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TKR My Knee Odyssey<

Thanks for your response, Josephine. My answers to the questions are essentially the same as they were awhile back when I answered them, so you can refer to that if you'd like. But I really don't want you to invest that much time when you have so many others on here who need advice. Mostly I was just wondering if my situation is extremely rare and needs attention from my doctor (or even a second opinion from another OS), or if it's not so unusual and I should just "chill" and continue to follow your previous recommendations.
 
That was April 18th, Murry. 12 weeks ago. But if you think not a lot has changed then we'll leave it there then.
 
Murry said:
Anyone else experience a good bit of pain at this stage of their recovery? Should I be concerned?
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By seven months, most people have minimal pain and have regained a lot of function. There are some people who continue to have pain and swelling longer, though, and may need longer to get to this point. You should definitely bring up your pain and swelling with your surgeon when you see him.

Your ROM is good enough not to require an MUA (which it seems your surgeon agrees need not be done), so the key is to reduce your swelling. Anti-inflammatories aren’t necessary for reducing swelling for most people. Ice and elevation should do the trick. Have you tried elevating at ALL times you are not up on your feet? Sleep with your legs elevated if you can do so. And ice for more than 40 minutes several times a day. I’m just wondering if more intensive elevation would help. (It helps a lot of people.)
 
I've been quiet for several months now, just waiting to see if things get better. I'm now almost nine months out from my TKR and my recovery continues to be much slower and more difficult than I expected. I do see very tiny improvements, but am still having a good bit of pain and swelling, and I'm still unable to use most of my exercise equipment (elliptical machine, treadmill) or go for long walks. Going down stairs is also very painful if I try the "foot over foot" normal way of going down them.

Today I went to see a very highly regarded surgeon at the Steadman-Hawkins Clinic of the Carolinas (Greenville, SC) just to ask for a second opinion. He doesn't do total knee procedures but specializes in diagnosing difficult knee problems. He is the one who originally suggested I have a TKR. He said I might be having an allergic reaction to the cobalt chromium replacement parts and became even more suspicious of this when I told him I always have reactions to any earrings that don't have surgical steel posts. I don't even want to think about the implications of this right now and will certainly wait several months before even considering a revision, if possible.

Do any of you forum administrators and participants have any information or advice you could pass along about allergic reactions to cobalt chromium? (My replacement parts were custom Conformis made of cobalt chromium molybdenum.)
 
I am going to tag @Josephine
our forum administrator and nurse director to address your concerns.
 
I'm officially one year out from my TKR and I continue to have excessive inflammation and pain. After reading some material on this forum and elsewhere about metal allergies, I decided to meet with an allergist to discuss this. I had skin patch testing, which showed a "medium" reaction to cobalt and blood testing by Orthopedic Analysis, which showed I was highly reactive to nickel.

I have a Conformis implant (cobalt, chromium, molybdenum, nickel) and when I contacted the company prior to my testing, they replied immediately (within just a few minutes) with a pre-prepared fact sheet about metal sensitivities, which tells me I'm definitely not the first person to contact them regarding this.

My orthopedic surgeon has never encountered this in his three decades of practice, but he just started using the Conformis knee on selected patients. He normally uses the Stryker titanium model and several patients I know personally who had TKRs (same surgeon) about the same time I did are doing great with the Stryker. My OS recommended the Conformis for me because it's designed specifically for each patient using 3-D imaging technology.

So how could that be a bad thing, right? Or at least that's what he and I thought. Overall, my OS is being pretty supportive about the metal sensitivity testing I did. Just this past week, I saw him for my one-year recheck and he did blood work to rule out infection and an xray to check the positioning of the implant (which looks good, he said). That means the only two sources of my crazy inflammation are
1) the metal allergy issue
2) just needing to give it more time to heal.​
Just this week, a nurse told me a friend of hers also had a Conformis knee put in a year ago and she is miserable.

I'm posting here to get feedback on three questions:

1) Anyone else out there have a bad experience with a Conformis knee?
2) Am I running any big risk by keeping this implant in my body, even though it contains some nickel? (0.5 -1.0 %, according to the manufacturer).
3) If I need to consult another orthopedic surgeon who has experience with patients who have needed revisions due to a metal allergy, does anyone have any suggestions?

My OS says some people just take longer than normal to recover from a TKR -- up to two years, in his opinion. I'm inclined to wait, unless I am running a risk of systemic problems by keeping this thing in my body. Any suggestions, "testimonies" or encouragement would be much appreciated.
 
I’m sorry you are having these issues.
I am going to tag @Josephine
our forum administrator and nurse director to address your concerns.
 
@Murry - Have you considered being tested for metal allergies/sensitivities?

For anyone who would like to get a full metal allergy test prior to any joint replacement surgery, you can get the test done in the USA by ordering the test kit from https://www.orthopedicanalysis.com/testing/order-testing-panel . You want the Orthopedic Panel Test 2. Once you get the test kit, your GP (or any lab) can do the blood draw and send it in for testing.
 
@Celle -- Yes ma'am, I did both a skin patch test (administered by an allergist) and the blood test from Orthopedic Analysis. The skin test indicated a reaction, although not severe, to cobalt, while the blood test revealed a high-level reaction to nickel. (Please see my earlier post.)
 
OK. Thank you for refreshing my memory.
I didn't have time this morning to read back through your thread and I wanted to make sure that you didn't miss out on knowing about the test.
 
Murry said:
My orthopedic surgeon has never encountered this in his three decades of practice
Click to expand...
That he knows of! :wink:
Murry said:
My OS recommended the Conformis for me because it's designed specifically for each patient using 3-D imaging technology. So how could that be a bad thing, right?
Click to expand...
The Conformis' patient design is nothing to do with anything like metal allergies so the comment "how could that be a bad thing" is totally erroneous!
Murry said:
Am I running any big risk by keeping this implant in my body, even though it contains some nickel?
Click to expand...
Had your allergy been more definitely diagnosed then I might answer that but it isn't so I'm afraid I am unable to comment. Sorry.
 
It's been several months since I posted here. I continue to have limited range of motion, inflammation and excessive pain. As my previous post indicates, the possibility exists that metal allergies are the cause of my ongoing post-surgical woes (I'm now 15 months post-surgery). I finally decided to get a second opinion from an OS at the Steadman-Hawkins Clinic (Greenville, SC) who had previously done three hip surgeries on me. He is referring me to a partner for a panel of tests to determine what is causing my problems. Apparently, this doctor will draw fluid off my knee and send it off for testing. The OS who actually performed my TKR seemed to have run out of ideas and dismissed my concerns about the heat coming from my knee. I'm still baffled why THAT surgeon didn't seem aware that a testing "kit" is available to determine if the problem is excessive scar tissue, infection, allergies, etc. I felt vindicated and a lot less crazy after the OS at Steadman-Hawkins, as well as his PA, confirmed my suspicions that the heat, pain, and swelling were real and significant. I guess I'm writing both as way of an update, as well as to encourage anyone out there who has a gut feeling that something is wrong to seek a second opinion. I only wish I'd done it sooner!
 
It is really depressing how many original OSs never admit that anything is wrong with our knees. It's like they just wipe their hands of us. Thank God you found someone who listened to you and is following up on your symptoms.
 
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