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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
I baffled as to why you can't get a doctor to prescribe testing.
My orthopedist was reluctant to have me get testing. He did tell me that the massive orthopedic hospital center in which he was only one of five surgeons did not do the testing. The center is part of a huge medical group covering our local area with every type of specialist and with a first class regional hospital, surgical centers and hundreds of doctors with offices. It also has multiple labs.
What he said I would need was not the 5 Day Extended Patch Test which had been given to me by my allergist a few years earlier, but a blood allergy test. He had to prescribe and order the test from a lab in Illinois. I had to pay in advance, Medicare doesn't cover this test. The test was ordered and the kit came to the orthopedic hospital and I believe it had to be frozen so a date was scheduled for my blood draw and then that was sent off to Chicago. It took several weeks to get the results. I wasn't surprised that I reacted to 5 metals, but was surprised I wasn't allergic to bone cement since I have other adhesive allergies.
This sounds cynical, but the only explanation I have as to why, even after I explained about my Allergic Contact Dermatitis, ACD, and positive test results to over a dozen contacts why I had to insist upon testing after he said I was ready for TKR is the Orthopedic Surgeons' have no incentive to order this test, if positive for allergens in the TKR or the cement then they don't have a patient. The ceramic coated implant he planned to use based upon my metal allergies I did my homework on and discovered a major class action lawsuit against it because the bone cement is failing to adhere to the implant. Also, even with coated implant, over time metals can escape. I am very happy the ceramic implants are working for some, but I plan to wait a few more years until desperate and make a decision based upon the history of each ceramic coated implant.
Replies to "I baffled as to why you can't get a doctor to prescribe testing. My orthopedist was..."
I totally agree with you about no incentive to get patients tested. Gotta self advocate. I researched a lot too and don’t see a great alternative if sensitive to metal; and forget cement-less. It’s a brutal pounding deep into bone. I’m 70 + and can imagine fracturing! I would still like to find a willing Dr to coordinate an LTT blood test. I’ll keep looking and, like you, will wait a while longer for a better solution
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@gardeningjunkie @montykona2 I think this is the lab in Chicago that you are speaking about.
https://www.orthopedicanalysis.com/
I had concerns and did their blood test for metal and implant allergies which was shipping in a warm blood sample so it stayed alive. I ran into resistance from a spine surgeon who would not authorize it saying it was not necessary, so I went to my GP and he authorized it. As patients we have to advocate for ourselves. One thing the test does is tell you what your immune response is right now before you are exposed to an implanted material (or for what is already in your body). That might change in time after exposure to a material and you can become allergic later even if a test had cleared you for an immune response. If you test positive, then you'll know what to avoid.
My test cleared me, and last year I broke my ankle and now have titanium plates and screws. After 6 months, I started having hives and have to stay on antihistamines. I also have some pain around the plates, so they will be removed. There are some other trace metals in the titanium, so it isn't pure, and those could be the culprits. The test was pricey, about $500, so I'm not going to repeat it now.