TKR Seems I am not progressing<

[OJ2]

@maryann73 rest and ice would definitely be worth a try. It surely couldn't hurt. And we all probably need more rest in our life.

 

[KarriB]

I believe trying just ADLs with no exercise accompanied by ice/rest/elevation should alleviate a good bit of swelling. You may have to commit to a few weeks though.

 

[KnewKnee]

I have to admit that I'm really surprised by the way that I seem to progress & then slide back. I had no idea this was going to take so long, and I'm still new! (5.5 wks post-op.) My latest "thing" is strong muscle spasms in my inner thigh when I straighten the leg while lying down. I'm sure they are just one more "normal" symptom of recovery!
Taza

 

[maryanne73]

Hi, liam2015, I will keep you informed.

 

[maryanne73]

Hi to all. I regret to say that since my last post Aug 31st I have been going steadily downhill. It have been 7 months since my surgery. I have had so many tests, MRI's, seen specialists in neurology, allergy, etc. I think I am dealing with a metal allergy. I had the testing done at Orthopedic Analysis in Chicago. It turns out I am more sensitive to aluminum than I was to nickel. That is why I had the Smith&Nephew Oxinium knee in the first place. I have been in touch with them and I find out that only the femoral component is the Oxinium or ceramic like part. The tibial part under the poly plate is titanium but with "quess what" 5.5 aluminum. It is an alloy because pure titanium is too soft to use alone.

I am in constant pain which seems to be systemic and effecting nerves all over my body. My knee gets very warm especially below the knee where the tibial component is. It is so stiff most of the time so forget ROM or anything like it. I have all I can do to just get through the day. I refuse to go back on opiates and gaba as they masked this whole thing all summer. I see my surgeon on the 24th of Oct and have no idea what he will recommend. I am asking if anyone has had something like this and who the best are for revisions. I have been in contact with HSS in New York but it is difficult to get in on a timely basis and I am in so much pain. Any other suggestions and Jo if you are reading this does it sound like I am on the right track to you. This metal stuff is so unusual to most doctors I talk to but on bonesmart I see it is not that uncommon. I just read "Angry Knee" tonight and she appears to have something similar.

I am at my wits end and any advice and encouragement will be much appreciated. I don't know what I would do without bonesmart.

 

[sistersinhim]

I suggest you see a revisionist who is not connected to your OS in anyway. They have the experience in knowing how to deal with problem knees.

 

[Pumpkin]

Maryann73,
I agree with sistersinhim, find a second opinion, for your TKR, from a surgeon specializing in Revisions, they have the education and background to determine what is happening with troubled knees. Look for a surgeon specializing in complex joint reconstruction or revisions. They should have no relationship with your present OS, not even golf buddies. You should be able to find surgeons who specialize in revisions closet to home in Milwaukee or Chicago.
There are several options for revision knees free of the metals to which you are reacting.

I am going to tag @Josephine for you, she can give you more information about available revision knees.

 

[skigirl]

I wonder . . . if you contacted the Chicago labs that does metal allergy testing, if they might be able to recommend surgeons who specialize in this narrow field? I know that @RunA42K has had some issues like this, and she might know someone. I agree with you that most doctors seem to minimize the risk about metal allergy and we have seen folks who struggle with this issue. I have not heard of anyone who specializes in these cases but HSS would probably be the first place that I would look, or Mayo clinic.

Since Smith and Nephew seem to be the leaders in this field of manufacturing the knee for metal allergy, perhaps you might be able to speak to someone there who would be more knowledgeable. If you call your local hospital, they should be able to contact you with the local Smith and Nephew rep.

Please let us know about your progress so that we can help others who struggle with this rare issue.

 

[SusieShoes]

HSS would be a good place to start. A Philadelphia woman who suffered an allergic reaction to the metals in her knees was referred there (Dr. Westrich), properly diagnosed through blood tests, and underwent revision. Mayo clinic would be closer, however, and they are also excellent. I hope you find someone soon to help you through this!

 

[Polkadot]

I'm so sorry to hear of your struggles. I have the same knee due to metal allergies, and I am following you in solidarity!

 

[Josephine]

I refuse to go back on opiates and gaba as they masked this whole thing all summer.

in other words, they worked, eh?

It turns out I am more sensitive to aluminum than I was to nickel. The tibial part under the poly plate is titanium but with "quess what" 5.5 aluminum.

There is an option for you but you will need a surgeon who is familiar with it and will negotiate with the firms concerned. This is an all plastic tibial component by Wright Medical but since you need the Oxinium femoral component, that's going to take a bit of planning. Something to think about anyway.

 

[Polkadot]

My thoughts about the pain meds were similar to @Josephine. You might want to rethink your determination not to use them. They seemed to help you. Now that you know there's an underlying problem, why not be as comfortable as you can make yourself while you pursue options? From my experience, I doubt that the opioids and gabapentin will remove the pain/discomfort/physical signs of swelling/distress completely.

 

[maryanne73]

Hi everyone, yes I will rethink about the pain Meds. I appreciate the advice but my reasoning was that I took them for 5 months waiting to get better and in the meantime was masking a much more serious problem with this metal allergy or toxicity which is making me so sick.

Question: I see my OS this Tuesday and want to be very prepared. Mayo Clinic turned me down which I can't understand but my Internist is trying to intervene. HSS has called and are reviewing my case.

Did someone say that they had BOTH femoral AND tibial components made of the Oxcinium in their Smith and Nephew implant? Does everyone have the titanium tibial part?

Also, any referral suggestions I could get for these two institutions would be appreciated. It seems you have to be half dead to be seen these days. I am only five hours from Mayo and that would be best. However, at this point I would go to China to get my life back. Interestingly enough, I read a good article from a specialist in this field who said all these metal problems are just the tip of the iceberg with implants. He specifically mentioned the aluminum in the titanium implants. When I checked where he was from, it was Singapore

In closing I hope anyone getting aTKR will be tested for metals and not risk what I am going through. Hugs

 

[phrog]

In closing I hope anyone getting aTKR will be tested for metals and not risk what I am going through. Hugs

I agree, @maryanne73. Getting the testing done would either alleviate our worries or identify a potential problem. I wish I had thought of it as I also have a nickel allergy and every rash or itchiness that pops up concerns me - at 8 months post op! There is no rhyme or reason for my particular brand of anxiety, but as recovery is often more zig-zaggy than straight, having more information is usually better in my book of rules.
Keeping good thoughts for you as you decide where to go from here.

 

[maryanne73]

Hi,phrog, thanks for your response. We are exactly the same time post op. I am curious, what was the brand of implant you had. Like I read in one of Jo's posts it is a deep hot feeling inside the knee. But mine has many other symptoms as I go along. Hope I get lots more direction tomorrow when I see my OS. Are the rashes and itchiness just around your knee?

 

[SusieShoes]

I also have very mild nickel sensitivity. I told my OS about it and he ordered allergy testing which included having actual pieces of implant components taped to my skin. It was kind of weird but I showed no reactivity at all to the implant components and —surprisingly— a significant reaction to gold. No gold in my implants, so I’m good. Still, like @phrog says, every time I get an itch or rash, I right away think it might be the knees. But the hives are on my arms, not my legs or knees. My dermatologist thinks I’m reacting to... get this... sunlight and dust mites.

 

[maryanne73]

Hi @SusieShoes , I would keep my eye on it. All my research says that skin patch testing is not as reliable as LTT blood testing for implanted devices. My reactions seem be be systemic or all over my nervous system as well as digestive and cardiac which I read is the norm for metal toxicity. Thank you for your response. I have been able to find some relief with a good soak.

 

[skigirl]

@SusieShoes I also react to sunlight with an itchy rash. That is why I love winter!! When a friend suggested a vacation in Mexico with a beach, I just laughed!!

 

[maryanne73]

Hi Everyone, I spent a lot of time today finally learning more about how to use this wonderful website and have finally added my avatar. This is my beloved Afghan Hound Aamir when he was quite young. He died in my arms on Sept. 11 at age eleven. Anyone who has lost a beloved pet knows the pain that brings. He was my best friend and was there for me with all that I have and am still going through with my knee. I just wanted everyone to see how beautiful he was. Thanks, Maryanne

 

[sistersinhim]

Yes, he is beautiful. I know how much it hurts to loose a pet. My kitties have helped me to rehab after many surgeries! When I lose one it hurts deeply. They are my family.