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Ask the Expert: Metal Allergies

metal implants and tools

It’s uncommon, but people can be allergic to the metal in the implant. Dr. Geoffrey Westrich, Orthopedic Surgeon, explains.

Knee replacement is a highly successful surgery in terms of eliminating pain and restoring mobility. It has given countless people a new lease on life. But a limited number of patients who have a metal allergy may develop symptoms following the surgery.

Diane is one such patient. She suffered for almost a year after knee replacement at another hospital. Extremely weak and in terrible pain, the 56 year-old traveled from her home in the Philadelphia area to see me at Hospital for Special Surgery.

She came in after a nine-month ordeal that started after a double knee replacement to get relief from severe arthritis.

Diane chose to have the operation on both knees at the same time. But months later, instead of getting better, her knees still ached. Then the pain started spreading throughout her body to her shoulders, arms and legs. She got weaker and weaker.

Four months after knee replacement, she could no longer get dressed without assistance, pick up a half-gallon of milk or turn over in bed. She says she became a different person — terribly weak, in constant pain and very unhappy.

It turned out she was allergic to the metal in the knee implants, and this was causing severe symptoms throughout her body.

For Diane, it took nine months of searching for answers, of being told you had knee surgery, you’re supposed to be in pain, and of being made to believe she was a nuisance to the doctors she pleaded with for help.

She was finally referred to me and traveled to HSS. When blood tests confirmed Diane was highly allergic to nickel and cobalt, I replaced the implants in both her knees using prostheses that did not contain those metals. The revision surgeries were performed several months apart, and week by week, her pain diminished.

Her symptoms went away after we replaced the metal implants. She is now doing well, has regained the use of her arms, can run errands and walk through a shopping mall.

Although severe reactions to metal implants are rare, orthopedic surgeons are advised to ask patients if they have ever had a reaction to metal, such as costume jewelry. If the answer is yes, the orthopedic surgeon can select an implant that does not contain a specific metal, most commonly cobalt and nickel. If there is any doubt, patients can be tested to see if they may have a metal allergy.

It’s important for any patient who has a problem after joint replacement to see his or her doctor and insist on being taken seriously. If the doctor dismisses the patient’s concerns, the individual should find another physician, preferably at a joint replacement center that does a high number of procedures and is used to dealing with complications. Having the surgery done in such a joint replacement center in the first place gives patients the best chance of a good outcome.

Dr. Geoffrey WestrichDr. Geoffrey Westrich, hip & knee surgeon, Orthopedic Surgeon, specializes in knee and knee replacement, including revision surgery and complex cases at Hospital for Special Surgery. He is director of research of the Adult Reconstruction and Joint Replacement Service at HSS.

The information provided in this blog by HSS and our affiliated physicians is for general informational and educational purposes, and should not be considered medical advice for any individual problem you may have. This information is not a substitute for the professional judgment of a qualified health care provider who is familiar with the unique facts about your condition and medical history. You should always consult your health care provider prior to starting any new treatment, or terminating or changing any ongoing treatment. Every post on this blog is the opinion of the author and may not reflect the official position of HSS. Please contact us if we can be helpful in answering any questions or to arrange for a visit or consult.