Good Morning All - Some of you "know me" from my TKR posts... which evolved to me finally understanding... well, many things about the "why" regarding I have had so many problems for so long... briefly... it turned out to be a metal allergy which I finally got self (serum) tested by MELISA for... after an off-hand musing/question by my 4th orthopedic surgeon (after the original TKR, MUA, Arthoscopy, and then Partial Revision... and now the accepted reasoning for this newest TKR (same knee) being "joint loosening" (brought on by constant inflammation, stiffness, pain) - but a fairly common reason these end up being replaced (again). 'Learned my lesson (not all of them - but this one)... this new TKR will be Smith & Nephews "Oxinium". Unfortunately... Smith & Nephews does not yet make an "Oxinium" shoulder joint replacement. My own metal allergy is not the far more common chromium/nickle but instead is to Molybdenum and Manganese. I may have problems with most "Titanium Alloy" products because most implants contain these two materials. And although Zimmer/Biomet does make a 100% titanium product (yes, there are still some HDPE plastics - but all metal is 100% titanium)... the "life of wear" may not be as good. I have also read of some potential problems with their "Comprehensive Shoulder System," which is the only one available in the 100% titanium I need the "reverse type" prosthesis because of previous damage to my rotator cuff. So this is probably not the implant for me. Tornier (recently acquired by Wright Medical) is apparently aware of the serious concern of metal allergies and is working on a "carbon-fiber" shoulder system, but this is not ready yet. (This is from Dr. Tower - Tower Orthopedics in Anchorage who specializes in hypoallergenic joint replacement surgery. He is himself a sufferer of a serious chrome allergy reaction to a hip replacement - and also from myself personally speaking with the local Oregon/Tournier rep). I see CeramTec is a sponsor on the Bonesmart and I wonder if they are now marketing their prosthetic joint replacement products in the US? About a year ago... I directly inquired and was "referred around" to several in their company... finally speaking to a nice man in Germany (who spoke excellent English thankfully), but informed me they were NOT yet available in US markets. He referred me to a doctor in Spain. So... I do love their product - but if I can't "get it"... in the US, then what? So... the hope is that my research can help others (at least in not wasting their time... going down these same fruitless paths). It may be that none of these are realistic options for persons living in the US with a metal allergy - that really need a shoulder replacement. The question that I have for all of you out there is... what other possible options might any of you be aware of? Once again - a product that is both "hypoallergenic" AND available in the US medical market (we'll fight with our insurance later - and of course they will initially "deny this"... we're used to that). Thanks for your help (and patience) all !!! And best luck with your own shoulders and their surgeries (and recoveries). John in Oregon (aka "Ottothedog") PS - Seriously - ANY of you still pre-surgical. I strongly recommend that you get tested for metal allergy. You will have to ask for this, you may have to fight for this, you may end up paying for this out of your own pocket as I did - about $5-600.00 USD including airfreight to Germany. But trust me, you do NOT want to find out AFTER surgery that you have an allergy to a prosthetic joint - already installed in your body. Please educate yourselves as fully on not only this subject, but on the surgery and recovery as possible. Be prepared not just for the most optimal outcome and be aware that all surgeries have potential problems (and some of these are serious). Don't be "in a hurry" or let yourself be "pushed toward" any surgery. I recommend at least second (and maybe third) opinions. A surgery once "done" can have consequences that are life changing in negative ways and are not easily "undone". Remember that "as the patient" - you are really the only one who can experience negative consequences - "when things don't go as well as intended." There is no such thing as being "too well educated" on these subjects.