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Body rejecting cement

Discussion in 'Knee Replacement Recovery Area' started by Rattlesnakeman, Sep 5, 2011.

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  1. Rattlesnakeman

    Rattlesnakeman Junior Member

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    Wednesday evening we went for a short walk. Towards the end of the walk my right knee started to hurt and I could barely put weight on it. We were at the walking trail and by the time we got home the knee was swollen twice it's regular size. Any movement caused very sharp pain.

    I went to my Orthaepedic Surgeon on Friday and he thought it could be that I had "popped a bleeder" which he said was popping a vein allowing blood into the knee and below causing the swelling and the pain. He drained a significant amount of dark blood from the knee.

    During my visit he detected some play in the knees and decided to x-ray them. He told me that it looks like my body was rejecting the cement used during the total knee replacements at the tibia. He wants me to come back in one month for more x-rays. He stated that rejection of the cement was very rare. Does this sound reasonable to anyone?

    Right knee total replacement October 15, 2010
    Left knee total replacement December 1, 2010

    I also was diagnosed with a GIST tumor in May. They took out a baseball size tumor, my appendix, two lymph nodes and 12" of small intestine. Am taking a chemo drug by mouth. Do you think this can have any bearing on the cement issue?

    It's been a tough year! :hissyfit:
     
  2. Jamie

    Jamie Administrator

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    I don't know that I've heard of anyone on BoneSmart experiencing rejection of the bone cement. I suppose a serious cancer drug might have an impact, but for non-medical me....that's just a guess.

    I'll tag Josephine so she can respond. @Josephine:

    Sorry you are having problems. You have been through so much!!! Hang in there and let us know how things go.
     
  3. PhoenixS

    PhoenixS Forum Advisor

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    I am so sorry to hear this.
    Life does never go the way we planned, doesn't it.

    I also have never heard of having a reaction to the cement.
    I thought it was made up inert ingredients.
    Is the tibial implant loose?
    Seems kind of odd, you started the walk OK and ended with swelling and pain. You didn't slip or anything? It would seem if you were rejecting it, you would have had slowly worsening in your knee. This seems kind of sudden.
    Wait for Jo to weigh in.
    are you feeling well cancer-wise?
    Best,
    Sandy
     
  4. janlyn48

    janlyn48 Sr Bonesmartie

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    Rattlesnakeman, are you taking mercaptopurine (6mp), or even imuran, by chance? They are chemo drugs and can cause joint pain. Maybe you could talk to your oncologist about it?
     
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  5. Jamie

    Jamie Administrator

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    Excellent point Janlyn!!!
     
  6. Rattlesnakeman

    Rattlesnakeman Junior Member

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    Thanks all for asking, I am doing fine cancer wise. Am taking Glevec, it was originally made for Lukemia but they have recently started using it for GIST tumors. The cancer is not cureable at this point but they think they can keep it in remission with the Glevec.

    The pain from the walk seems to have been due to a vein bleeding. I was unaware of the cement problems until I went to see my OS. Have always had some pain in the knees but thought that was just the way it is.

    KC
     
  7. Josephine

    Josephine Forum Admin and Mother Hen Administrator

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    Hi, KC. I am so sorry to hear of all this. However, I am a bit confused so let me address this point by point
    That's a very odd conclusion to come to after 11 months! :scratch: Veins don't just 'pop' for no good reason and the only reasons I could think of are inflammation or abrasion on something like a stray piece of cement (but would imagine that would have happened long ere this). But even so, it strains the imagination that it would be in such a place that it would cause a haemarthrosis (blood in the joint).
    This is also an odd conclusion to come to just from one xray. Much more likely that either a) the implant is just loose or b) there is a late onset infection. Give the aspiration of dark coloured fluid, I'm thinking more likely the latter.
    You could say that again! I trust you are seeking a second opinion from a superior knee revision specialist? :wink1:
     
  8. Bumpa

    Bumpa Forum Advisor

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    Josephine, as always (!) your comments are excellent. I did read, however, that occasionally the body just rejects against a large foreign body - but hardly at this time post-op
     
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  9. janlyn48

    janlyn48 Sr Bonesmartie

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    Sorry about all your issues. :frown:

    I'm definitely not a medical professional, but perhaps it would still be a good idea to question your oncologist about the side effects of your chemo drug?

    I mean, if glevec is an immunosuppressant, maybe it makes artificial joints more susceptible to infection.

    Maybe that's a question Josephine can answer.
     
  10. Josephine

    Josephine Forum Admin and Mother Hen Administrator

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    You have a very good point, Jan.
     
  11. Rattlesnakeman

    Rattlesnakeman Junior Member

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    When I got up from my desk at approximately 5:30 PM, my knee started swelling with pain again. Had been out working claims and driving most of the day, I am a property insurance adjuster, and at my desk since 2:00. No signs of pain out of the ordinary but when I stood up there was a sharp pain in the knee and then big swelling again. It hurts to try and lift my leg, enough pain that I can not stand it. Any movement causes extreme pain. This is exactly they way it acted the other day and my OS thought I "popped a bleeder". The pain is still severe and throbbing. The leg is starting to look purple, not as much as last week and there is heat at the site. Does anyone have any idea what could be causing this?

    Thanks,
    KC
    :scratch::hissyfit:
     
  12. Jamie

    Jamie Administrator

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    @Josephine:

    KC.....I do think you need to find another OS right away. You have someting going on in there that needs attention. Please don't wait and just let it go. Jo may have some specific ideas. But I frankly think what is going on is beyond your original surgeon. You need a revision specialist that is used to seeing unusual cases like yours.
     
  13. Josephine

    Josephine Forum Admin and Mother Hen Administrator

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    I totally agree. It needs urgent and pro-active treatment.
     
  14. Rattlesnakeman

    Rattlesnakeman Junior Member

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    I visited with another OS. He has done many TKRs and many 2nd surgeries. He said that the xrays do show a gap at the top of the lower legs which is much wider than it should be at one year out. Since there is no pain involved we are just going to do "serial xrays" and keep an eye on them.

    On the swelling, pain and purple color of the knee and below, he stated that he has seen a few people where a vein will bleed with the symptoms of the swelling and purple color in my lower leg. He said that if it does happen it will normally not be more than 2-3 times with the pain and swelling being less each time. It happened to me twice and the second time was not as severe.

    The Dr. did say that once in a very great while they will have to go back in and cauerize a vein. All in all it seems that everything is not too bad and that we plan on living for at least 30-40 more years :)
     
  15. Josephine

    Josephine Forum Admin and Mother Hen Administrator

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    Good outcome! I've seen a lot of people with that bruising and never yet seen an occasion we had to go back in.
    Usually a compression bandage for the first 24hrs would suffice.
     
  16. Jamie

    Jamie Administrator

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    Thanks for posting an update, Rattlesnakeman....I've been wondering how you are doing. I'm glad you were able to see an excellent surgeon who could accurately address your concerns.

    Let us hear from you when you have time to post.
     
  17. Bees Knees

    Bees Knees Senior

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    I hope things continue to improve. You have been through alot and deserve good news!
     
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