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Swelling and stiffness, 3 years after total knee replacement

Posted by bengalady @bengalady, Oct 9, 2019

I had knee replacement 3 years ago. It is worse than previous knee pain, and getting worse as more time goes by. My surgeon (in another state) says everything normal based on X-ray. Ortho doc here says the same, and said I’m having pain and he referred me to pain clinic for possible nerve block. I want to know WHY am I having pain, although I didn’t call it pain. ROM is 100. They can’t see everything on X-ray. I want an MRI. Want to go for second opinion. Should I tell new doc I’m there for second opinion, I don’t think that’s necessary......I think that would cause some bias, ie they would just say same thing.
Has this happened to anyone ? Thoughts ?
TIA

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mrsflutterby | @mrsflutterby | Dec 10, 2020
In reply to @gardeningjunkie "Nickel is probably the most common metal allergy because it is easily recognized. That's why costume..." + (show)
@gardeningjunkie

Nickel is probably the most common metal allergy because it is easily recognized. That's why costume jewelry has "nickel free" pierced earring posts. I learned early on my pieced ear holes would swell and turn black, but gold or surgical steel posts were okay sometimes but gold is the best. Blood Test showed I have a moderate nickel and moderate aluminum allergy the other metal allergies are only mild, but with exposure I have learned allergies become more severe. I do not understand why the 5 Day Extended Patch Test on the skin didn't show a reaction to metals. I even had it done twice for metals, yet I had clear reactions on the blood test. The full 5 Day Extended Patch Test testing for about 80 natural and chemical elements, plus the full metal panel is an additional cost. Basic 5 day test, $1,500 plus and Medicare pays for this. Yet Medicare wouldn't pay for the this metal test in the blood which my ortho said was more reliable for metals.
I learned I blister up from liquid bandage as well as other adhesive Band-Aid products. Yet some are okay. I do fine with the adhesive on paper tape. Also blood test showed no allergy to bone cement. This bone cement was not on my 5 day Extended Skin patch test.
If your bone cement is gone, it doesn't really vanish. It is transferred from your cells into your blood stream but I have no idea how long it lasts there before the body eliminates it.
You may not be allergic, but your body seems to attacking the bone cement to break it down and eliminate it.

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Oh boy does it attack it! The good news here is that it is a lifetime medical case with Workers Comp who will cover the odd test or some things Medicare doesn’t cover. I’d love to get to the bottom of this since the revision is now getting progressively looser. It randomly bruises and swells as well as feels like hyper-extension on the back of the knee. Ugh. Thanks for the insight.

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gardeningjunkie | @gardeningjunkie | Dec 10, 2020

Until you get a name for what is happening to you it can't be treated. I have learned that about other health issues I have had. Once you figure out the cause you can go forward. I hope my ideas give you new ideas to research an glad you have good insurance.

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Erika | @erikas | Dec 13, 2020
In reply to @mrsflutterby "I find your case fascinating because I have adhesive allergies as well and my first knee..." + (show)
@mrsflutterby

I find your case fascinating because I have adhesive allergies as well and my first knee replacement had to be revised after 5 years due to the cement having “vanished”. Literally, there was no cement left when they went in to drill out the old knee, the doc just lifted it out without any problem! Now the revision is a bit loose. I wonder if my allergy to adhesive could be related to an allergy to bone cement thereby causing the cement to breakdown and vanish! My other knee is ready for replacement too and now I’m wondering if this is something I need to look at. Since I’ve had allergic reactions in the hospital to all forms of adhesive (from Bandaids to Tegaderm) I’m thinking I need to do the allergy testing. I’m also allergic to Nickel which piqued my inquiry.

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@mrsflutterby Welcome to Mayo Clinic Connect, a place to give and get support.

It sounds like you have had to undergo multiple knee surgeries and you are wondering if you have an allergy that is causing the, "cement" to disappear.

May I ask if an allergist would be the provider to discuss this with first or the surgeon?

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1 reply
mrsflutterby | @mrsflutterby | Dec 13, 2020
In reply to @erikas "@mrsflutterby Welcome to Mayo Clinic Connect, a place to give and get support. It sounds like..." + (show)
@erikas

@mrsflutterby Welcome to Mayo Clinic Connect, a place to give and get support.

It sounds like you have had to undergo multiple knee surgeries and you are wondering if you have an allergy that is causing the, "cement" to disappear.

May I ask if an allergist would be the provider to discuss this with first or the surgeon?

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Technically yes (and thank you for the kind welcome!) it could also be a test my dermatologist could perform. My allergist is only seeing patients virtually right now and honestly, I’m not in a hurry to run out and get tested because it requires Workers Comp approval (not likely to happen). The ortho/surgeon said it could be one of many things besides an allergy. I was just surprised to see how similar my symptoms were to others!

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1 reply
eeppeerr88 | @eeppeerr88 | Dec 30, 2020

I had a tkr 5 years ago and within the last 3 month I"m experiencing pain and swelling. I"ve always had swelling and warmer than normal at the knee. I"ve had blood tests, MRI, Cat Scan, and a ultra sound. All has come up normal. I need to go to a second Doctor for a opinion because this can"t be normal .

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2 replies
Mentor
John, Volunteer Mentor | @johnbishop | Dec 30, 2020
In reply to @eeppeerr88 "I had a tkr 5 years ago and within the last 3 month I"m experiencing pain..." + (show)
@eeppeerr88

I had a tkr 5 years ago and within the last 3 month I"m experiencing pain and swelling. I"ve always had swelling and warmer than normal at the knee. I"ve had blood tests, MRI, Cat Scan, and a ultra sound. All has come up normal. I need to go to a second Doctor for a opinion because this can"t be normal .

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@eeppeerr88 I'm sorry to hear you are still experiencing pain and swelling in the knee 5 years after your TKR. It does sound warranted to seek another opinion if your current doctor is unable to figure out why you are still having pain and swelling in the knee. If it were me and I had the ability to seek another opinion I definitely would do it. I did run across an interesting article that you might find helpful.

The Unhappy Total Knee Replacement Patient: Figuring out What is Wrong: https://holycrossleonecenter.com/unhappy-total-knee-replacement-patient-figuring-wrong/

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1 reply
sprinrosa64 | @sprinrosa64 | Dec 30, 2020

my TKR is now 2yrs , with a revision 8mons ago and i still can't take a step without server pain. I have asked about MRI but was told MRI are not trust worthy after replacement yet I read here many patients are having MRI . Is a MRI ok after replacement or not

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2 replies
eeppeerr88 | @eeppeerr88 | Dec 30, 2020
In reply to @johnbishop "@eeppeerr88 I'm sorry to hear you are still experiencing pain and swelling in the knee 5..." + (show)
@johnbishop

@eeppeerr88 I'm sorry to hear you are still experiencing pain and swelling in the knee 5 years after your TKR. It does sound warranted to seek another opinion if your current doctor is unable to figure out why you are still having pain and swelling in the knee. If it were me and I had the ability to seek another opinion I definitely would do it. I did run across an interesting article that you might find helpful.

The Unhappy Total Knee Replacement Patient: Figuring out What is Wrong: https://holycrossleonecenter.com/unhappy-total-knee-replacement-patient-figuring-wrong/

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Thanks for the reply John I will follow up with the Leone center.

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gardeningjunkie | @gardeningjunkie | Dec 30, 2020
In reply to @mrsflutterby "Technically yes (and thank you for the kind welcome!) it could also be a test my..." + (show)
@mrsflutterby

Technically yes (and thank you for the kind welcome!) it could also be a test my dermatologist could perform. My allergist is only seeing patients virtually right now and honestly, I’m not in a hurry to run out and get tested because it requires Workers Comp approval (not likely to happen). The ortho/surgeon said it could be one of many things besides an allergy. I was just surprised to see how similar my symptoms were to others!

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I had to pay for blood testing for the knee implant parts. It's the best $600.00 I ever spent. If you are allergic it must come out, once allergic always allergic and the reaction time and severity will only get worse.

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1 reply
eeppeerr88 | @eeppeerr88 | Dec 30, 2020
In reply to @sprinrosa64 "my TKR is now 2yrs , with a revision 8mons ago and i still can't take..." + (show)
@sprinrosa64

my TKR is now 2yrs , with a revision 8mons ago and i still can't take a step without server pain. I have asked about MRI but was told MRI are not trust worthy after replacement yet I read here many patients are having MRI . Is a MRI ok after replacement or not

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Check with another doctor because a MRI should show any problems. Why the waiting period makes no sense.

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