I have spent the last few days trying to figure out how to get the metal allergy testing done. Below are my notes for anyone else who wants to get tested prior to having an implant. You will need a prescription from your doctor and your insurance may or may not cover it. Most likely not.
I do know I have a metal allergy to some jewelry. I don't think I have one to Titanium but, I would prefer to spend the money and get tested just in case. It is possible that some of my symptoms could be due to the Titanium screws I've had in my knee the last 25 years. I don't think so, but, better to be safe than sorry. Old Codger had a terrible reaction to Titanium. I'll post a link to his thread at the bottom. It's a small percentage of people that have this problem which is why the surgeons in the U.S. don't test for it. When I mentioned my allergy to jewelry to Dr. Clavel, he suggested I get tested...so, there you go, different attitudes in different countries! I've decided to get the Melisa test done by a lab called NeuroScience. They sent me a list of companies to contact where I live. I found one that would order the test kit for me for free. I just have to pick it up and then take it to someone to draw my blood. It was a bit of a puzzle to figure out. The Tax ID and NPI are for insurance purposes as well as the CPT Code.
Here are my Notes:
https://www.aesculapimplantsystems.c...geon_Guide.pdf
Unusual skin cancer linked to chronic allergy from metal orthopedic implant:
Unusual skin cancer linked to chronic allergy from metal orthopedic implant | Newsroom | Washington University in St. Louis
Metal Testing:
CPT Code 86353
Metal in M6-C
Titanium alloy composed of 6% aluminum, 4% vanadium and the balance is Titanium (minute impurities: Nitrogen, Carbon, Hydrogen, Iron, Oxygen, Yttrium).
Mobi-C materials
The Mobi-C disc has three parts: two metal plates and a plastic insert in the middle. The plates are made of a mix of metals commonly used in spine surgery (cobalt, chromium, and molybdenum).
The plates have teeth on the top and bottom that help hold the plates to the vertebrae. The teeth are pressed into the bone with no bone cut out, which makes the Mobi-C design and technique bone sparing.
The outside of the metal plates are sprayed with a coating (hydroxyapatite). This coating helps the vertebrae to grow and attach to the metal plates for long term stability.
The plastic insert is made from polyethylene. The insert is flat on the bottom and round on the top. The insert is made to move as you move your neck.
Melisa Test:
NeuroScience Lab aka NeuroRelief - $400 if cash and $540 if insurance billed.
• Aluminum
• Chromium
• Cobalt
• Molybdenum
• Nickel
• Titanium Calcium
• Titanium Dioxide
• Vanadium
Panel 55605 test kit needs to be ordered.
TAX ID 391841640
NPI 1760576755
Melisa® measures the Type-IV delayed hypersensitivity reaction due to exposure to metals. A Type-IV hypersensitivity reaction is mediated by memory T-lymphocytes that have had prior contact with a given antigen. These profiles are suggested for patients with symptoms of metal hypersensitivity and those who have had possible immunological responses to: dental amalgams and implants, orthopedic and electrical implants, cosmetics and jewelry, foods and cookware, and occupational exposure, as well as reaction to thimerosal, a preservative in some vaccines.
MELISA and LTT:
MELISA and LTT | MELISA Medica Foundation
The Lymphocyte Transformation Test was originally developed in the 1960s for evaluating histocompatible class II HLA antigens. The method was then modified for class II antigen typing and also applied extensively to detecting type IV allergies to drugs, metabolites, infectious organisms and metals. LTT became a common test for detection of allergy to beryllium, nickel, gold, cobalt, chromium and palladium. LTT to beryllium is now accepted as the “gold standard” for diagnosing berylliosis, a lung disease, in USA.
In 1994, Stejskal and colleagues published a modification of the LTT for detecting metal sensitivity – the MELISA test. The reason for the development of a modern in vitro testing tool was that Astra, a large Swedish pharmaceutical company needed a test for the diagnosis of occupational drug allergy for their workers exposed to dust containing beryllium during drug production.
By optimizing of the methodology of LTT, MELISA has improved both the specificity and the sensitivity of the test. Below are the four major changes that MELISA implements, in contrast with LTT.
• MELISA uses a higher number of lymphocytes per test
• The metal concentrations used have been chosen so that they are non-mitogenic and non-toxic
• The test uses partial depletion of macrophages which restores the lymphocyte-monocyte balance so that it is similar to that in the blood
• In addition to objective determination of lymphocyte proliferation by radio labelled thymidine, morphological examination gives an additional reading directly on the level of stimulated lymphocytes
Orthopedic Analysis
Metal-LTT Test
Orthopedic Panel 2
$573.00 due after kit ordered and blood sent in to them. Fed X included.
Coding | Orthopedic Analysis
• Aluminium
• Cobalt
• Chromium
• Iron
• Molybdenum
• Nickel
• Vanadium
• Zirconium
• Titanium Alloy Particles
• Cobalt Alloy Particles
• Bone Cement Particles
• Bone Cement Liquid
TAX ID 202454193
NPI 1821318601
Why Use Metal-LTT?
Despite the amazing success of orthopedic implants to restore movement and quality of life, reports of metal-sensitivity responses have increased recently, such as unexplained pain, effusions, stiffness and/or cutaneous eruptions following total joint arthroplasty. This is because the number of people getting orthopedic implants has increased and the relatively high levels of metal exposure by some types of implants. By avoiding metals that an individual is sensitive to, or diagnosing sensitivity after surgery, surgeons and patients can work together to optimize implant success.
Alternative methods used to diagnose metal allergy reactions, such as dermal patch testing, are not well accepted in orthopedic practice, and actually run the risk of causing metal sensitivity.
LTT assays have been well established over the past 50 years as a test for drug sensitivities. The allergens available to test at Orthopedic Analysis include: Aluminum, Chromium, Cobalt, Iron, Molybdenum, Nickel, Vanadium, Zirconium, Bone cement, implant alloy Titanium particles implant alloy Cobalt particles, and other metals or drugs which may be available by request.
Metal-specific reactivity (or the Metal-LTT Stimulation Index) is evaluated by comparing treated to non-treated lymphocyte proliferation from the same individual. The degree of reactivity is categorized using the following general criteria:
• 2-4 fold response =mild reactivity
• 5-8 fold =moderate reactivity
• >8= high reactivity
Old Codger's Story: https://www.adrsupport.org/forums/f5...t-metal-13020/
FOREIGN BODY REACTION TO BIOMATERIALS: FOREIGN BODY REACTION TO BIOMATERIALS
Unusual skin cancer linked to chronic allergy from metal orthopedic implant: Unusual skin cancer linked to chronic allergy from metal orthopedic implant | Newsroom | Washington University in St. Louis
Could You Be Allergic to a Joint Implant? Metal Implant Allergies | OA Treatment