Safety of Bovine and Porcine Derived Orthopaedic Implants: Growing Concern for Alpha-gal Syndrome

Background Alpha-Gal Syndrome (AGS) is a growing concern, particularly in the Northeast United States. AGS is most known for the gastrointestinal and integumentary manifestations after consuming bovine or porcine derived products. Hypothesis/Purpose The purpose of this manuscript is to highlight the growing concern of the safety of bovine and porcine derived orthopaedic implants, as they relate to the AGS population. This article reviews the available literature on orthopaedic porcine and bovine implants in the AGS population, and future avenues of research Study Design Narrative Review Methods Literary search using available PubMed and Embase. Results People can develop AGS after being bitten by Lone Star Ticks carrying galactose-⍺-1,3 galactose, which once introduced to the human immune system, illicits an immune response to subsequent exposures. Being a common carbohydrate found in bovine and porcine derived products, this immune sensitivity makes it dangerous to ingest. Conclusions Upon search of the orthopaedic literature, there are no studies researching the immunologic impact of porcine and bovine derived bioprosthesis and patches that would mirror the studies performed in other fields of medicine. There theoretically remains the potential risk of AGS/meat allergy transmission from bovine and porcine derived orthopaedic implants in the field of sports medicine. Clinical Relevance There are many orthopaedic biological augments/implants that are derived from bovine and porcine sources. Implants have been investigated in cardiology, demonstrating dangerous effects on the survivability of the implants in the AGS population. Little is known about the effects of orthopaedic porcine and bovine implants on the AGS population.