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Revised PKR to TKR Agilitymom's revision recovery<<

Finally saw the new Dr. away from San Diego. He was very concerned and first thought after seeing my knee swollen, warm and painful was infection. He aspirated my knee right then and took blood for testing. Got back to me this morning and no infection from the testing clinic in Chicago but monocytes were abnormally high. So he thinks it shows that the appliance is loose, again. He thinks it may be the cement is loose and causing problems. So he wants another bone scan done to make sure it is lit up and for me to do a allergy testing through the specialty lab that costs $500. Told him I was all in on both.
This is the first time in 3 years and 2 Dr's that someone has actually agreed with me that something is wrong in my knee and is working to figure it out. Yippee!!
 
So glad to read that you found someone who will actually listen to you, @agilitymom! Hope. that this will lead to a solution soon.
 
Thank God you have found someone to listen to you and follow up on it. We are here for you!
 
This is sounding promising. I'm glad you kept searching for someone else to take a look at your knee.
 
Spoke to my new doctor in Irvine on the phone today. Bone scan done 3 weeks ago shows definite uptake, his words, on my right knee. His opinion at this time is it is loose again as I have suspected. We are waiting on the results from the allergy testing at Orthopedics Analysis done about 2.5 weeks ago. Thought I would have results by now. I sent them an email to see when I should have results.
Has anyone been told that if a previous replacement was done using cement that you can't go backwards and do it completely cementless? My new doctor said that to me today when I asked about it. He said he can do it partially cementless but not entirely since cement had been used before.
So my husband and I are considering this good news, weird I know, but at least this new doctor is not just brushing me off and telling me my knee is fine.
 
I am sorry to read the news you will be facing another revision.
agilitymom said:
Has anyone been told that if a previous replacement was done using cement that you can't go backwards and do it completely cementless?
Click to expand...
I will tag @Jamie, or @Jaycey for an opinion on this.
We're here for support if you need us. Best wishes.
 
When doing a revision, the most important factors are getting a good stable fixation to the bone with the new implant and dealing with whatever bone loss may be present. A cemented revision is the gold standard to best meet these two challenges and it’s what you’ll see just about every surgeon using. That said, I did see at least one older study regarding using a cementless prosthesis in a revision that had some success. But I don’t think it’s a procedure you’ll see supported very strongly in the medical community. Frankly, it’s a rush I wouldn’t be willing to take with a revision.

Is there some reason you think a cementless revision might be a good idea?
 
So good that you finally have a surgeon who takes you seriously, I do too now and have a loose component and rotated implants. It is indeed a “yippee “ moment to find out what’s wrong, even if the way forward is daunting. Do keep posting, it really helps to share experiences.
 
@Jamie my doctor thought allergy testing would show reactivity to one cement so he was talking options. However turns out I am not reactive to bone cement only to aluminum which I read is a small percentage of titanium alloy. My doctor finally called me back today and he is at a loss as to what to do next so he is going to present my case at the meeting next week of local joint surgeons in the area.
Hopefully someone will have an idea. My knee is getting more painful every week and more swollen.
 
That’s sad, you are almost back to square one with getting a diagnosis and a solution. Your surgeon, however, seems to be very proactive and determined help you. Let’s hope that he finds the way forward soon and get’s your life back for you. Wishing you all the best.
 
i am also considering lookin into HSS looking into my case. I am not having much luck with loosening of my replacement and then fixing the problem. Maybe they have seen something like my problem.
 
It's worth checking into, that's for sure. You have been through so much and I know you are sick of it!
 
I agree that a consultation with HSS would be a good idea if you can afford to do that. I know this is frustrating to keep hitting brick walls. I wish I had some magic words to make things improve. But I think the best thing to offer is to tell you not to give up and to keep searching for answers. There has to be something causing this.
 
@Jamie, thanks. My hubs and i agree that figuring this out is worth the cost and efffort. I already paid for the allergy testing so in for a penny etc. At least this surgeon is willing to work with me on it. The other 2 have given up.
 
I’m glad you did the allergy testing. Maybe it will have the answer. :console2:
 
I spoke with a case manager at HSS today. He asked if any prior surgereons had done infection testing on me during the surgery and if so did they culture it for at least 21 days.
I know no aspirations have been tested that long. So my questions are: 1. Is a 21 day culture normal? 2. Is aspirated fluid taken while knee is open and being operated on the same as aspirated fluid taken from swelling knee during an office visit?
The HSS person thought that based on info I had given them, loosening but no lucency on scans or x-rays, and it has loosened up three times that he suspects a fungus or something causing the lunceny that needs to be cultured longer than a week.
Any thoughts? My entire leg, from knee down is so painful that I am cutting my walks shorter every day.
 
agilitymom said:
The HSS person thought that based on info I had given them, loosening but no lucency on scans or x-rays, and it has loosened up three times that he suspects a fungus or something causing the lunceny that needs to be cultured longer than a week.
Click to expand...
I don’t have any answers, but that’s an interesting concept. I hope they can figure things out for you. :console2:
 
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