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Nickel and knee replacements

Discussion in 'Knee Replacement Pre-Op Area' started by apraxia, Mar 1, 2011.

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  1. apraxia

    apraxia New Member

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    I can not stress enough how important it is for people with allergies to investigate whether you have a nickel allergy before knee replacement surgery. I knew I had an allergy because I had had a reaction to eye glass frames when the "gold" outer layer wore off and the base metal, nickel, caused a rash where it touched my face. Unfortunately neither I nor my doctor thought of this in 2001 when my first knee replacement was done.

    Afterwards my knee was still in constant pain for several reasons, one being the fact that it was metal and contained nickel. That knee was revised (replaced) again in 2004 after I had allergy tests to confirm a nickel allergy. My orthopedic specialist (different surgeon) had only worked with metal knee replacements and did not believe that a "skin contact allergy" would occur under the skin with the replacement knee.

    It was revised with a metal knee containing nickel. That knee was better but still constantly painful when I put weight on it. It remains that way today. In 2009 the same orthopedic specialist that did the second surgery took one look at my other knee and said "We are going to put an Oxinium implant in that knee." I did not have to say a word. He knew in the four years that passed that his revision had not gone well and was convinced that NOT having a metal knee replacement when you have a nickel allergy IS important.

    He had also, in the intervening years, worked with the oxinium implant. It is great. The 2009 replacement in my other knee is doing great! Does it feel like my "real" knee? No. But my "real" knee had become extremely painful and I had to go any distance in a wheelchair. Now I walk and just wish the doctors had been 10 years more informed when they did my first knee in 2001. I have very little bone left to revise the first knee for a third time so I will live with my metal as well as my oxinium knee and can compare them every day. Oxinium wins every time!
  2. Josephine

    Josephine Forum Admin and Mother Hen Administrator

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    Hello, apraxia, and welcome to BoneSmart. You are right that anyone with a nickel allergy should get themselves checked out before having any joint replacement. But it's still an extremely rare thing to happen. Mostly the knowledge of this reaction is relatively new and back in 2001 it was widely supposed that contact allergies would not affect internal implants. Even in 2004 it was little understood and even less accepted! We are learning all the time and one of the results of this knowledge is the Oxyinium knee which is actually a standard knee with a very hard nickel-free coating. These coatings have been specially designed to be long lasting and durable.

    Barring accidents, I doubt you'll ever have to worry about having a third revision. Nowadays these implants last a considerable time, up to 30 years at last reckoning, though I'm confidently expecting my knee to last me out the rest of my life!

    I'm not quite clear about your last paragraph (I split your post to make it easier to read) - do you mean your other knee is arthritic and will need surgery? Of has it already been done? In which case, why is it painful?
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  3. Caroline109

    Caroline109 Member

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    I did the nickel testing as I can't wear cheap earrings. Turns out I am not sensitive to the nickel (or the cobalt that was tested too), but the paper tape the disks were attached to me with! Sorry you had troubles.
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  4. Jamie

    Jamie Administrator

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    Welcome to BoneSmart, apraxia. I'm glad you've joined our forum. And I'm glad to hear that your current surgeon has recognized your issues with nickel.
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  5. RestAssured

    RestAssured Forum Advisor

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    Apraxia, I have a nickle allergy also.

    The doctor decided it was best to put in Oxinium knees. The allergy issue for my knees is no longer.

    I wish I could wear pierced earrings, or clip ons. Any type of metal to my ears causes swelling of the earlobes, and blisters to form within 30 minutes of wearing them!


    On my wedding day, we had picked out some very expensive earrings "guaranteed" to keep me from breaking out. Let's just
    say after all the pictures and the wedding was over, I put them in my jewelry box and have not gotten them back out! I can't wear earrings even though I would love to!:skeptical:


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  6. cotton1958

    cotton1958 Supremo

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    I too had nickel allergies and Stryker rep sent a disc to put on the side of my knee to wear 2 weeks. I too had more irritation to the bandaid and no reaction to the disc. I live in a pretty huge city and Stryker and Doc never had come across an allergic knee. But I know I felt better and worries went away just doing the disc test.
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  7. kneeper

    kneeper Forum Advisor

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    My mom has major nickel issues and can't wear earrings anymore. She had no problem with her knee. I wonder if they used the Oxinium type? :what:That was several years ago.
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  8. cotton1958

    cotton1958 Supremo

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    I meant to say in my last post, that a lot of metals we wear have nickel in them. I have a friend who is a jeweler, and when I told him I was afraid of having a nickel allergy, that's what he told me.
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  9. Josephine

    Josephine Forum Admin and Mother Hen Administrator

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    My sister has it too - she always used to buy ear ring that were gold plated then she had no trouble.
    I wonder sometimes if it's to do with the degree of the allergy.
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  10. apraxia

    apraxia New Member

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    Josephine, this is a summary to help clear up what knee had what done:

    Right knee: 2001 replacement with metal knee - bad pain after

    Right knee: 2004 revision - different surgeon - different metal knee (somewhat custom made) - still pain but did not need brace I was using before. Did need cane.

    Left knee: 2009 replacement with Oxinium knee - no pain

    Both knees were arthritic- no cartilage

    Present: one very good knee (left one) and one still somewhat painful (right)
    No cane, no wheelchair, limited distance walking and avoid hard surfaces to walk on. Tennis anyone:hysterical:. NOT ME!

    On the subject of nickel allergy and jewelry:
    Gold filled jewelry means its base metal contains nickel or an alloy. Thus gold filled is only good as long as the surface gold is intact. Nickel is what makes implants, jewelry, etc. hard so it is usually present at least as a base metal.

    There is a doctor in Chicago who is running (or was running) a clinical trial in 2009 to see if by using a blood sample a person could be tested for an adverse reaction to a nickel implant before it was done. My blood in his trial showed I would NOT have a reaction to a nickel implant. So much for his clinical trial. As for me, the "proof is in the pudding".
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  11. Josephine

    Josephine Forum Admin and Mother Hen Administrator

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    Ah - gotcha - thanks for the explanation!

    You're right about the gold plated stuff. After a time, my sister's gold plated ear rings would start to cause irritation and when she looked, the gold was wearing off!
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