Case Presentation

61 year-old male with a past medical history of coronary arterydisease complicated by myocardial infarction in 1984, type 2diabetes mellitus, hyperlipidemia, hypertension, and right totalknee replacement in 2006 presents to the outpatient allergist’s officefor evaluation. The patient reports that he never fully recoveredafter the knee surgery and never regained function. The right kneeremained swollen and painful with limited range of motion andweight bearing as a result. He denies any rash, redness, or itching inthe area. He also denies any history of reactions to metals in the past.The orthopedic surgeon referred the patient to an allergist to assessfor an allergic reaction to various components of the orthopedichardware prior to the right knee revision surgery.