• REGISTER for Joint Replacement Awareness Day on May 9th, 2020!

    Surgeons, patients, and other medical professionals will talk about topics you've told are important to you. You can ask questions LIVE of the participants. Please "like" and "share" our JRAD notice on your Facebook page too!

    Register and learn more in this announcement:

Watch 2019 JRAD Videos

TKR Polyethylene Disease

lionsm13

senior
Joined
May 31, 2010
Messages
266
Age
66
Location
United States
Gender
Male
Country
United States United States
Polyethylene Disease

First time that I have heard of this.

Went to my orthopedic urgent care today as yesterday out of the clear blue my TKR started to feel extremely stiff which was due to the swelling that I had.

Had Xrays today spoke with the P.A. who said that by the looks of the Xray that what I had was polyethylene disease which is the plastic spacer failing in my TKR that is 9+ years old.
(DePuy Rotating platform.)
He was very sure of it.

So now is to make an appt. with the surgeon, do a fluid pull out of the knee to verify that there is not a mild infection which he said that did not think that there was due to me not exhibiting any signs or symptoms.

Following this they will change just the plastic spacer and remove the scar tissue.
The PA said that recovery this time will be much easier w/just replacing the spacer and not the hardware.
He said that the earlier it is caught the better the chances are in it taking w/out having to do a full revision.
So we'll see.
Time will tell.
I already do not like walking around stiff=legged again due to swelling.

Just sayin' here.
 

Jamie

ADMINISTRATOR
Senior Administrator
Joined
Mar 24, 2008
Messages
58,602
Age
71
Location
Kansas
Gender
Female
Country
United States United States
So sorry to hear that it appears you'll be headed for another procedure. But it definitely is a good thing you caught this situation early so the spacer can be exchanged before things got worse.
Good job "listening to your body" and taking action!


Here is an example of what might be seen on an x-ray in a case where there is damage and wear to the plastic spacer in a knee replacement (although at this early stage, your problem may not be quite so pronounced). The knee on the right in the x-ray is just fine. But the lack of adequate space in the joint in the knee pictured on the left is clear.

1570287596867.png


In looking at the image on the left, you can see why continuing to walk on such a mis-aligned knee could cause problems with the entire implant. Without a properly functioning spacer, there is stress on the entire joint. In addition to the release of plastic particles from wear (Polyethylene Disease), the irritation and inflammation from these particles can result in osteolysis and loosening of the implant itself. Then a revision is required.

Here's hoping you can get this taken care of quickly. In the meantime, baby that knee as much as possible.
 

Pumpkln

MODERATOR
Moderator
Joined
Oct 27, 2011
Messages
21,756
Location
United States, West
Gender
Female
Country
United States United States
@lionsm13
Welcome back to BoneSmart, sorry to hear you are having trouble with your spacer.
I agree with Jamie, getting this taken care of sooner rather than later is best.
@skigirl had a spacer exchange that went very well, she spent the first few weeks resting, elevating, and icing to allow her knee to heal.
I have tagged her for you, she is away from the forum right now, but will respond when she returns.
 
OP
OP
lionsm13

lionsm13

senior
Joined
May 31, 2010
Messages
266
Age
66
Location
United States
Gender
Male
Country
United States United States
Thank you for the support and caring.
To say that I am overwhelmed is an understatement, more like devastated would be more accurate.

For 3 years following my TKR when I first had it done I kept thinking that something was wrong with it and truthfully it never did feel right. I was in pain for a long time following the procedure.
I have not enjoyed it very much and would give it a C- if I had to give it a grade, maybe even a D+.

One OS I saw for my other not good at all now knee and actually have an appointment to do a cooleif procedure on it just due to the agony I experienced with the knee that now has to be redone w/a new spacer said that it could be cleaned out but I chose not to due to not wanting to prolong all of the problems I was having with it. I know I have nothing to complain about compared to many on here.

Just can't stand to think of having to go through this pain and worry again.
I was planning on having this TKR last the rest of my life.
It's a very depressing place to have to go to again and live.
 

Jockette

SENIOR FORUM ADVISOR
Senior Forum Advisor
Joined
Aug 29, 2017
Messages
16,465
Age
64
Location
Delaware
Gender
Female
Country
United States United States
I understand a bit about how you feel. I’m 2.5 years post op from a Patellofemoral partial which I thought would solve my problem and last the rest of my life.

It was an upsetting shock, about one month post op, to learn that partials don’t have the longevity that totals do. I was never offered a total and I don’t remember being explained the differences.

My partial, like your replacement, has never felt right. I have more issues now than I did before surgery. 2 second opinions, from highly rated surgeons, have not been interested in looking past my X-ray to find out what my problem is, as my X-ray looks fine.

But my knee is far from fine. In spite of that I do continue to see improvements, even at this late date. My ROM, while very slow to come in, is good now. But I do feel there will be a revision in my future and I am most definitely not looking forward to it. It’s hard to have faith in a revision when the first one turned out so bad.

Best wishes as you consider all your options and make decisions.
 
OP
OP
lionsm13

lionsm13

senior
Joined
May 31, 2010
Messages
266
Age
66
Location
United States
Gender
Male
Country
United States United States
So sorry to hear that it appears you'll be headed for another procedure. But it definitely is a good thing you caught this situation early so the spacer can be exchanged before things got worse.
Good job "listening to your body" and taking action!


Here is an example of what might be seen on an x-ray in a case where there is damage and wear to the plastic spacer in a knee replacement (although at this early stage, your problem may not be quite so pronounced). The knee on the right in the x-ray is just fine. But the lack of adequate space in the joint in the knee pictured on the left is clear.

View attachment 75207

In looking at the image on the left, you can see why continuing to walk on such a mis-aligned knee could cause problems with the entire implant. Without a properly functioning spacer, there is stress on the entire joint. In addition to the release of plastic particles from wear (Polyethylene Disease), the irritation and inflammation from these particles can result in osteolysis and loosening of the implant itself. Then a revision is required.

Here's hoping you can get this taken care of quickly. In the meantime, baby that knee as much as possible.
Thank you very much Jamie for explaining what Polyethylene Disease is.
Now I understand what is going on thanks to your explanation.

No doubt I have plastic particles floating around which is probably what is causing the irritation/swelling effect feeling even though my knee does not look or appear to be swollen.

My joint was maybe a 3rd to a 4th smaller on one side than it was the other but the plastic must have broken off and is now floating loose and being an irritant.

You explained if much better than did the P-A.

It is sure painful I know that much.

I have a clearance physical this week with my GP that I was going to get for my other not good knee but it has been set aside unfortunately/fortunately for now. I have already had blood work as well for a procedure that I was going to get for it called cooleif, but this does not look it will happen now for a while longer anyway.

I work part time as a corrective thinking counselor but I still have to walk to my vehicle and back from the parking lot and my house.
Nothing I seem to do makes my joint feel any better.
Getting up from a sitting position seems to put a strain on it and sitting too long also does.
An abrupt or jarring movement seems to upset it quite a bit too.

No happy medium here it would appear.

Ibuprophen seems to help a little bit but over all not much of anything does.
 
Last edited:

Celle

MODERATOR
Moderator
Joined
Nov 19, 2011
Messages
37,070
Age
78
Location
New Zealand
Gender
Female
Country
New Zealand New Zealand
I'm sorry to hear you have this problem with your spacer, @lionsm13 .

I had a partial knee replacement (PKR) in 2000. By 2011, unknown to me and without any warning signs, the spacer had worn so thin that one day it just broke, while I was walking fast. One minute I was walking. The next minute I was on the floor, in extreme pain and unable to walk at all.

Once the spacer no longer protected them, the metal components of my knee replacement rubbed on each other and by the time I found a new surgeon (my previous surgeon had retired) and had my surgery, I had metal filings inside my knee capsule. Instead of just a spacer replacement, I had to have all the hardware removed and my PKR was converted to a total (TKR).

My advice to you, based on my own experience, is get that spacer replaced as soon as possible, Compared to what I needed to have, spacer replacement is a much less serious operation.
 
OP
OP
lionsm13

lionsm13

senior
Joined
May 31, 2010
Messages
266
Age
66
Location
United States
Gender
Male
Country
United States United States
I think that is part of the problem Celle, is getting word to mine that I need to see him.
The OS medical office said that they would. I left a voice mail with the PA yesterday.
The OS was out Friday, and in surgery most of this week.

Then there is always the prerequisites required on my part too,
the blood work which is done, the EKG and physical from my GP who I plan on seeing this Thursday for those two things and no doubt an MRI which any more takes no time to get and then wait until I get in to get it done and try to live a relatively sane life in the interim while babying my knee as much as I can what Jamie said which I am trying to do and as you said getting it done ASAP.

I'm concerned as well as worried about all of it truthfully that maybe there is metal in the joint capsule as you said that was with your's as that's the way mine felt when I had the reaction last Thursday is that my knee was very painful and almost frozen like something had given out.
 
Last edited:

Celle

MODERATOR
Moderator
Joined
Nov 19, 2011
Messages
37,070
Age
78
Location
New Zealand
Gender
Female
Country
New Zealand New Zealand
You won't get metal on metal problems while there is still a spacer in the joint.

I think you'll just have to be the squeaky gate and keep pestering the surgeon's office, until you get an appointment.
 
OP
OP
lionsm13

lionsm13

senior
Joined
May 31, 2010
Messages
266
Age
66
Location
United States
Gender
Male
Country
United States United States
Thank you Celle.
That made me laugh.:heehee:
"The squeaky gate" (good one):rotfl:

I have called them again this morning and they said that they are aware of my situation and have informed the OS of it and are awaiting instruction from him.

I also called and got lucky w/a cancellation at my GP's and got the EKG along with the physical so good to go there. Only thing now would be needed would be the MRI.
Got a flu shot there today too.

So beings how the joint feels irritated is that a good indication that would be plastic in the joint or floating around in the compartment then or?
 

Lexus05

junior member
Joined
Jan 26, 2011
Messages
33
Location
Missouri
Gender
Female
Country
United States United States
I just had my spacer replaced in my right total knee on July 26, 2019. He used the same incision and it hurt, but the recovery was much faster I think. Glad I had mine done as the knee was unstable and lax, but since the spacer was changed out to a larger one for me I'm not having any problems. Now to get my partial knee revised to a total knee in December. The partial is 11 years old.
 
OP
OP
lionsm13

lionsm13

senior
Joined
May 31, 2010
Messages
266
Age
66
Location
United States
Gender
Male
Country
United States United States
I just had my spacer replaced in my right total knee on July 26, 2019. He used the same incision and it hurt, but the recovery was much faster I think. Glad I had mine done as the knee was unstable and lax, but since the spacer was changed out to a larger one for me I'm not having any problems. Now to get my partial knee revised to a total knee in December. The partial is 11 years old.
So how are you doing now then Lexus?
Also if you don't mind me asking what prompted the getting the new spacer?
Pain, swelling or felt like something stuck inside or?
This is how I feel at the moment.
 

Lexus05

junior member
Joined
Jan 26, 2011
Messages
33
Location
Missouri
Gender
Female
Country
United States United States
I am doing great! Still some stiffness at times, but for the most part I'm pain free.
What prompted my getting the new spacer - I was having some pain, achy feeling but was consistently falling without any reason I thought. X-rays were fine, nuclear bone scan fine also. Told metal components were not loose, but on physical exam my knee was very lax with so much instability. Now no more falling or knee feeling loose. Now have to have my Left partial knee revised to a total knee in Dec. sometime. No date set just yet. Oh I have 130 degrees flexion and 0 degrees extension since 6 weeks post op. Hope I answered your questions.
 
OP
OP
lionsm13

lionsm13

senior
Joined
May 31, 2010
Messages
266
Age
66
Location
United States
Gender
Male
Country
United States United States
Well, finally at least got an appointment after waiting a week after going to the ortho urgent care.
It only took 3.5 weeks to do so.
Guess I'm special eh? lolol

Glad I haven't gotten worse and in fact have gotten a bit better but as Jamie said trying to take it easy.


Wonder what the or why the heck it just went out?
 
Last edited:
OP
OP
lionsm13

lionsm13

senior
Joined
May 31, 2010
Messages
266
Age
66
Location
United States
Gender
Male
Country
United States United States
It is really hard to know what to do and what not to do as just about anything I do causes pain.
If I do nothing it hurts, if I do much of anything it hurts.

Ibuprophen and I are real close. lolol

Seriously though I am trying to be optimistic but I most certainly do worry that this is more than a spacer that needs to be replaced.

Thank you for allowing me to the space to vent.
 

Hopeless

junior member
Joined
Feb 26, 2018
Messages
43
Age
67
Location
Indiana
Gender
Female
Country
United States United States
It is really hard to know what to do and what not to do as just about anything I do causes pain.
If I do nothing it hurts, if I do much of anything it hurts.

Ibuprophen and I are real close. lolol

Seriously though I am trying to be optimistic but I most certainly do worry that this is more than a spacer that needs to be replaced.

Thank you for allowing me to the space to vent.
Sorry to hear of the problems and pain,,,, and wishing you the best outcome.
 
OP
OP
lionsm13

lionsm13

senior
Joined
May 31, 2010
Messages
266
Age
66
Location
United States
Gender
Male
Country
United States United States
The problem is all the waiting.

I remember the P A saying last week
"If we can catch it in time"(if it is just a failed spacer)

That's what I worry about while trying to live as normal of a life as possible but all the while taking care.
 
OP
OP
lionsm13

lionsm13

senior
Joined
May 31, 2010
Messages
266
Age
66
Location
United States
Gender
Male
Country
United States United States
Got a call today from PA to OS, and OS said that after looking at the X-rays he did not feel that I had poly disease.
Don't know if that's a good thing or not...
Said maybe a bone scan or CT scan would be the thing to get..

So back to the drawing board.
 
Last edited:
OP
OP
lionsm13

lionsm13

senior
Joined
May 31, 2010
Messages
266
Age
66
Location
United States
Gender
Male
Country
United States United States
Saw OS finally the other day after having bone scan and CBC.
He said tests look good but said that knee was looser than it should be and to give it a bit more time since it reacted the way that it did 3 weeks ago.
Still some pain as well as stiffness if I stand on it too long.
Don't really know what to think about this...
Thoughts?
 
Last edited:

BoneSmart #1 Best Blog

Staff online

Forum statistics

Threads
50,110
Messages
1,360,091
BoneSmarties
31,526
Latest member
Marcy00
Recent bookmarks
0

Top Bottom