Become an Insider

TKR Lesions caused by metal sensitivity

Can you get an allergy test to check your sensitivity? Might be useful for when you see a new surgeon x


Sent from my iPhone using BoneSmart Forum
 
I had that test done before my surgery. It may be good idea to have it done again to see if I have developed an allergy to zirconium especially since the Aesculap revision implant is covered entirely with zirconium. I think I will contact my doctor to have it done again. Thanks cherub.
 
ucsbgal1971 said:
10-15% of patients have allergies to nickel
Click to expand...
That's 10-15% of people. But allergies to nickel in the population do not necessarily infer allergies to implants as the internal tissues don't react the same as skin.

We have an article about implant allergies here Metal allergy in joint replacement. It contains a link to another testing laboratory. However, a word of warning about them - they invariably include many results which may not directly apply to a patient with a joint replacement.
 
I did have a second test from a Colorado facility and I am so glad that I did. The second test contained copious notes about everything but the kitchen sink that could be used medically that I may have an allergic reaction to. I found out that one was heart stents. Who would have known?! My father had a stent and several of my friends did as well. If I ever need such a procedure thank goodness I know that I am allergic. I never would have thought of such a thing. I really am grateful for that other test that literally includes almost everything. I think I killed two birds with one stone so to say.
 
Joesphine, Dr McPherson has been studying patients who have allergies to the implants and he feels that if a person is allergic to nickel, they will have an adverse reaction. He has treated 46 such patients recently and presented a paper on his findings at a recent conference. I have to agree with him that it is absolutely too risky to have an implant installed that contains nickel if one is allergic to nickel. Revisions are more difficult than tkrs. The opportunity for infection is higher with revisions etc. Since there are alternatives out there that do not contain nickel, there is no good reason to have an inplant installed that contains nickel if one is allergic to nickel. The consequences can just be too dire.
 
ucsbgal1971 said:
Revisions are more difficult than tkrs. The opportunity for infection is higher with revisions etc
Click to expand...
Really? Well I never! All those years scrubbing for revisions and I never noticed the difference! And that's not sarcasm, honey - that's fact. Generally speaking the notion that revisions are more difficult is not altogether true as it depends why the revision is necessary but generally, in skilled hands they aren't that much different from primary knees.
 
Josephine I so hope that is accurate and true for me! I can only go by what the two docs told me. I was told that TKR's take an hour or so whereas revisions can take up to 3 hours or more. Because of the longer time for a revision, infections are more prevalent in a revision than in tkr's because the tissues are open to the air longer. That is the main problem besides being under for a longer period of time which is also risky I guess. Of course the other risk is bone loss which can be dealt with but who wants to deal with that?! What they told me is what I read online about revisons as well. I am starting to think I should come to England for this revision if it is as easy as a tkr in your country. Have you got a spare room to rent out? : ) I can imagine that each surgery is different so maybe some are a peace of cake but perhaps the average one is not. I can only go by what I have read and been told by my doctor. I won't be able to report actual experience obviously until I have gone through and come out the other side. I definitely hope you are right. BTW they fill out a rating sheet in this country as far as your chances of getting an infection. I only got a C rating. I keep telling myself that is average but I would rather be an A or B or above average going in for sure. Maybe they tell people things like that so that their expectations aren't high to prevent lawsuits. I can't think of another reason for my doctor to mislead me regarding revisions. It is difficult, for me at least, to remain positive when doctors tell me these scary things. It is definitely helpful to hear more positive things from your experience.
 
Last edited by a moderator:
I had a revision from a PKR to a TKR. For me, the recovery was no different (maybe even a little easier?) than from the original surgery.
In the hands of a skilled surgeon, a revision is nothing to be afraid of.
 
Thanks Celle. I have just about decided to forget the surgery and deal with the pain.
 
Last edited by a moderator:
It's your knee and your choice, but be assured that, if ever the time comes when you say "Enough! I've reached my limit", a revision is not as terrible as we imagine.
 
ucsbgal1971 said:
Maybe they tell people things like that so that their expectations aren't high
Click to expand...
Bingo! Well, actually, yes and no. They are obliged to tell patients the risks on the grounds of 'freedom of information'! Can't say I enjoyed them reading off the check list of possible complications either only minutes before surgery but it has to be done. So nothing you were told is a blatant untruth except for the possibility of it being taken as inevitable rather than a risk! I wasn't seeking to make light of your plight, truly I wasn't but it is a fact that most of the revisions I've ever scrubbed for weren't that complicated and didn't take that much longer than a primary. But then a again, it depends what the revision is being done for: if it is an infection or a periprosthetic fracture then yes, it did often take around 3-3½hrs but for loosening or treating an idiopathic pain, in good hands it wasn't that much longer or more difficult than a primary.
 
I am so happy happy i had my revision. 12 weeks post op and i dont regret it. I lost more of my femur bone that they would have liked and some tibial but these were filled out with augments. My surgery took 4 hours but they were really trying to preserve as much bone as possible ( im 43) i have none of the pain i had pre op. The difference in swelling is amazing. I have better rom. I know i may possibly only get 10 years out of the revision. But in comparison to how i was im glad i did it. I am finding recovery easier this time around. Sure theres some niggles and swelling if i do too much. But im getting better. With the primary i just wasnt recovering and in constant pain swelling. I was terrified of getting a revision. The os told me all the complications. Just wanted to say from a revision point of view how its went for me. Wishing you the best of luck as its not an easy decision to make x


Sent from my iPhone using BoneSmart Forum
 
Cherub, It is wonderful that you are doing so well and comforting to hear of a success story. I went back to see Dr. McPherson today with a list of questions. He decided to do another allergy test to see if my titres are up from the last test before my first surgery. I like Dr McPherson but I don't like the hospital and his office looks pretty worn. After having my first surgery at Cedars in Beverly Hills, which has a brand new state of the art operating room that is like something from a science fiction movie that even has special lighting on the floor to kill germs, it is hard to go to a poverty stricken hospital that is up for sale, looks very run down, and is in a bad part of town. I don't know if I will be safe there. Dr McPherson's reviews are good but I can't get beyond appearance of things. Also, he doesn't believe in putting stuff in the nose to ward off MRSA infections. I am surprised at that. Unfortunately, he is the highest rated doctor in the area who uses the Aesculap revision system. I wouldn't consider the other doctors because of their low patient ratings. Apparently the system is very expensive so most docs in the U.S. don't use it.
If I travel to Tennessee or Alabama there is a Dr Siegel and a Dr. Milhalko who use this implant the most. I would have to go there alone and not have an advocate with me if I run into trouble so not sure that is a good idea. Anyway, am overwhelmed with the whole thing and have decided not to do anything and put it on the back burner, and just live with the pain for now. BTW is it not common practice to put stuff in the nose before surgery to ward off MRSA infections?
 
I believe the nasal swab is to test for MRSA, not treat it.
 
I had a pre-op test where my nose was swabbed to see if I tested positive for MRSA. If I had, I would have been given an ointment to use.


Sent from my iPhone using BoneSmart Forum
 
Yes, I had the same pre-op test. They just swab your nose to check for MRSA then if it's positive, they have to treat you differently as a patient.
 
To my knowledge, I had no such test. When I was talking to the hospital to schedule my surgery, I asked about Hibiclens, and she said, just wash with an anti-bacterial soap like Dial (which I already use). Protocols vary widely.

I understand your concerns about the hospital, and I can only suggest you share your concerns with Dr. McPherson and give him a chance to address them.
 
You must log in or register to reply here.
Active Antimicrobial Hydrogel
Corganics CBD

Staff online

Members online

Total: 616 (members: 2, guests: 614)

Latest posts

Back
Top Bottom