Revision TKR Metal Allergy or Infection or Something Else

[Born2teach]

Yes, of course. A first time knee replacement does not have "rods". However, a revision needs to be secured into the bone with what my surgeon has called "rods". This is most likely a layman's terms. In device those "rods" are made if titanium.

 

[Born2teach]

Hi @Polkadot,
Wow, I am so surprised to hear that you received a ceramic knee! I have spoken with 4 different orthopedic surgeons (different practices and in different parts of the country) and all 4 have told me that there is not a ceramic knee available in the US. Can you tell me who manufactured your device and what it is called?

 

[Josephine]

Do you mean an extra long post or posts that go into the tibia? Something similar to this?

As for ceramic knees, they're not exactly all ceramic but enclosed in it like this

And sadly they are not FDA approved, so far as I am aware.

 

[Polkadot]

Implant manufacturers, BioMet and Smith & Nephew, both make nickle-free versions of the femoral part.

I just contacted my doctor's office, and the nurse there said the ceramic knee I got is made by DePuy. CORRECTION: My husband just came home and said the nurse got it wrong. My new knee that is biocompatible for those with metal allergies is made by Smith and Nephew.

 

[Polkadot]

@Josephine, Definitely, the parts should be in a system by one manufacturer. My husband had a long talk with my doctor about knee replacements for metal allergies. I was totally out of it so can only report what my husband just now related to me from their conversation. The doctor was quite enthusiastic about product development because he has served on several design teams that are using these materials. He has a PhD in biomedical research in addition to being an OS. So he went into great detail on the materials and how they interact. (Maybe I'm glad I was out of it! DH loved it because he is also a scientist. Go figure!)

Smith and Nephew is one of the companies who have done this (make the parts of two different materials). My new knee is actually from this company, but BOTH parts of the model he selected are made of a metal alloy welded together with a strong ceramic exterior. Surely he'd not use a product that is not FDA approved. Perhaps there have been recent changes?

I really just wanted to let people with metal allergies know that there are options in the US.

 

[Polkadot]

Hi, @Born2teach,
I don't know the name of my knee, but I am afraid that it's likely to be the latest version of your Smith and Nephew Oxinium knee, which is considered a ceramic. So as Josephine clarified, the base material is a metal alloy with a ceramic exterior.

 

[Born2teach]

@Polkadot,
Wow, it sounds like you have a wonderfully informed and caring doctor!!! I wish there was an easier solution to my metal allergy situation. Since, I am allergic to zirconium, which is the material in the Smith & Nephew oxinium device I have now, I feel like there are no options that are free of the numerous metals I cannot have. I surely hope one day a solution becomes available.

I hope you have great results with your knee!
Thank you so much for your concern and advice. It means so much!

 

[Josephine]

Smith and Nephew is one of the companies who have done this (make the parts of two different materials). My new knee is actually from this company, but BOTH parts of the model he selected are made of a metal alloy welded together with a strong ceramic exterior. I really just wanted to let people with metal allergies know that there are options in the US.

@Polkadot, I understand that but this is much the same information as we already have in the Forum Library here Metal allergies and knee replacements but in much greater detail.And we also have this page on our website.

Surely he'd not use a product that is not FDA approved. Perhaps there have been recent changes?

I couldn't say. Last I heard it wasn't.

 

[jboles]

@Born2teach I just had my knee replacement done on July 17, my doctor used the Smith & Nephew oxidized zirconium (ceramic) femoral component. He worked with the manufacturer to make an all poly tibial component did not use the titanium base plate. My first cousin and I had knee replacement same day same surgeon and we both have almost identical metal allergies. He said our case will probably be in medical journals. She was the first to receive this special implant, my surgery was second. Our reaction to zirconium was mildly reactive.

 

[Born2teach]

@jboles,
What what an interesting story with both you and your cousin going through surgery on the same day with the same surgeon. You are right, it will make a great case study. It sounds like your doctor really knows his allergy and his implants well. I have read that Smith & Nephew does do custom implants, so it sounds like you got exactly what you need. Best wishes to you and may you have a fantastic recovery.

 

[jboles]

What I failed to mention was we both had spinal with sedation and nerve blocks. Funny thing is, we both woke up in the OR. I told my daughter that I woke up and there was a blue screen or sheet in front of my face and I looked to the side and saw people, then I heard someone say oh dear, she's awake. Next thing I remember was the recovery room. My daughter said my cousin told her almost the identical thing before I was brought to my room.