Metal Allergy Problems in Total Joint Replacements

Increasing awareness of metal allergies has raised concerns within the orthopaedic field for our patients receiving joint replacement implants.

There are many different materials used today to manufacture orthopaedic implants. Typical prostheses may include:

  • Cobalt
  • Chromium
  • Nickel
  • Molybdenum
  • Titanium
  • Zirconium
  • Polyethylene
  • Polymethylmethacrylate

While statistically it is unlikely that a patient will have an “allergy” to one or more of these materials, it is more common than once thought. Hypersensitivities to nickel may be present in up to 15% of the population. As a consequence, increased emphasis has been placed on using materials that are less likely to cause an allergic-type response in our patients.

Dr. Kaper has extensive experience helping patients who have previously undergone knee and hip replacements containing nickel, who require revision surgery.  Here is the story of one of our patients:

     “I had my right knee replaced in August 2015.  Things were not right from the beginning.  I experienced increased swelling and loss of mobility.  I ended up with a 3rd back surgery because of serious problems with my gait.  I was on crutches for 362 days.  I was in excruciating and constant pain.  Each doctor’s visit was difficult as I was accused of not doing enough and needing to do more.  But, to be honest, I did all I was asked to do and more.  I did all my exercises, but nothing I did made things better, only worse.  

At no time during this 16 months of pain and discomfort did my doctor ever look for any other cause of trouble.  I always left there feeling defeated.  My family went through this horrible journey with me because they had to help me all the time, especially my husband.

Finally, my back surgeon asked me if I had been tested for a metal allergy.  I had not and he referred me to Dr. Kaper.  I liked him from day one.  Not just because he wasn’t telling me that I wasn’t doing enough, but because he said my leg was NOT normal for what had been done.  He said a metal allergy was a very valid thing to test for at that point.  He also was honest with me from the very beginning which I appreciated so much.  He said that he was willing to keep trying things until he figured out what was causing all the trouble.  He immediately ordered test for metal allergies and infection as my knee was still hot to the touch.  The test results showed that I have a high reactivity to nickel which was one of the main parts in my implant.  So, for 16 months, my body was fighting against the nickel.  I wasn’t just a little bit allergic, but highly allergic.  I was just so happy to have some answers and to have a doctor willing to continue exploring until he found some answers.  Unfortunately, this meant another major surgery, but this time I was happy to start anew.  I only wish I would have had this information before ever putting the implant in my body.  

I am forever grateful to Dr. Kaper and his kind and attentive staff.  I feel like he saved my life.  My leg is not perfect yet, but like he says, it could take up to a year.  But my knee is 1000 times better than it was and with no use of crutches.  My mobility is great, along with my range of motion.  After this last surgery, I was up walking on the first day and off the walker in a week.  There is really no comparison to how I felt over the last year and a half and how I feel now.  I can walk again.  I feel free for the first time in a long time.  I have my life back and so does my family!!!!

If you are going to have any kind of implant put into your body and you have any kind of allergies to jewelry, please tell your doctor so they can run a test before putting the implant into your body.  Or make a decision as to the best possible implant for your body.  Dr. Kaper has fixed many of these problems in many patients.  So, while many doctors turn a blind eye to the metal allergy possibilities, Dr. Kaper is well aware of the existence and knows what to do with that information.  Thank you again Dr. Kaper, from the bottom of my heart.”  –  D.R.

 

At the present time, the Verilast system, manufactured by Smith & Nephew, for hip and knee replacement surgery, offers the least likelihood of an allergic type response. This system consists of the use of titanium, oxidized zirconium, and polyethylene and is routinely recommended and used by Dr. Kaper.

Metal allergy testing is readily available to help identify patients with potential allergies or to evaluate patients with previous joint replacements who may be experiencing allergic-type response to their implant. For this type of highly specialized testing Dr. Kaper will use the Orthopedic Analysis lab in Chicago.

 

If you have specific questions about metal allergy and how this may affect you, please direct your questions and concerns to Dr. Kaper at the time of your appointment.