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Avoid Knee Replacement If You Have Allergies!

POSTED ON IN Knee Latest News BY Chris Centeno

knee replacement allergy testing

The idea that the metal we’re installing in people’s knees may be causing allergies has been talked about at many orthopedic conferences over the last few years. This is because of a growing realization that knee replacement can cause tissue reactions due to wear particles that shed off of these devices. Now a brand new research study is linking any patient report of any random allergy to poorer knee replacement outcome.

A knee replacement is the amputation of a joint and insertion of prosthesis. That means that a piece of metal, ceramic, plastic, or some combination of these materials is installed. The fact that these devices are shedding wear particles has received a lot of attention lately. For example, we know that in some patients, metal ions from the knee replacement device can build up in the blood.  In other patients who have a known jewelry allergy, the risk of being allergic to the metals used in these knee replacement devices is high. In addition to metals, some of the new plastics in knee replacement prostheses also cause allergies. If you are allergic, the device is more likely to fail, cause chronic pain, or need to be replaced sooner. Until now, it was assumed that allergy related issues were confined to those select patients, but the new study suggests that it may encompass all patients who have an allergy to anything.

About the Knee Replacement Allergy Study

The new study was out of Spain and involved hundreds of patients who underwent a knee replacement for arthritis. Roughly two thirds of the patients had no reported allergy on their medical chart, while about one third had a reported allergy. The group with at least one reported allergy fared worse in outcome scores than the group without any allergies.

Why is this happening? About 1/3 of us tend to have allergies and this may mean our immune systems are more “jacked up” than most people. Allergic people may be much more sensitive to having a foreign body shedding particles as it wears, causing their immune systems to attack the device. When your body rejects something, you can bet that swelling and pain will ensue, in addition to poorer bonding of bone to the device.

If you have a known allergy to something, you may want to think twice about getting a knee replacement to treat arthritis. While more research needs to be done, this study adds to the growing evidence base that what we implant into certain patients may not be compatible with their bodies!

 

    comments

    Bob says

    I am suffering badly from podt operative pain after knee teplscement surgery....I am unaware of sny sllergies Imay have....how do Idetermine if I am allrtgic?

    replies

    Regenexx Team says

    Bob,
    Knee replacement surgery is a BIG surgery, and severe post operative pain is to be expected. This link will bring you to several different studies and articles about this issue: http://www.regenexx.com/?s=knee+replacement+pain. The fact that you have no allergies that you know of is a good thing in this case, because it lessens the chance of an allergy to the components of the prosthesis. Pain and swelling are normal parts of the healing process, but can also be indicators of an allergic or other problem. It's the timing of these issues which is important. New pain and swelling once the expected pain and swelling have resolved, or pain and swelling that lasts significantly longer than expected should be reported to your doctor. If your doctor is concerned that there might be an allergic component to your recovery, an IgE blood test can confirm the presence of an allergic reaction. How long ago was your surgery?

    replies

    Merccedes says

    Is there a test to find out if I am suffering from such allergy. I had to have my knee replaced in 2011. I would have done something else but those treatments are reserved for the very wealthy therefore I have to have my joints replaced if I want to be able to function!

    replies

    Regenexx Team says

    Merccedes,

    The lack of insurance and medicare coverage is very frustrating for us as well. If you're not having symptoms like severe pain, loosening or failure of the prosthesis, unusual swelling, or instability of the prosthesis, this is most probably not an issue.

    If you are experiencing any of those systems please contact your doctor and if he feels there is reason for concern, an IgE blood test would reveal the presence of an allergic reaction, and a toxic metal blood screening would reveal an issue with metal ion toxicity.

    replies

    Bridgette says

    When speaking to patients that have had replacements or are candidates for replacements, there are some tests that are not completed, which I find shocking!! Only X-rays are completed and not followed up by an MRI and allergy tests. These should be a major priority when moving forward with replacing any joint but unfortunately they are not on the list.

    replies

    Regenexx Team says

    Bridgette,
    You are correct. There are other things in a person's medical history that should be considered as well, and sadly are not. It's very much a "if it's not working well let's cut it out" paradigm, that we and others are working hard to shed light on and change.

    replies

    Kiesha N. says

    I had partial knee replacement in August 2015 and I am still having a tremendous amount of pain, I have reported to my Dr and Physical therapist. I'm still in physical therapy (09/02-present), I do have some allergies to some meds. When I woke up Thursday morning I had swelling and pain to where I could not bend my knee, saw my dr Friday and he gave me the gel shots. Now he wants to do a full knee replacement! Feeling very frustrated!!

    replies

    Regenexx Team says

    Keisha,
    Feeling frustrated is completely understandable! Hoping the gel shots will help. Unfortunately chronic pain is all too common in knee replacements ( http://www.regenexx.com/?s=knee+replacement+pain ) but regarding the sudden swelling and increased pain, you might consider asking your doctor what he attributes that to. Is it that the prosthesis has loosened, is it some kind of an allergic response, is it a reaction to the metal of the device, is it an infection? These would be important questions before proceeding with a TKR.

    replies

    Matty says

    Thanks for shginra. What a pleasure to read!

    replies

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    About the Author

    Chris Centeno

    Christopher J. Centeno, M.D. is an international expert and specialist in regenerative medicine and the clinical use of mesenchymal stem cells in orthopedics. He is board certified in physical medicine as well as rehabilitation and in pain management through The American Board of Physical Medicine and Rehabilitation.…

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