31 Mar METAL ALLERGY AND KNEE REPLACEMENTS

Joint Replacement surgeries involve metal implants. These metal over long years have proven to be biocompatible (Friendly to body tissues). Some people might be Allergic or sensitive to particular metals.Prior to Joint replacement surgery it is important to inform the surgeon if you are allergic or sensitive to metal.

Metal allergy  before surgery

During the outpatient visits prior   to knee replacement surgery. You should inform about any reaction to jewellery (Necklace, Rings, Earrings etc…) or eye glasses.

This may give a vital clue.Some may develop reaction to certain metal in work places. Let your surgeon know prior to surgery. He would opt for other implants if they are available. You can find the format which we follow at our Alpha Ortho Clinic.

                                                                                                    Alpha Ortho Clinic
                                                        No.265,BussyStreet,Puducherry – 605001 Ph: 0413 – 2221855

Metal Allergies

 Patient Name:…………………………………………………………………………..

Do you have any known allergies to metal?
Please check the box that best applies

No known allergies to metal
Metal allergies (i.e rash blistering any type of jewelry or metal framed eye glasses)

• Aluminium
• Nickel
• Other………………………………..
• Other……………………………….
• Other……………………………………..

Physician reviewed

Physician Comments…………………………………………………………………………………………………

Patient signature:……………………………………………………Date………………………

The most common metal allergy is Nickel. It is found in very small quantity in Knee Replacement Implants. With prior history of Metal Allergy surgeon can avoid using the corresponding implants.

Though skin testing can give information on MetalAllergy.Many a time skin allergy and invitro allergic studies do not correspond. Hence positive skin test does not necessarily mean that knee implant with that metal would lead to failure. Henceskin on blood test for metal allergy is not routinely recommended.

Metal particles in Joints

In majority knee replacement the joint surfaces are of metal on polyethylene. Hence the metal debris formation is relatively rare. But in hip replacements especially in some special  joints metal surface sits on another metal surface and  it produces metal debris. Metal particle formation in common surfaces like metal on polyethylene / ceramic on poly/ ceramic or ceramic is rare phenomenon.

Metal allergic  after surgery

Around the joint the skin may show rashes discoloration, can produce itching.

Joint can get swollen,  with pain and stiffness. But these symptoms can happen  invariety of other reasons  also and it would be very difficult to diagnosis. It is rare to have a hip or knee replacement failure because of metal allergic/ sensitivity. If you have allergic /sensitivity history to metal its best to alert the surgeon in the outpatientconsultations prior to surgery. Discussing with the surgeon about the treatment options would provide the best solution to it.

Dr.Naveen ThiyaguBashingam, M.S.Ortho,
Fellowship in joint replacement,
Double Fellowship in Sports Medicine & Arthroscopy (Germany)
Director &Consultant ,Joint Replacement , Sports Medicine.