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Reason for reaction to metal after surgeries in ankle.

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I am a 47 year old female who has had 18 surgeries on my right ankle due to non-specific/benign/yet aggressive bone tumors in my talus. Over time I've discovered I am allergic and/or react to every piece of orthopedic metal put in me. It causes an extreme reaction and needs to come out. I've also had significant allergy issues with most opiate drugs.

My graft failed, once again, and I am about to go have my 19th surgery to try to repair and incorporate the graft in my foot. I recently went to an immunologist and he did some testing, attached, and says my immune system appears deficient.

I am trying to create the best outcome for this next surgery as I know my options for further surgical intervention are few and I need the graft to incorporate.

I saw an endocrinologist who suggested a short-term course of Forteo. He did blood work and it came back anemic, vitamin D deficient and my CRP was normal-high.

I'm very concerned about the CH50 test and the Pneumococcal tests as I've had significant issues with post-op infections and I need to make sure my body is ready for this new challenge.

Christine Atkinson

Category: Orthopedic Surgeon

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Category: Spine Surgeon
 27 Doctors Online

Thank you for your query at
Thanks for writing your problem to us. You seems to be in lot of pain.
I have read your history and saw the attached reports. Your ankle bony structure is grossly osteoporotic with fusion at multiple joint line levels mostly because of your old ankle problem. Currently a fracture can be seen at talus bone region.
Looking at the current situation, grafting appears to be the best solution out which will help in better healing. One can go for autograft, to increase the graft acceptance by body and reduce the immue related complication chances.
Looking at the osteoporosis of you ankle bone and vitamin D deficiency, teriparatide (forteo) is one of the well advised treatment. It is well documented also with good out come. I suggest you to add oral calcium and Iron pill also in your treatment after discussing with your treating doctor.
Please feel free to ask further queries,

Dr. Karun Jain
Category: Spine Surgeon
MBBS, 2002 - Kasturba Medical College, Mangalore
D.Orth, 2009- J.S.S Medical College, Mysore
MS - Orthopaedics, 2011 - University of Seychelles - American Institute of Medicine
Currently pursuing ChM (Trauma & Orthopedics) from The Royal college of Surgeons, Edinburgh & University of Edinburgh, U.K
Dr. Karun Jain and 4 other Medical Specialists are ready to help you

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