Is there any benefit to testing for metall allergies due to an implant from a TKR? I had a Conformis implant and on their site it states testing has not been proven to be an accurate predictor of the likelihood of a reaction. I'm wondering if they're talking about a test on the external skin. Someone mentioned to me Orthopedic Analysis in Chicago does an Orthopedic blood test panel
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This is the link to the paper mentioned https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6510463/
Kayley
Hi Jessica,
Thanks for the excellent question! This is not an area I have expertise in, but I found a 2019 paper titled Exploring the Incidence, Implications, and Relevance of Metal Allergy to Orthopaedic Surgeons by Haddad et.al. This is open access, so you'l be able to download it. It's a small study and there is recruitment bias, so the percentage of people with a metal allergy is not representative of the general population, however it's a thoughtful and educated discussion of the topic. I'll copy some quotes below. There are different types of tests, both blood and skin patch tests and the authors say the blood tests can be useful. I would do this if you have cause to think it's needed.
Kayley
"Much remains unknown about the clinical relevance of positive reactions. Individuals with positive patch
tests may not experience clinically identifiable reactions to a metal implant."
"A portion of patients were nonreactive to all metals tested. In the reactive patients, a portion showed sensitivity to only one metal, whereas others were sensitive to multiple metals." and "The clinical manifestations of metal implant hypersensitivity can be nonspecific and difficult to trace to a symptomatic implant." "surgeons should be aware of the possibility of metal sensitivity and have a low threshold
for sending patients for metal hypersensitivity testing..especially given the utility and simplicity of skin patch testing with low risk of side effects".