Last reviewed: September 29, 2026

Yes. A skin allergy to nickel, cobalt or chromium does not rule out a knee replacement, and for most people it does not appear to change the result.

Most knee implants are made mainly of a cobalt-chromium alloy that contains a small amount of nickel. In most studies, people with a nickel allergy had the same pain relief, function and redo rates as people without one. This held whether the allergy was self-reported or confirmed by a skin test. Not every study agrees. One found lower function and satisfaction scores in people who reported a metal allergy. A large insurance-records study found more redos in people with a metal allergy diagnosis. Neither shows the allergy was the cause.

Special implants exist. Some are made from other metals, such as titanium alloy or oxidized zirconium. Others are standard implants with a protective coating. In people with a nickel allergy, results with these and with standard implants have been about the same. In trials of people without an allergy, coated and standard implants did equally well for ten years. A German registry found more redos with coated implants. But many of the people who received them had a metal allergy, so the coating may not be the reason.

Testing before surgery is not routine. It is usually reserved for people with a real history of metal allergy. The two tests are a skin patch test and a blood test. Neither predicts well how a new knee will do, and positive results are common in people whose knees work well.

In general:

  • A metal allergy on its own is not a reason to avoid a knee replacement.
  • Tell your surgeon about any past reaction to jewelry, eyeglass frames or other metal.
  • Ask your surgeon whether testing or a special implant makes sense before surgery.
  • A rash, or pain and swelling that do not settle after surgery, has many possible causes. Allergy is considered only after infection and loosening have been ruled out.

Drafted with AI assistance from published sources, reviewed and edited by Babak Sheikh, MD.

Sources:

This is general information about what published research shows. It is not medical advice and it is not about your situation. Reading it does not create a doctor-patient relationship with me. I am a retired orthopedic surgeon and I do not see patients. Talk with your own doctor before changing anything about your care. If something feels suddenly or seriously wrong, get medical care promptly rather than waiting.

This page is provided as is. I make no guarantee that it is accurate, complete or current, and medical evidence changes. Use of it is at your own risk.

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