Total Hip Arthroplasty in a Patient With Alpha-Gal Syndrome

Alpha-gal syndrome (AGS) is an IgE-mediated reaction against galactose-ɑ-1,3-galactose, an oligosaccharide found in mammalian-derived foods and numerous medications containing animal products. AGS is an acquired condition brought about by a tick-borne illness that is increasing in prevalence in the United States. Managing this condition is particularly challenging in the surgical setting, where many commonly used hemostatic and analgesic agents contain animal-derived inactive ingredients. We describe a multidisciplinary approach taken to prevent triggering an allergic reaction in a patient with AGS who underwent total hip arthroplasty leading to a successful recovery. This case highlights important perioperative considerations in patients with AGS and describes a safe pathway to successful arthroplasty in this high-risk population.