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Joined: Sep 13, 2018

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

Posted by @okieshan1, Thu, Sep 13 11:20am

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!


Here's the test results showing allergy levels.

Allergy Test Results

Okishan Im glad you are proactive on the metals and cement Im sorry to hear your problem now I dont have any answers maybe contacting Mayo they may good luck.

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, 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.

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