TKR Effusion & neuropathy

I just got the results of my blood analysis for metal allergy and it came back "highly" sensitive to Nickel. You'd think the operative notes on my knee replacement would mention what make and model of implant went in, but it doesn't. So I will have to call Monday to see if it's in my file. The surgeon has retired and not sure how things were left.

My PCP found some research that led him to believe this test is of dubious value. (I have to laugh, because physicians have been doing dubious things for decades as those things were perfectly valid.) He stated that if the test results came back abnormal, he isn't going to know what to do. That's fair, for him to say he's not in a position to act on the results.

Well, I'll see what my implant is before deciding what to do. Is there a website that lists implants and their metal makeup?
 
You probably saw this already but I'll paste it here anyway just in case.
https://bonesmart.org/knee/knee-replacement-implant-materials/
You make me wonder if I should get the same test done. I also have had trouble with weird pains in my TKR and neuropathy as well. Mine was done in Sep 2013 and I need to get the other done. It's falling apart :-/
 
Nickel allergy test came back "highly sensitive." My PCP acknowledges this could be the source of my significant effusion every since 2010 TKA. He however cannot find any research showing that having a knee one is allergic to causes neuropathy, as if to say that connection is unlikely. A third of people with neuropathy have no known cause so who's to say a joint implant might not be one cause?

Wondering if there's a way to put feelers out to see if there are others who developed neuropathy after a joint replacement. @Josephine @skigirl
 
What you've said is perfectly correct. Generally there is no known cause of neuropathy so it would be unwise to therefore assume that it is in anyway connected to the implant.
 
Generally there is no known cause of neuropathy so it would be unwise to therefore assume that it is in anyway connected to the implant.
Interesting @Josephine - I can see where there may be no known link between an implant and neuropathy. It does seem unlikely. It seems like there is still a great deal to learn about the human body. I still think I'm going to get myself tested before I go ahead with my second knee - which is really starting to fail me.
@maryo52 please let me know if you find a site linking metals and implant types. I really thought I was told my implant was titanium not cobalt and nickel.
take care.
 
People have been known to be sensitive to titanium too!
 
Actually not ceramics!
 
@Josephine, would a metal allergy make you extra tired and achy all over? Or is it just pain around the knee area?
 
Has somebody said this is cause and effect?

Actually those kinds of issues can cause all sorts of symptoms, including fatigue.
 
Has somebody said this is cause and effect?
No, a person not on here asked me. I said I'd ask you. When I looked it up, I didn't see those things listed as symptoms of a metal allergy. But, I still wanted to get your opinion. Thank you.
 
Saw my surgeon yesterday - he told me I definitely do NOT have a metal allergy. He told me I would know if I did. I would have effusion and limited range of motion.... hmmmm.....
 
Wonderful that you now know you don't have a metal allergy! That's one worry off of you.
 
Oh, I thought you had had the blood test for metal allergies. It would be probably be best if you did get one to rule it out totally. I will before my next implant.
 
Oh, I thought you had had the blood test for metal allergies. It would be probably be best if you did get one to rule it out totally. I will before my next implant.

Well - I got the patch test done ... no allergy.

:)
 
We recommend the complete blood test. The patch test is very inconclusive. Make sure that whatever metal testing you have done is the expanded test. Here in the states it's only done by a lab in Chicago. I'm not sure how metal testing is done in Australia, but I'd ask. Here's the link to the USA website. You want the Orthopedic Panel 2:

https://www.orthopedicanalysis.com/testing/order-testing-panel

Research is finding that some of these allergic sensitivities can be fairly difficult to diagnose, but they can really affect an implant's performance. You want to be able to completely rule this out along with the RA and lupus.
 
Here we go again. I guess. My 8 year old TKA with chronic issues of laxity and effusion is apparently getting overly lax. I hyperextend and the valgus has increased. I saw a local orthopedist (my TKA surgeon retired); I was warned of ligaments stretching out, and there is a question of tibial implant loosening. It seems that to keep going is to only delay the inevitable.

I would like to hear people's experiences and wisdom regarding insuring a good outcome for a revision. My state of Maine has an excellent ortho/revisionist, Dr. Becker, who friends have used, a three hour drive. But when I sought a second opinion a few years ago, I went to Dr. Andrew Freiburg at Massachusetts General Hospital in Boston, and apparently he's top drawer. It's 6 hours away. As much as I loathe going to Boston for surgery, I'm thinking that my decision should be based on the best possible surgeon rather than convenience. Your thoughts?

I also learned that I am highly sensitive to nickel. I have cobalt-chromium components and am told the nickel allergy isn't an issue. Anyone have experience one way or another?

The bottom line is I'm scared because my TKA was a nightmare due to arthrofibrosis. You get the 3rd degree from physical therapists, whose best efforts make you worse. My knee came out bulbous and with that effusion it's still bulbous; whatever causes that, I fear, is linked to the arthofibrosis, and going through that again is a hard thing to think about.

Any wisdom, suggestions, etc. appreciated!!
 
Maryo52,
Good to see you, sorry to hear you may be facing a revision.
I agree with you about choosing the best possible surgeon, even if it means traveling.
The OS will select a nickel free implant, knowing about your allergies.

@lovetocookandsew had a revision this last summer, for a nickel allergy, arthrofibrosis, her implant was loose.

All the best in your search for answers.
 

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