Revision TKR Hetrotopic Ossification or Metal Allergy after BTKR

[Angelstalk1111]

Hello
I have been told that I have Hetrotopic Ossification (bone growing back in to soft tissue) and had one revision surgery after total knee replacement and it happened again. Have you found anything that has helped the excruciating pain? I also had a metal test done and it revealed that I am allergic to nickel. I am not guaranteed that if that do a revision surgery at 61 and place a prosthetic without nickel that I won't have OA again? I have been in extreme pain since 2013. Have any alternative therapies worked for you other than lots of traditional p.t.?
Thank you so much!

 

[Cjackso21]

Hello, I too had problems with loosening of my metal components. Blood testing revealing I was allergic to nickel. After a revision knee replacement with titanium, had problems again a few years later. New doc said it can’t be due to nickel because my left TKR. He did another knee replacement and problems went away. Only difference was that he used robotics and recovery was 100% easier than previous one. But after so many surgeries, my ligaments stretched so I have to wear a brace. But no pain. Wish you luck!

 

[Layla]

Hello and Welcome to BoneSmart. Thank you for joining us.
I am sorry for all you're dealing with. We do have a current member on the hip side dealing with HO.
not what I expected

Just five days ago, Jamie, from Admin posed this question to that member, Mr.fun.
Jamie typed the following -
"I wonder if you would be interested in getting a review by the surgeon team at the Hospital for Special Surgery in New York City? They will review cases via telemedicine, but there is a cost….I believe it’s about $600. If they had recommendations, you obviously would have to travel there for the treatment. They do this frequently for residents of the US and have hotels and other support available at reasonable costs. This process does work for people who are willing to travel for treatment. If you had the review now, they might decide there was something they could do now and not make you wait until the ossification had stopped growing."

Just wondering if that may be a consideration for you? If not, I understand, just thought I'd mention it as an option. Hopefully you'll receive other feedback in regard to the HO and metal allergy. Please share the date of your Bilateral (?) TKR so we're able to create a signature for you. It will be helpful to those stopping by your thread. If it wasn't a bilateral surgery, please identify when each TKR took place, as well as the revision and which knee it involved. Thanks in advance and best wishes for resolution with perfect healing. @Angelstalk1111

Heterotopic ossification

 

[Layla]

I will also leave our Recovery Guidelines in case your last surgery was recent.

In addition, you can use the SEARCH at the top right of the page, typing in key words or phrases such as Heterotopic Ossification, or nickel allergy, and all of the threads where its been mentioned will pop up.

KNEE RECOVERY GUIDELINES

As you begin healing, please keep in mind that each recovery is unique. While the BoneSmart philosophy successfully works for many, there will be exceptions. Between the recommendations found here, your surgeon's recovery protocol and any physical therapy you may engage in, the key is to find what works best for you.

1. Don’t worry: Your body will heal all by itself. Relax, let it, don't try and hurry it, don’t worry about any symptoms now, they are almost certainly temporary.

2. Control discomfort:

rest​

elevate​

ice​

take your pain meds by prescription schedule (not when pain starts!)​

don't overwork.​

3. Do what you want to do BUT

a. If it hurts, don't do it and don't allow anyone - especially a physical therapist - to do it to you​

b. If your leg swells more or gets stiffer in the 24 hours after doing it, don't do it again.​

4. PT or exercise can be useful BUT take note of these

the BoneSmart view on exercise​

BoneSmart philosophy for sensible post op therapy​

5. At week 4 and after you should follow this

Activity progression for TKRs​

The Recovery articles:
The importance of managing pain after a TKR and the pain chart
Swollen and stiff knee: what causes it?
Energy drain for TKRs
Elevation is the key
Ice to control pain and swelling
Heel slides and how to do them properly
Chart representation of TKR recovery
Healing: how long does it take?

Post op blues is a reality - be prepared for it
Sleep deprivation is pretty much inevitable - but what causes it?

There are also some cautionary articles here
Myth busting: no pain, no gain
Myth busting: the "window of opportunity" in TKR
Myth busting: on getting addicted to pain meds

We try to keep the forum a positive and safe place for our members to talk about their questions or concerns and to report successes with their joint replacement surgery. While members may create as many threads as they like in a majority of BoneSmart's forums, we ask that each member have only one recovery thread. This policy makes it easier to go back and review history before providing advice.

 

[WFD]

@Angelstalk1111 , I had heterotopic ossification after my first two surgeries, a TKR and an open lysis of adhesions. As you know, the sharp bony plates in the quad were very painful.

When I had my next two revisions, I had a different surgeon, a revision specialist, who was more skilled, and who also put me on celebrex after the surgeries. The H.O. did not recur. I don't know whether it was the surgical skill or the celebrex that did it in my case, but a study showed that NSAIDs after surgery reduced the likelihood of developing H.O., and celebrex worked the best. It was theorized that it works by disrupting the process of formation of the excess bone, so it would only be helpful immediately after surgery. Obviously you shouldn't put yourself on NSAIDs right after surgery without your surgeon's agreement because of the risk of bleeding.

If it were me, if and when I opted for a revision, I would insist on 90 days of celebrex, even if I had to pay out of pocket for it.

I don't know whether the metals allergy can cause H.O. formation, but it sure doesn't help anything.

If you do go for a revision, I'd suggest you find a different surgeon, the best revision specialist you can find. Where are you located?

 

[Angelstalk1111]

I am in Iowa. I actually used NSAIDs and my surgeon had me undergo radiation prior to the revision surgery as he said that is a way to try to treat the OA coming back during the revision.
I was asked when my double knee replacement was and it was in July 2013 and I believe my revision surgery on one new was in 2015.
Thank you for responding!

 

[Angelstalk1111]

I accidently changed my status to unwatch and I don't know how to change it. Thank you Layla and Cjackso21 for your responses as well. I appreciate it.

 

[Layla]

Hi again, wondering which knee was revised for your signature. Right, or Left?

If I am understanding you correctly, go to the navy navigational bar a the top of the page and click on your user name. A small box will pop up with two columns of options. I believe you want "Preferences" in the column on the left to make changes. Let us know if you're having an issue and we'll help.
@Angelstalk1111

 

[Angelstalk1111]

Hello
My revision was on my left knee. Thank you for the instructions! I will give it a try.