Need TKR and had positive allergy testing / Bone Cement and Metals

Posted by okieshan1 @okieshan1, Sep 13, 2018

Does anyone have any suggestions on any medical replacement joints on the market my orthopedic surgeon might not know about? I was scheduled for total knee replacement and my surgeon MADE me take a blood allergy test from Orthopedic Analysis.. Test showed "reactive" to Bone Cement monomer so surgeon referred me to a colleague who could do a cement-less knee. Upon his review of my results however, he also stated I was "mildly-reactive" to Chromium, Molybdenum, Nickel, Vanadium, Zirconium and Iron. (Screenshot of levels attached). I'm also 'mildly reactive' to Cobalt Alloy and Titanium Alloy Particles.

My surgeon said, "I recommend you exhaust all other options, because I can do the cement-less knee, but if the metal allergy bothers you, there will be nothing I can do." Very hard to hear as I'm only 55 and active. In the meantime, I've gotten Genicular nerve burn in both knees which helped reduce pain level from 7 to a 4, but I'm trying to find out if there are any other surgical implant options that might work for someone with Bone cement and certain Metal allergies? Also, wondering will this even affect me as I can wear any type of cheap costume jewelry without ever having a reaction? If I have no issue with metal touching my skin, will it bother me if I have it in my joint for TKR?

Thanks in advance for ANY advice!

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@irish283

In reply to iturn9@turn9
I too have a failed TKR from Aug.2019. I never knew that doing allergy testing “was a thing” that was available. Went full steam ahead with my surgery and realized fairly early in during rehab something was wrong! Well 13 mos post op and after seeing 5 other doctors, and a doctor who i went to see for torn rotator cuff, sent me to the last doctor, who in turn sent me for allergy testing.
Results showed I am allergic to bone cement, as well as antibiotic neomycin sulfate! Needless to say I am DEVASTATED. I need a revision, he said I need to do cement less , with no guarantee it will become stable. Someone suggested a press fit, but need to talked to knee doc about this....but you mention a polymer knee, What exactly is that and have you gone ahead with this ?
All of this must wait now, as I’m scheduled for rotator cuff surgery Jan 12, 2021. ALSO IF ANYONE HAS INFO TO SHARE RE ROTATOR SURGERY FEEL FREE TO SHARE WITH ME YOUR EXPERIENCE. Thanks, Irish283

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I would advise waiting if at all possible till Covid 19 is under control. Too risky

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I am highly allergic to silicone, especially on a large patch that was used in a heart procedure. Not only did I develop a rash at the site of the patch, but both legs had one huge rash all the way around both legs from head to toe.

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I am afraid your options are limited. I also am allergic to Bone Cement and the 1st 2 TKR's on my L leg failed because of the allergy., # 3 also failed but the reason for the failure of #3 is not known (at least to me). #4 has been in place for 3+ yrs and when it was put in place the doc had to trim a lot of bone from my femur and shin so now my leg is almost 4" shorter than the other mandating I use a walker or wheelchair everywhere I go. When #4 fails my only option will be an above-the-knee amputation. Can't tell you what a huge life style change this has been & will be. If I had known the trouble I would have, I would have learned to live with my bad knee. I have Neurpoathy in both legs and the symptom in my case has been severe pain in my lower legs. Luckily, the neuropathy has made my legs numb so I haven't had any TKR pain but the Neuropathy has more than made up for it. I know you don't need another sob story and were only looking for help with your sad situation. I wish there was something I could say to make life better for you, but all anyone can say is to tell you to take life 1 day at a time and try to make the best of things. . God Bless and Merry Christmas..

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@lturn9

I am afraid your options are limited. I also am allergic to Bone Cement and the 1st 2 TKR's on my L leg failed because of the allergy., # 3 also failed but the reason for the failure of #3 is not known (at least to me). #4 has been in place for 3+ yrs and when it was put in place the doc had to trim a lot of bone from my femur and shin so now my leg is almost 4" shorter than the other mandating I use a walker or wheelchair everywhere I go. When #4 fails my only option will be an above-the-knee amputation. Can't tell you what a huge life style change this has been & will be. If I had known the trouble I would have, I would have learned to live with my bad knee. I have Neurpoathy in both legs and the symptom in my case has been severe pain in my lower legs. Luckily, the neuropathy has made my legs numb so I haven't had any TKR pain but the Neuropathy has more than made up for it. I know you don't need another sob story and were only looking for help with your sad situation. I wish there was something I could say to make life better for you, but all anyone can say is to tell you to take life 1 day at a time and try to make the best of things. . God Bless and Merry Christmas..

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I have a severe allergy to cobalt which is in stainless steel and also a severe allergy to bone cement. Dr. Mark Tuttle in Denver Colorado does many revisions to failed surgeries involving knee replacement. He obtained a custom knee for me that did not contain cobalt or nickel. It was basically a titanium knee with another component that I don’t recall. It was cementless. I suggest that you contact as many doctors as is necessary to find the product and procedure that will work for you. I think that mine is what you would call a press in joint replacement. It is absolutely stable and the bone grows into the surface of the implant.

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Thank you for the reply! I had intended to mention the "Long Spike" cement-less knee joint I was fitted with during my last surgery. It is press fitted although I am told the method surgeons use is more like Smash and Bash as they force the spike as deep as possible into the femur and tibia bones. I'm glad I was asleep during all of that! 😉 You are correct about seeking other surgeons. I had 3 different surgeons for the 4 surgeons with each suggesting the next Dr. They told me I was being sent to the surgeon that specialized in 'problem' joints.
Merry Christmas -

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Would you mind sharing the Doctors name who you were referred to for problem joints. I too am having a lot of issues with my knee after TKR. Thank you

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@denver

HI, see my reply below and welcome to the We Love Dr. Tuttle Club! I would love to talk with you. I'm doing well now too! Send me your text or email if you'd like to talk.

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Were you able to have a cementless revision after a TKR? I’m allergic to the bone cement and having terrible trouble. I worry my bones are not good enough for a cementless replacement or even for my other failing knee. Thank you.

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@kact

Were you able to have a cementless revision after a TKR? I’m allergic to the bone cement and having terrible trouble. I worry my bones are not good enough for a cementless replacement or even for my other failing knee. Thank you.

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@kact, You will notice we removed your email address to protect you from spammers who harvest email addresses from public forums like Connect. If you wish to share your email address with @denver, you can safely share contact information by using the private message function on Connect. To send a private message, just click on the members @username and click on the Send private message link under their profile description. More tips for how to perform tasks within Connect can be found in the Get Started on Connect guide. There is a link to the guide in the left column of the footer on every Connect page.

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I had TKR 3 1/2 years ago and a revision 1 1/2 years ago. I'm allergic to Nickle, we found out after I was having problems with TKR. Then I had a revision and I'm also allergic to it. My Surgeon told me that he put in a coated knee replacement. I'm concern to having a 3rd knee surgery. The revision is getting worse swelling, stiffness and pain. Also concern about the long term effects of my body rejection the revision.
Thank you
t

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