Revision TKR Revision: Second Time Is the Charm

[maryo52]

The only advice I have is, if your life is somewhat manageable, give it time. I'm in a similar quandry having a less than satisfactory TKR but I've learned to live with it (with the help of a rigid brace). @RunA42K's incredibly wonderful revision experience is giving me new hope and I am slowly working on a plan to go back to see one of my second opinion docs to see if he will provide a more specific idea of what he'd do to make my knee right.

For anyone wondering about metal allergy, I had heard there was a lab in Chicago that has a more specific test for allergies to implants since patch testing doesn't necessarily correlate with implant allergy. They make this claim: "Metal LTT is a Lymphocyte Transformation Test that measures immune cell reactivity (Type IV Delayed Type Hypersensitivity reactions) to metal antigens. The Metal LTT test measures the proliferation (activation) responses of white blood cells (lymphocytes) after 5 days of exposure to selected metals." Here's a link to their info sheet: http://www.genesislab.com/Files/Documents/Metal Allergy Testing Brochure.pdf

 

[spinfanatic]

Hi all. Saw revision specialist last week and surgery set for February 6 due to suspected metal allergy. Cobalt chromium implant being replaced with oxinium titanium implant. HSS Surgeon is very familiar with metal allergy complications after TKR and offers no assurances but thinks this is 'the real thing'. New surgeon is very impressive but already missing all the TLC my original surgeon and staff provided. Trying to follow Bonnie/RunA42s positive approach and be positive. I went into primary replacement in great shape and very optimistic. Outcome was great with terrific ROM and pain control. So busy getting my life stuff and head organized. Bonesmart library a gift!!
Guess my thread name should be changed. How does this get done?
Thank you Bonesmart!

 

[Pumpkin]

Glad you have found someone to help with your TKR, all the best for your upcoming revision!
@Jamie can change your thread for you.

 

[kneeper]

Good to hear you found a revision surgeon who is fairly optimistic. fingers crossed for you.

 

[Pumpkin]

Only a week and a half, wishing you and uneventful surgery and recovery!
Keep us posted on how you are doing!

 

[spinfanatic]

Well I made it! Revision completed. Day three and feeling confident. I am walking with cane, have 90 degree bend and readily handled stairs in PT. Pain well managed. Plan is to go home today but waiting for medical release. Incision is crazy! It's a good 2 inches longer than original. My surgeon for first tkr used dissolving stitches with steri strips which was relatively pretty to look at. This incision is glued. It is shiny and lumpy which at first glance looks wet but in fact is hard to the touch. @Jamie could you change my thread to Revision: second time is the charm. Thanks to all on this forum. So much info and best yet support!

 

[Jozilla]

Congratulations! Looking forward to your updates. Just curious - How was the HSS and did you have original surgery there? All my best to you.

 

[busylizzie]

All the best, hopefully I will be following you soon with a revision

 

[Dhare63]

Congrats! Take it slow and easy, you know the mantra. We will be here all the way!

 

[Jamie]

Okay....thread title revised for you. It sounds like you're doing just fine and I'm certainly happy to hear it! Keep the updates coming.

 

[spinfanatic]

I made it home! I got myself really worked up leaving hospital but feel great now. Prescriptions are filled, bedroom and day space organized, slept like a baby and waiting for my new friend from lab for blood draw. Husband is wonderful. Thank you all for the encouragement and @busylizzie your next!! Plan on spending day deep breathing and relaxing. So much on Netflix and of course the Olympics. @Jozilla HSS is great but it's a factory. They do hundreds of surgeries a day. This is my 4th surgery at HSS.I had my surgery Thursday at 5 and got to room following day after 2pm. There were at least 30 overnighters in recovery with me waiting for beds. I prefer the attention you get in recovery so considered the overnight stay a good thing. While in recovery family visits limited to 15 minutes every 4 hours which is very hard on loved ones. Big advantage to HSS is that it is a stand alone facility that only does joints so less worry about infectious diseases you may find in a big hospital. The docs are the very best! Nursing staff is very capable. I have to believe it may be a difficult place for out of towners as New Yorkers are not for everyone. Thanks @Dhare63 as your story really helped me get to this moment. And always @Jamie ....your amazing!

 

[Pumpkin]

Congrats for being on the other side of a revision, glad you are home and comfy. Keep us posted on how you are doing.

 

[spinfanatic]

Thanks @pumpkin. Tax day will be here soon enough for you! Get yourself ready! It's a great decision to move forward. Maybe at day 5 it's premature to say but it seems easier the second time. Yes I get anxious but I know the pitfalls and where to set my expectations. The hospital stuff was less intimidating overall and I knew what little comfies to get in place at home to pass the day. All my 'new friends' from the visiting service are a little much but I am better second time round at managing them. I know to be satisfied with great pain control and peaceful sleep. That's the goal for now. Over the next few weeks, I will reset and consider some added goals. TKRs are a hell of a thing but here's hoping we are riding our bikes this fall someplace special. I have my sights on California wine country!

 

[Jozilla]

You sound wonderful! I look forward to reading about your recovery. All the best.

JoAnne

 

[Dhare63]

Great news and upbeat report. I found that after my revision, I was much more prepared and knowledgeable. That in turn made me feel like I was in control, unlike after TKR where I felt like I was on a carnival ride with no end in sight. The good news is you timed the surgery when there is good tv day and night!

I'm glad my story helped. It was a struggle for sure, but worth it in the end.

Be well,

Dawn

 

[Pjmc]

Please tell what was the Vitamin regiment ? I had not heard of this before .thanks ,Pam

 

[spinfanatic]

Hi @Pjmc. How are you? You have really been put through a lot! I hope you get to a doc you trust soon. As for vitamin regiment, at 4 months my new knee starting clunking and catching inside knee by patellar area. OS, who could feel the scar tissue, took a wait and see approach and in spite of my already good eating habits added mutivitamin, 2caltrate tablets and muscle milk(light) daily in conjunction with rest. At 6 months, scar tissue removed via scope. He repeated same strategy at 10 months (vitamins and rest) when knee was chronically swollen, stiff and painful. At 12 months, he called the TKR a 'bad outcome' and started testing. Testing led to revision and here I am today. I restarted 'vitamin regiment' this week which really only meant adding muscle milk.
At 11 days post revision, all is as to be expected. Normal amount of swelling, upset tummy, mood swings and bed rest which includes ice and elevation. Had great first PT session this morning with out placement therapist! Focus on stim, massage and stretching. IT band not happy which is causing quad not to fire. Problem is I missed my blood draw for Coumadin this morning so I'm 'in trouble' but secretly would love to get off blood thinners and replace with aspirin and NSAIDs and reduce oxycodone intake. Anyone else thinking there has got to be better strategy to preventing DVT post tkr in patient with no historic markers? HSS doc monitoring Coumadin is going to have a fit. Can't wait for that talk later today. But all in all so far so good! There are no guarantees in revisions involving metal allergies but I see improvements already. My ankle for the first time since pre first tkr is not swollen! Husband thinks my revision knee looks more like a real knee than it has in two years! So I am pleased!

 

[Pjmc]

Thanks @spinfanatic

I see you have been through many surgeries .

It is wonderful to hear you are seeing improvement .

 

[spinfanatic]

Yes indeed....too many surgeries! Wish I had skipped micro fracture and gone straight to TKR. But in a bit of good luck, my original OS doesn't do two knees at once and I needed both done. It was just a matter of which one first. Imagine if I had TKRs on both and had to do double revision due to metal allergy.

 

[busylizzie]

Spinfanatic, I've just read your complete thread. You've had your set of problems too. Have they anthing planned for your vocal chords yet? It must be very frustrating.

Hope your quads fire soon and you recover quickly. I'm also on blood thinners from my last surgery and will be glad to stop the injections and get rid of the teds.

Take care