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Revision TKR My Revision after a Loose Implant

Josephine

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We don't tend to use Norco (hydrocodone and acetaminophen) in the UK. Mostly Tramadol. And that 150mg dose my doctor suggested, I only ever used it as a one off. Once a day for the odd day (or night!) here and there. I doubt I used it more than half a dozen times altogether! And never for my second knee. You have to be very, very careful when using higher doses like that.

I found this in the NICE website (National Institute for Clinical Excellence) UK
For Adults
50–100 mg twice daily, increased if necessary to 150–200 mg twice daily.
Doses exceeding the usual maximum not generally required;
Usual maximum 400 mg/24 hours..
 
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The NICE website does not open. Curious as to why the UK does not use Norco?
 

Josephine

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Curious as to why the UK does not use Norco?
Just a cultural thing! Each country has their own ways of doing things.
And I did say it doesn't TEND to use it. Not that it never does.
 
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Here in the US, my OS prescribes Tramadol 50mg 1-2 tabs every 4-6 hrs.
 
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Kimberley, here is a picture of my left TKR at 6 weeks: note the gap! My OS thought it would fill in and he was not worried. 19½ months later my implant has failed and the gap is bigger!!!

2016 12 01__resized_MED    L KNEE 6 weeks TKR.jpg
 

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Cementless. That is shocking and quite obvious that it is wrong. How do these surgeons get away with it? I hope you have managed to get another surgeon to correct this?
 

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I just love that sweet face in your avatar!
 
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This is what my knee looks like 19½ months later on 5/25/2018. I am researching my revision OS because it needs to be done cementless. I am allergic to the bone cement. I think normally the bone cement would fill in that gap? I do have osteopenia.

L. knee TKR (lateral x-ray) 5.25.2018.jpg
 
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Thank you Jockette! That is our sweet rescue we have had a year this August the 6th!!!
 

Kimberley

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Good grief, I think that looks serious. I'm not sure what you've got but one of the administrators will tell you I'm sure.
 

sistersinhim

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Rescues make the best pets! They seem to appreciate their families more! At the time of my tkr, I had 13 rescued kitties. The first week, I had a neighbor come in and clean out the litter boxes since they were down some steps. From the 2nd week on, I was mostly on my own! Having these 'kids' of mine was the only therapy I needed. Taking care of them helped me both mentally and physically!
 

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That avatar just makes me smile every time I see it! :roseshwr:

I have said for years, I love OTHER people’s dogs, and now I’ve added cats to that list, as for me and all my arthritis issues, the days of having my own pet are over.
 

Josephine

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Here in the US, my OS prescribes Tramadol 50mg 1-2 tabs every 4-6 hrs.
This is nothing to do with the US or any other country. Nor even with your surgeon. They can be taken 100mg 4 times a day. That's what drugs.com (a US site) says!
 

Celle

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@Cementless ,
I have moved the X-Rays that you posted in Kimberley's recovery thread and the responses to them into your own recovery thread.

Here on BoneSmart,each person has her/his own recovery thread, in which the main topic of conversion should be about her/his knee. It's OK to post in other people's threads, as long as you talk about their knee and not about your own, unless you think that something you have done might help them.

Posting pictures and talking about your own knee in someone else's thread takes the emphasis off their recovery and hijacks (Or derails) their recovery thread, so we don't allow it.
Forum etiquette: being polite when posting
 
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I had my 2 year bone density DXA dual done on July 3, 2018 and it continues to show I have osteopenia. In fact my left hip (L. TKR done 10/19/2016) has become worse. 2016 (T-score -1.90) 2018 (T-score -2.3) The way I understand it, -2.5 is the edge of osteoporosis. If and when I have a revision of my L. knee due to loosening, can it be done successfully without bone cement and osteopenia/osteoporosis?

I read an old post that is no longer active from Dawninplover, 04/04/2015, she also had a failed TKR from the DePuy LCS rotating platform. I think she had osteopenia. Does anyone know how she did?
 

Josephine

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it continues to show I have osteopenia. The way I understand it, -2.5 is the edge of osteoporosis. If and when I have a revision of my L. knee due to loosening, can it be done successfully without bone cement and osteopenia/osteoporosis?
The difference between these is marginal:

The difference between osteopenia and osteoporosis is that in osteopenia the bone loss is not as severe as in osteoporosis. That means someone with osteopenia is more likely to fracture a bone than someone with a normal bone density but is less likely to fracture a bone than someone with osteoporosis.

As for doing a knee replacement with either of these, there are remedial things that can be done to prevent problems such as using bone grafts, synthetic bone and artificial bone.
 
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@Mr Gary/sistersinhim, I did this Orthopedic Analysis blood tests (Chicago) a couple of weeks prior to my LTKR (10/19/2016) and found I was "mildly allergic" to the bone cement monomer.
It was close in regards to Colbalt and Titanium. Next week, I will do the patch testing for Metal and bone cement by an allergist who developed this patch test for orthopedic surgeons that do implants. I get the patch put on Monday (July 9th, go back for 3 readings 11th, 13th, and final reading the 16th.)
Sistersinhim, how come you don't think the patch test is as accurate? I had another allergist that is not doing the patch test say these type of orthopedic blood analysis can be very inaccurate. So confusing.

My insurance completely reimbursed me for this $550 test. Yes, you do need a doctors order. I had to sweet talk the lab (LabCorp) into drawing my blood and I mailed it off. I did pay for them drawing the blood though.
 

Josephine

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@Mr Gary/sistersinhim, I did this Orthopedic Analysis blood tests (Chicago) a couple of weeks prior to my LTKR (10/19/2016) and found I was "mildly allergic" to the bone cement monomer.
It was close in regards to Colbalt and Titanium. Next week, I will do the patch testing for Metal and bone cement by an allergist who developed this patch test for orthopedic surgeons that do implants. I get the patch put on Monday (July 9th, go back for 3 readings 11th, 13th, and final reading the 16th.)
Sistersinhim, how come you don't think the patch test is as accurate? I had another allergist that is not doing the patch test say these type of orthopedic blood analysis can be very inaccurate. So confusing.

My insurance completely reimbursed me for this $550 test. Yes, you do need a doctors order. I had to sweet talk the lab (LabCorp) into drawing my blood and I mailed it off. I did pay for them drawing the blood though.
@Cementless I've moved your post into your own recovery thread but out of "Mr Gary's Recovery Thread" because you would be at risk of derailing his thread which is discouraged here.
 
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Metal Patch Testing 7.09.2018.jpg I started Metal Patch Testing today which includes bone cement. What is really interesting is this allergist developed this Metal Patch Test for a particular revision surgeon in the area where I live. I requested from Jamie the names of some revision surgeons in my area. The # 1 revision surgeon on the BoneSmart list is the one that requested the metal patch test be developed by this allergist!!! What are the odds.
 

Celle

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It sounds as if you're looking at the right person for your revision.

Do let us know the results of the patch test, won't you?.

Usually, the patch tests are more reliable for things that come into contact with you externally, such as pollen and detergents, while the blood tests are more reliable for things like metals - and bone cement. I'll be interested to hear how the results of the special patch test compare with the results of the blood tests.
 

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