positive allergy testing / Bone Cement and Metals https://connect.mayoclinic.org/discussion/need-tkr-and-had-positive-allergy-testing-bone-cement-and-metals/

@grandpacb is stem cell therapy an option for your wife?

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@jennla

<p>I have a known titanium allergy, doctor diagnosed who also advised I have my metal tooth fillings removed, which I did. With my knee, it went from no issues to suddenly needing a TRK starting in April. I also have a promixal tibial stress fracture with bone marrow involvement, according to the MRI. I am bone on bone with bone spurs and am still on crutches and my life is in shambles. I am sofa bound. I’m also getting all out of alignment since I’m trying to deal with not using my right knee at all. (Aside from the 9/10 pain, it’s like it doesn’t work any more).</p><p>My understanding is in the US, there is no 100% metal free implant. I’m looking into stem cell procedures. I refuse currently to get an implant with metal since I believe it would open the portal to hell.</p><p>Any ideas?</p>

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Stem cell is expensive and not covered by Medicare. The doctors we work with state there is no conclusive proof that stem cell therapy works.

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@grandpacb

Stem cell is expensive and not covered by Medicare. The doctors we work with state there is no conclusive proof that stem cell therapy works.

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Had my yearly appointment with stem cell Dr. He said if i do yearly PRP i will never have to undergo TKR. I can golf, garden on one knee, bike etc. Not having to suffer through another TKr is great in my mind. Spending out of pocket was a choice that i made and as i look back, was a wise choice. I read every day those who suffer with their TKR. So yes, i did not take government money to do another TKR but i take no pain pills etc. I do have constant pain from my TKR but i try to ignore it, ice and elevate it. Enough said. By the way, the surgeons in my area also say stem cells do not work. I did read that Ohio State hospitals have new procedures for the knee. One is they insert the cartiledge through an incision in the knee, the other is a meniscus replacement . Both without major surgery. Watched their news clip. Might be something to investigate .

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@jennla

<p>I have a known titanium allergy, doctor diagnosed who also advised I have my metal tooth fillings removed, which I did. With my knee, it went from no issues to suddenly needing a TRK starting in April. I also have a promixal tibial stress fracture with bone marrow involvement, according to the MRI. I am bone on bone with bone spurs and am still on crutches and my life is in shambles. I am sofa bound. I’m also getting all out of alignment since I’m trying to deal with not using my right knee at all. (Aside from the 9/10 pain, it’s like it doesn’t work any more).</p><p>My understanding is in the US, there is no 100% metal free implant. I’m looking into stem cell procedures. I refuse currently to get an implant with metal since I believe it would open the portal to hell.</p><p>Any ideas?</p>

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Thanks for info. We asked about stem cell therapy and were quoted a cost of $7,000 not covered by insurance or Medicare. I have seen a lot of posts on here about stem cell therapy for knee replacements but nothing on shoulder replacements. Does anyone have knowledge of stem cell being used for shoulder joints? The doctor who quoted the price for the shoulder didn’t seem very confident it would work for a shoulder.

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