Sent: Thursday, November 08, 2007 3:30 PM
Metal allergy – an OS writes

While metal allergies are indeed rare, they can be (or have
the effect of being) all too real…..

My wife is 31 yrs old and had her right hip resurfaced 2
years ago by Dr. De Smet (she originally broke her hip
around 10 years, developed AVN, had an osteotomy 7 years
ago, developed arthritis, which ultimately led us to Ghent –
can’t say enough about the experience there).

Around a month ago she started experiencing terrible hip
pain. X-rays (and a CT Scan) show that the bone just below
the bottom end of the femoral cap is essentially dissolving
(osteolysis).

Blood tests were performed and, while it is not an exact
science, there does appear to be sensitivity to both
chromium and nickel – chromium being one of the main
by-products of the resurfacing components.

While there certainly could be other factors at play (e.g.
improper load bearing due to prior surgeries/injuries or
decay of the cement used in the femoral cap [which,
according to one prominent surgeon I spoke to, can happen,
particularly in cases where the femoral head has already
been significantly damaged]), I don’t believe it. Both of
those factors can, I believe, be worked through with
exceptional surgical technique – and I have the utmost
confidence in De Smet.

According to De Smet, around 1 out of every 500 patients has
this type of reaction to the metal. To quote De Smet, “That
indeed is a possibility. Metal sensitivity is a risk of
1/500 in my series. A lot of people do not believe it and
say it is non existing or very rare. If [metal] is the
problem……she has really bad luck”.

We are now looking at a THR (which will most likely happen
in the next week or so) and, while there is no way to know
for certain whether a “metal allergy” is causing the
problem, at this point, we certainly can’t risk having a MoM
THR – ceramic is the only option.

Joel Feldman (Meg: De Smet – Sept 05)