TKR Lesions caused by metal sensitivity

[sistersinhim]

I am so sorry to read of all you're going through. I agree that you should get all the information you can and document it. There is an OS somewhere out there that will help you. I pray that you will find that person.

 

[ucsbgal1971]

Thank you so much! Prayers are what I need at this point.

 

[ucsbgal1971]

Does anyone have any experience with either allergic reactions to implants or PICCS that are used in lieu of IV needles?

Can a person continue without having another revision if one is allergic to the revised knee implant or is continuing to leave it in your body dangerous?

Other than a large discoloration on my skin and itching, I don't have any symptoms of the allergy. My knee is working pretty well. I can't get a new doctor to take my case. I think it may be because they fear getting involved in litigation since a hole was blown in my leg and a large quantity of bone cement leaked into my leg.

I have told doctors that I am not interested in suing anyone but they still won't help me. It is a real problem. Also, I have a continued pain under my armpit since they gave me a PICC because they couldn't put in the needle for an IV. At least I think the pain was caused by the PICC but not entirely sure. I had an ultrasound but nothing was seen on that test. Is there anything else that might be considered to figure out what is causing my pain? The pain goes down from my armpit to my elbow and sometimes to my wrist and middle two fingers. Thanks.

 

[Jockette]

I’m so sorry things are not resolving for you and that doctors don’t want to take you on.

I’ll tag @Josephine for you to address your questions.

 

[ucsbgal1971]

Thank you.

 

[sistersinhim]

I hope you can get some answers really soon!

 

[Josephine]

Also, I have a continued pain under my armpit since they gave me a PICC. At least I think the pain was caused by the PICC but not entirely sure.

I think you may have radial nerve damage caused by the needle used to set up the PICC line.

It is entirely possible to get nerve damage from an intravenous catheter inserted into the cephalic vein which causes an injury to the superficial branch of the radial nerve. When an IV catheter penetrates a nerve, it can cause temporary or permanent damage.

Recovery from nerve damage may take only weeks or a year or more. Some patients, however, may sustain lifelong damage depending on the severity of the needle stick to the nerve.

(https://www.ncbi.nlm.nih.gov/pubmed/10876452)

 

[maryo52]

I guess you have to find a surgeon who fixes messes. Most surgeons don't. So that may be the reason. You have to go to a major orthopedic department to get someone who deals with the problems you describe. (I ended up with someone at Massachusetts General Hospital.)

Not sure the background of your allergy issue but I had blood drawn and sent to Orthopedic Analysis in Chicago and found to be "highly sensitive" to nickel. So my revision will be with titanium components.

 

[ucsbgal1971]

Hi Josephine, Thank you for responding though that isn't exactly what I was hoping to hear for sure. I bet you are right. It has been 8 months since my surgery. Hopefully it will heal in a little more time. I wonder why my family doctor didn't tell me that? I truly am becoming disenchanted with doctors. Do you know is there anything that I might be able to do to encourage it to heal like not exercising or lifting or something or would using it be good? Thanks again. Pam

 

[ucsbgal1971]

I am sorry I can't remember how to get back to my original thread but I have a serious problem following my right knee revision and hope I can find an answer here.

I recently had to have a CT scan for another reason and it was determined that I now have lesions on my kidney, liver, pancreas, and lung. I also have developed a deep cough in the mornings. No doctor could figure out why this is so.

It was thought that perhaps I had a fungal infection called Valley Fever but I tested negative for that. Then I came upon a study that indicates the metal from knee and hip implants can cause serious illness including lesions on ones internal organs. Has anyone out there ever heard of this or experienced this problem?

I guess I will have to have my revised knee implant removed. It is an Aesculap knee made of zirconium which I now test positive for allergy but did not prior to having the implant installed in my body.

I would greatly appreciate any comments I am scared to death.

Apparently when the metal ions get into your blood stream it can affect your brain, eyes, and other organs. The doctor also blew a hole in my bone and a very large amount of bone cement leaked into my tissues. This also may be the cause of the lesions.

Does anyone know of a doctor who might be knowledgeable about this problem or have experienced the same problem? Thank you in advance for responding.

 

[Jaycey]

@ucsbgal1971 I merged your new thread into your existing recovery thread so that we have your history in one place. Here's an article on How can I find my threads and posts?

Very sorry you have developed this reaction. I'm going to tag @Josephine for her input on this.

 

[Josephine]

My dear, I'm so sorry you're getting all these problems. I don't wonder you are scared.

Then I came upon a study that indicates the metal from knee and hip implants can cause serious illness including lesions on ones internal organs. Has anyone out there ever heard of this or experienced this problem?

Yes I have heard of this but it was an awfully long time ago. It would help if you could give me the link to the study you mentioned.

The doctor also blew a hole in my bone and a very large amount of bone cement leaked into my tissues.

I don't understand what you mean by "blew a hole in my bone". I've certainly never heard of bone cement causing issues like this. Not ever.

 

[ucsbgal1971]

If you google Clinical Cases in Mineral and Bone Metabolism you will find several articles. The one I read is at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3710008/.

Under the systemic effects of metal ions it says, "Most in vitro and in vivo studies that have been published in the literature are related to the effects induced by Cr and Co. Other known potential toxic ions released by orthopaedic implants are Titanium (Ti), Aluminum (AL), Vanadium (V) and Nickel (Ni). Co, Cr and possibly Ni and V are normal components of some enzymes of our body. They mus be introduced with the diet, but become toxic at high dosage. Co toxicity can affect many organs, and can cause various type of symptoms: neurological (tinnitus, vertigo, deafness, blindness, convulsions); cardiological (cardiomyopathy); hematological (polycythemia); and endocrine (hypothyroidism). Cr seems to be less cytotoxic but more genotoxic than Co. It induces tubular necrosis and interstitial cell damage which can result in impaired renal functioning. Also potentially severe hepatic lesions have been described..." Since it mentioned hepatic lesions and I now have a lesion on my liver, as well as kidney, pancreas, and lung, I started to wonder.

I am not a doctor so I am hoping I am putting two and two together and getting the wrong answer but something has to have caused the lesions and nothing is different except my knee revision surgery which resulted in bone cement leaking into my leg, a big allergy to something which the doctor just avoided discussing. It made a huge red sore on the side of my knee and there is still a mark from it. The knee sometimes itches and sometimes burns but not all of the time.

When I had my knee revision, I noticed on an xray that I had what looked like fireworks or star bursts through the lower portion of my calf that I had never seen on any of the previous X-rays taken of my knee. When I asked the PA what it was he explained that they had accidentally blown a hole in my bone and that bone cement had leaked into the tissues. The doctor did not mention that this occurred in the operative report but did admit to it when I asked him about it. He said it was nothing to worry about unless it started to cause me pain.

Now I test highly positive for an allergy to aluminum which was normal in two previous allergy tests and I test positive to Nickel, Vanadium, Molybian, and Zirconium. The only thing I tested positive to the first time I was tested before my first knee replacement was Nickel. The second test after the knee replacement showed reactive to Nickel, Molybian, and Vanadium, and the third test after the revision to the Aesculap knee now shows reactive to Nickel, Vanagium, Molybian, Aluminum and Zirconium. I test mildly reactive to bone cement in the last test. All of the allergy tests were done in the same lab, Orthopedic Analysis, in Chicago. I think tests were called Metal-LTT tests.

 

[Josephine]

When I had my knee revision, I noticed on an xray that I had what looked like fireworks or star bursts through the lower portion of my calf that I had never seen on any of the previous X-rays taken of my knee. When I asked the PA what it was he explained that they had accidentally blown a hole in my bone and that bone cement had leaked into the tissues.

You know, it's very common for surgeons to use Garramycin beads which are made of methylmethacrylate and embedded in the tissues around the replaced joint. They are intended to remain in there for some weeks or even months and to my knowledge, have never caused any side effects. So I don't understand how this accidental extrusion of cement would cause any problems either.

 

[ucsbgal1971]

The PA participated in the surgery. He never mentioned the beads. All I know is what he told me that a hole was made in my bone inadvertently and bone cement leaked into my tissues. My doctor did confirm that was accurate so I am guessing that the cement became toxic to me and now I have lesions on my internal organs. If that isn't accurate then perhaps the implant is causing a problem but I only tested mildly reactive to the zirconium after it was implanted. It is very concerning. I will have to check out the beads to see if there is anything in them that may have caused the problem but my leg looked nothing like that xray. My xray was reversed and looked like a negative and there were silver starburst or firework looking things throughout my leg. The PA said it was bone cement.

 

[sistersinhim]

Can you post a copy of your xray?

 

[ucsbgal1971]

I wish that I could. I asked the doctor for the xray but he wouldn't give it to me.

 

[Jamie]

You need to contact your doctor's office again and make that request. You are entitled to a copy (not the original) of anything in your medical records under current HIPAA laws. You can also request the format, such as a disk. The copy must be "reasonably" priced and provided within a "reasonable" time frame. If they still say you can't have a copy, I'd remind them of HIPAA and, if you still cannot get a copy, contact an attorney who can refresh their memory.

 

[ucsbgal1971]

You know what Jamie, I told them about the law but they denied that there even was an xray. They gave me a copy of an xray but it didn't show the star bursts because it hadn't been reversed like a negative. I have asked over and over and they deny that it exists. The PA won't even talk to me about it now and the doctor admits that there is bone cement in my tissues but denies that an xray exists. I was not hallucinating. I know what the PA showed me. I think the PA got in trouble for showing it to me, but he felt I should know. Maybe I can go to another doctor and ask for that reverse negative type of xray that will show the cement in my leg. The problem is if I start accusing the doctor of doing something wrong, no one will work with me. I have to be very careful. It is a real dilemma and meanwhile my life may be in danger with all of these lesions in my organs.

 

[Josephine]

so I am guessing that the cement became toxic to me

Another thing I forgot to mention was that when doing revisions for infection, surgeons often make temporary space fillers out of bone cement which they might leave in place for weeks or even months. And even companies make them and they are all made of bone cement - methyl-methacrylate.

Maybe I can go to another doctor and ask for that reverse negative type of xray that will show the cement in my leg.

Why are you so hung up on the 'negative' xray. If you think about it, all xrays are in the negative - i.e., black and white.