Metal Allergy implant solutions for nickel and bandaid allergies

[MeowWoofMomma]

Hi there! I am scheduled for total replacement of my right hip on February 7, 2023. I've reviewed all the library materials on site here, and ordered my post-op recovery gadgets. I have my pre-op appointment in 2 weeks, and plan to ask my doctor/team the questions below. But in the meantime, I'd like to gather some information from people who've actually had the surgery, so I'll be better prepared.

My main concern is that I tend to be allergic to many things: grass and tree pollen, nickel metal, adhesive bandaids, and various soaps and lotions. So I'm concerned about the materials used in the implant and surgery. I'd really like to hear from folks who have similar issues.

Metal allergy: I'm allergic to nickel (maybe other metals as well?), so the ceramic-on-ceramic (COC) type of implant seems like the safest option for me. I'd love to get feedback from folks who have had this type of implant, and whether they had any reactions positive or negative.

Dermabond skin adhesive: My surgeon plans to use this type of material to close the wound. I get skin irritation from the adhesive on various types of bandaids, and especially from liquid bandaids. Has anyone here had a sensitivity to bandaids and had a successful experience with Dermabond? Are there safer alternatives to Dermabond?

Bone cement vs non-cemented implant: I'm also concerned about reactions to the bone cement that is often used to adhere the implant to the bone. The non-cemented approach uses implants that have a porous surface that the bone eventually grows onto. Does anyone here have experience with the non-cemented approach?

Sorry for the long post, and thanks for any feedback!

 

[Eman85]

Only reaction I had was to the tape they covered the incision with. I'm not sure if it was actually the tape that caused it but I had a rash around the area. OS said to use cortisone cream on the rash which I did and rash went away. I'm generally not allergic to anything and rarely have any skin rashes.

 

[Mojo333]

@MeowWoofMomma
and welcome to the forum!

. I have my pre-op appointment in 2 weeks, and plan to ask my doctor/team the questions below.

You certainly need to raise all of these concerns with your OS ...

Metal allergy: I'm allergic to nickel (maybe other metals as well?), so the ceramic-on-ceramic (COC) type of implant seems like the safest option for me.

Many folks who have contact sensitivities do very well with implants...
No doubt your surgeon has dealt with this before.

Dermabond skin adhesive: My surgeon plans to use this type of material to close the wound. I get skin irritation from the adhesive on various types of bandaids, and especially from liquid bandaids. Has anyone here had a sensitivity to bandaids and had a successful experience with Dermabond?

My sister was highly allergic to latex and bandage adhesives, but had many procedures including a hip pinning where dermabond was used to close the wounds with no issues.
Apparently allergic reactions to dermabond are extremely rare.

The actual dressings used to cover actually were more the problem...so gauze and hypoallergenic wraps were the go-to .

Bone cement vs non-cemented implant: I'm also concerned about reactions to the bone cement that is often used to adhere the implant to the bone. The non-cemented approach uses implants that have a porous surface that the bone eventually grows onto. Does anyone here have experience with the non-cemented approach?

Sorry for the long post, and thanks for any feedback!

I feel like we are seeing a trend, possibly due to younger patients, toward uncemented implants.
I had BTHR in 2017 and they are uncemented.

I hope your surgeon can address your concerns so you can be reassured and get on to getting rid of hip pain and back to healthy and happy!

 

[Ocean]

I have two uncemented replacements,

 

[subie2021]

I'm old, glued together, and uncemented...no problems.

 

[MeowWoofMomma]

@Eman85 I could deal with a minor rash, but dreading a major reaction... I'm surprised that even non-allergic people have reactions to the tape. Maybe because it stays on the skin for so long?​

 

[MeowWoofMomma]

@Mojo333 Thanks for your informative reply!​

Apparently allergic reactions to dermabond are extremely rare. The actual dressings used to cover actually were more the problem...so gauze and hypoallergenic wraps were the go-to .

My doctor uses the Dermabond Prineo skin closure system that uses a water proof mesh adhesive dressing on top of the dermabond. I've been reading through some of the threads in the recovery section with horrible reactions to the dressing. Pretty scary. I'll definitely ask for gauze and wraps instead!

 

[MeowWoofMomma]

@Ocean, @subie2021 Good to know that uncemented implants are successful! I'm hoping that my doctor can provide me with that option.

 

[Eman85]

My tape was on for 2 weeks. I'd say some of the problem is sitting with ice pad on the spot and scratching the itchiness of the incision healing.
No cement just screws with mine as far as I know.

 

[zauberflöte]

Hi @MeowWoofMomma ! I am a very allergic person too. I even had a note from my asthma/allergy dr that in-hospital staff were not to wear scented body products in caring for me!

I have two uncemented hips, and both had the dermabond stuff with no problem. Before my first hip I'd done some PT which had included KT-taping my SI joint. The tape made me break out within about 24 hours-- little bubbly rash surrounding its edges, red and itchy under the tape. That tape adheres fiercely for 3 or more days and is murder to take off! So that was my first exposure to adhesive contact dermatitis, and the tendency continued with the first hip. Thankfully, the second one must have had a different brand of stickum bc there was no problem.

I had a problem with a cheap """"gold"""" ring as a teen, but I am a professional flute player who wears a piece of silver on her chin/lip for hours at a time with no problem. The silver has nickel in it, and I guess that teenage ring was a one-off.

I expect your surgeon has lots of experience with these things. We had a member back in maybe 2017 who had an allergy testing shortly before her surgery which helped her OS find the right equipment for her. @Layla @Mojo333 do you remember who I'm talking about? I don't want to tell this story wrong.

 

[Layla]

I am sorry...I do not recall who that was back in 2017.

While here, I'll weigh in. My hip, uncemented, and I did have a reaction to a large bandage that was removed after the first twenty four hours. My skin was angry / red but gradually faded once it was removed.

Not too long now until your big day. I wish you comfort as you wait and an uneventful surgery and recovery.
@MeowWoofMomma

 

[MeowWoofMomma]

@zauberflöte Good to know that you were able to tolerate dermabond, even though you're allergic to adhesives. More confirmation that it's the tape/bandage that tends to cause reactions.

I'm okay with gold, silver, and stainless steel jewelry, but any kind of mixed metal breaks me out with red, itchy, weeping blisters: earrings, necklaces, rings, watches, metal eyeglasses, even the buttons on my jeans.

I've ordered the metal-LTT test kit from OrthopedicAnalysis (pretty spendy!) The gal at my ortho's office said they don't do metal testing, and that I should have my primary doctor do it instead. Hope that's not a red flag... In any case, I plan to ask my primary to sign the prescription form that comes with the kit. Something just occurred to me. Wonder if Medicare pays for the blood draw, or do I have to pay for that too?

 

[MeowWoofMomma]

@Layla, Thanks for the comforting words. I'm anxiously waiting for my preop meeting next Tuesday, and hoping they will calm my concerns. As the day approaches, I find myself spending hours online researching various implant types and scientific studies on bioactive coatings, ceramic vs metal vs polyethylene ball/socket, etc. Is it just me being obsessive, or is this a common behavioral response to pending scary surgery?

 

[RSC]

Min is uncemented, ceramic on ceramic, and I'm not exactly young. My understanding is that the metal part of my implant is titanium.

 

[MeowWoofMomma]

@RSC From all my research so far, ceramic on ceramic is the gold standard! Studies show zero debris from wear/tear after years of use, unlike the ceramic on polyethylene that results in microscopic particles of polyethylene debris that can cause inflammation. The only potential downside is squeaking or popping sounds, but apparently that is less common these days. Anyhow, I would rather live with squeaking than pain any day

 

[Layla]

Best Wishes tomorrow!
Please join us on the Hip Recovery forum once you're home and feeling up to it. We'd like to support you on your healing journey. Will be watching for your first update.
@MeowWoofMomma

 

[Mojo333]

Thinking of you today @MeowWoofMomma
Bye bye hip pain

 

[MeowWoofMomma]

Thanks for the well wishes, but my surgery has been postponed to April 3rd. I had a family emergency and needed to fly to Asia. Luckily my hip is behaving well in the meantime (even though it's bone-on-bone with multiple sharp bone spurs).

Some good news! I finally got the results back from my Metal-LTT test, and the only metal that showed a reaction was nickel! (Highly reactive 19.3) No reaction to cement either! So I can breathe a sigh of relief.

My OS uses titanium implants with ceramic ball and polyethylene cup, uncemented. Though I still haven't been able to learn the actual name/manufacturer of the implant.

Also discussed my bandaid allergy, and they will use an alternate closure method instead of the dermabond prineo system.