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Revision TKR Would like advice please, I think knee has moved

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Hi Lizzie. Thinking of you and praying you get some answers and a solid plan on Monday. You have been so strong, patient, assertive and well researched throughout this long ordeal. I believe a strategy that you are comfortable with is next for you. Your friends on this forum are routing for you! Anne
 
Thanks both of you At last the time is almost here. Only 3 more nights. I dislike the nights the most, there is nothing to distract me and they drag. In the daytime there are other things going on. My husband is childminding our grandaughter quite a lot and that keeps me going if only the reading of storybooks and the constant chatter. She knows only to sit on my good knee and stay well clear of the other. I tend to mask the pain and discomfort when she is in the house.
 
I have just been catching up on your thread. You have been through so much. I truly hope you have some answers this week. I will be looking for your updates!
 
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Best wishes for the procedure and answers for you. Lee
 
Just back from my appointment. Yes I've got a foreign body reaction. We had a long discussion about the reaction and although it is there it could be a worse reaction.

We discussed immusupressants, fusion and attempting to implant a new knee. He still thinks it could have been a low grade infection in the original knee that caused the original problem as it started on day 1 of the replacement. I again said I positively didn't want a fusion. We both came to the conclusion it was worth one last attempt to try and get a functioning knee. If this doesn't work there are no more options. He has only come across me and 2 others in his career with possible knee allergies. He has done 5 to 6 thousand original TKRs and about 1 and a half thousand revisions. Since taking out the knee the pain, heat and swelling have not resolved and I said I'd rather have the situation before as then at least I had some bend in my knee. It was easier to live with than now. The recent antihistamines have helped a little and the knee does look a little better now. I think he is surprised that I still can't fully weight bear for the pain.

He again is unsure what to use. We ruled out a cobalt chrome one as I definitely react to both metals on patch testing. He doesn't want to put in another oxinium knee as I've had so much bother with it. He's thinking along the lines of a total titanium one maybe. He is going to discuss it with the manufacturers and it may be a bespoke knee. Again whether to use cement or not was discussed. Nothing was finalised. It will probably be 8 weeks before the op which seems an awful long time to me. I guess there is a lot of decisions to be made before then and a knee to order.

There is a glimmer of hope now that there is a possibility of a resolution ahead by this summer. The waiting game begins again!
 
Glad to hear you have some answers and a possible solution for a new knee. A custom implant sounds like it will work for you, made out of titanium to reduce the chance of a reaction.
The 8 weeks seems like a long time, takes forever, and all of a sudden the date is here.
Thanks for the update!
 
Pleased to hear that you may at last have some answers and that your consultant listened to you. I know another 8 weeks seems a long time to wait, but it will soon pass, especially with the better weather in prospect and the lighter evenings from this weekend.

I have titanium uncemented replacements in both my knees. After my infection saga my consultant decided that would be the best thing for me. Then when I had the revision last November he went straight for that option, so I now have a matching pair, and both knees will set off the alarms at airports rather than just the one.

You have been so patient and strong through all this and I do hope and pray that by the summer you will see an end to it all and you'll have a functioning knee again. Linda x
 
Thank you Pumpkin and Coppernob. Can I ask you @Coppernob if you know the manufacturer of your knees. I'd be very interested to know, especially as they are cementless.
 
I seem to remember my surgeon saying it was a Johnson and Johnson knee when he did the first one, and presumably my latest one is the same. Linda x
 
Glad that at least you have some more information. I hope he finds something that will work out great for you after all the things you have gone through and you end up with a functioning shiny new knee. I will keep you in my thoughts. Lee
 

@busylizzie
Will you be getting any additional consultations and opinions? I am in the USA and unsure how things work in the UK; but for something so serious, I'd be getting one, maybe two more opinions. Just to be sure of a path forward.

Maybe Josephine can enlighten how second opinions work in the UK. #167 above @Josephine
 
@Josephine that is what Prof Kay told me on Monday. I thought it was a lot. I was working out how many he must do a week to get to that number. I guess it is just about feasible.
 
Just checked and he carried out a total 325 ops (combined knee and hip ) in 2012, Almost 3 times national average.
 
Actually he did 146 primary hips and 49 revisions in 2012. And that year he was on a LOT of committees! So in a 'normal' year, it could be as high as 200 primaries or even more. He's in his late 50s so has a career spanning maybe 30 years which does work out at around 5½-6,000 primary hips!
 
@1ELISEA This was my original second opinion. I was referred to him last July. It has taken this long to get this far. As far as any more opinions I don't know where else I could go nobody seems to know much about allergies/reactions . I have got an appointment with my rheumi next month. He was the one that was very concerned about me when my original surgeon told me I had to live with what I got. He did additional tests and confirmed my feelings that my knee was not right. I'm going to discuss the foreign body reaction with him. I can't think of anything else I can do. The hospital I'm with now is one of the best in the uk for joint replacements
 
@busylizzie
It is a dilemma. The cementless implants are not nickel free; and the nickel free implants are not cementless.

Went down the whole decision path before deciding to go with the nickel free. Tough position to be in lizzie.

Even it you had a totally complete custom made, including the materials (with your own blend of titanium), don't know if it could be made cementless. And they are still rare and very six figures expensive.

Hope you get some positive news; and good that you are seeing your Rheumatologist.
 
@1ELISEA
See below what Coppernob said in post #169 She is from the UK also. Coppernob says that the knee is from Johnson and Johnson. From what I've researched a completely titanium LCS total knee prosthesis (Depuy®) is available as a special implant. (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3081493/)

"I have titanium uncemented replacements in both my knees. After my infection saga my consultant decided that would be the best thing for me. Then when I had the revision last November he went straight for that option, so I now have a matching pair, and both knees will set off the alarms at airports rather than just the one."
 
I'm getting really fustrated now. I'm fed up living as I am. I've got about 6 weeks to go if he keeps to his time scale this time. No dates yet. The days and especially the nights drag. I've returned the Red Cross wheelchair and bought my own as it fits in the car easier and is more comfortable. It is 19 weeks now that I have been without a knee. I just hope when the time comes he is able to fit me with a functioning new knee. Sorry for the rant but I'm feeling low at the moment and my good knee is really playing up with the extra stress on it.
 
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