Allergic reaction to metal (esp titanium) surgically inserted plate?
May 28, 2014 3:13 PM   Subscribe

I have a titanium plate that was used to fix a radial fracture about a year and a half ago. I've been experiencing symptoms that include episodes of extreme fatigue, as well as sore throat and general sick feeling for the past 6 months or so. Before that I would experience this sick feeling minimally starting shortly after the plate was surgically implanted in my arm. The plate is now useless and can be removed, I was wondering if anyone had ever experienced a similar reaction? All my other blood/urine test show that I should be in perfect health. Thanks for any help! Desperately trying to get to the bottom of this mystery!
posted by kvoorhees to Health & Fitness (10 answers total) 1 user marked this as a favorite
Yes, but I'd get an allergy test first , as it's less invasive, I think?, than just getting it yanked out.
posted by tilde at 3:22 PM on May 28, 2014

Wow that's crazy I had a titanium implanted for a bad fracture of my humerus in March of 2013. Mine just hurts all the time. The bone has healed and it just adds strength I guess.

Hope I don't develop an allergy to the titanium. Will be following this post to keep up with you on it.
posted by Twinedog at 3:51 PM on May 28, 2014

Since I am not a doctor, I will simply summarize my unqualified understanding of titanium implants (I have one as well). There are many web pages to look for under this subject; I am deliberately not linking you to any of them as I am not qualified to indicate which ones are more or less accurate.

As I understand, titanium allergies are incredibly rare, but not non-existent. Most surgeons are both generally unwilling to entertain the possibility of an allergy (due to the rarity of the allergy) and generally unwilling to preemptively remove an implant (due to possibly performing unnecessary surgery). However, similarly, most surgeons are willing to remove an implant after a certain amount of time if it really bothers you - for instance, my surgeon offered to remove it after a year.

This is a reasonable question to ask your surgeon, but be prepared to be faced with skepticism.
posted by saeculorum at 3:56 PM on May 28, 2014 [2 favorites]

Neither a medical professional, nor taking any related courses any longer, but during a bio course a few years ago, I had the opportunity to tour the Center for Genomic Sciences at AGH here in Pittsburgh, during which time we were able to view imaging of (mostly staph) biofilms growing on, among other things, titanium implants (despite improvement in antimicrobial coatings). From what I remember, some of these infections were difficult to detect without drawing fluid from/entering the site, and also caused the more vague, entire-body symptoms you describe, as opposed to the expected fever/chills, warmth around the area or localized pain, etc.
posted by notquitemaryann at 4:41 PM on May 28, 2014 [4 favorites]

IANAD, but I've played a long running role in the ortho wards. I'm just going to tell you what happened to me.
I smashed my femur in a MC accident. They installed a kirshner (sp) rod and wrapped all the fragments onto it with bailing wire.
Fell off M/C again, hit end of rod which sticks up just a tiny bit above the end of the femur where it turns and becomes the femoral neck. Broke femoral neck - i.e., broke the hip. They told me it was because of the rod not allowing flexibility elsewhere. Pull out rod, install big honkin bolt up into the femoral neck with a plate on the outside of the femur.

Then I start getting necrosis in the hip joint - i.e., the ball is dieing off. Incredible pain. Was on crutches for three years or so. Saw lots of doctors that disagreed with lots of other doctors on what should be done. Long term advise was to wait as long as I could stand it and get a replacement hip, which might last 15 years.

Not being able to work, I went back to college. Since I was handicapped, I ran around with the other gimps (our name for ourselves, no insult.) Started dating a lady who was a quadrapeligic. She'd had a diving accident and broken her spine fairly high up. She was a pistol! On the track team, very active. She told me that she had also broken her elbow in the accident, and they had put a plate in there. She was unable to use the elbow for several years, and had to use an electric chair. She got the plate removed, and, voila! She's squirting around in a Quicky. She told me I oughta get the bolt out.

I listened, my Ortho doc said it wouldn't help, but I went ahead. When the internist was about to put the gas mask on me, he asked why I was getting it removed, I told him. He asked if I thought my hip would re-hematize if the bolt were out, I said I hoped so, he said it probably would. Within 3-4 months I had moved to a cane. A few months after that, no more cane. And then in a few more months, I found I could run again.
What she told me was "Our bodies aren't designed to have metal in them, you don't need it any more, get it out." That's been 30 years ago. I've used the cane for a day or so maybe 30 times.
posted by rudd135 at 5:25 PM on May 28, 2014 [2 favorites]

Thank you all. Yes, my surgeon, who has been practicing for 28 years, said it was impossible that titanium would cause my body to react this way. He pointed out that the symptoms were not something like a rash around the site, but instead whole body sickness and fatigue that this was not the culprit. All the websites I have found stating that this could be an issue seemed to be associated with the company (MELISA) selling the titanium allergy test so I sort of gave up on the idea. I decided to post here as I have no other theories as to why I could possibly be feeling this way. Thanks again for your stories and suggestions.
posted by kvoorhees at 5:36 PM on May 28, 2014

I think you are much, much less likely to have a titanium allergy than you are to have the kind of biofilm notquitemaryann suggests-- and I think that's a possibility well worth exploring.

I urge you to find someone who specializes in biofilm problems and get that checked out.
posted by jamjam at 6:12 PM on May 28, 2014 [1 favorite]

How is the plate attached? With, say, nickel-containing screws? Nickel allergies are a lot more common.

My wrist and heel have both been greatly, vastly improved once they had hardware removed (lordy, here I go revealing what an orthopedic nightmare I am) and I worry / suspect that some of my chronic back pain is due to the bolts and plates around my Ti cage. But the latter is most definitely not coming out.

Honestly, in your same place I'd yank the hardware first and ask questions later. Or not.
posted by Dashy at 6:33 PM on May 28, 2014

Is this sort of a followup to your previous question? Have you been able to eliminate some of those other suggestions?
posted by annsunny at 9:12 PM on May 28, 2014

Yes it is. I've eliminated pretty much everything else realistically and keeps coming back to this. I feel like this is the most likely culprit given my perfect health otherwise.
posted by kvoorhees at 9:28 PM on May 28, 2014

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