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Severe Pain after 2nd TKR

Joint Replacements | Last Active: Jan 11, 2023 | Replies (66)

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@psg25

Severe Knee Pain for 21 months after Knee Replacement.
Sorry in advance for this being so long. I need suggestions from any and all on severe pain after a knee replacement. Had Left knee replaced in Sept 2019. Age 65. I knew what to expect due to prior knee and hip replacements. Due to a severe basketball injury at age 24, I've had two replacements on my right knee. One when I was 39 and a revision at 55. I've also had both hips replaced. The left one replaced twice due to a recall when the metal broke down and gave me blood poisoning. I mention all this as I knew what I was getting into and didn't have an unreal expectations as some doctors accuse people of when there are problems.
I have been in severe pain ever since the left knee was replaced and it just never got better after the surgery. The pain is mostly above the kneecap, below the kneecap and on the lateral (outside) side of my leg. But my entire leg is sensitive and painful just to the touch. I go nuts if my cat walks over my leg. It is also stiff and totally useless on stairs but I do have full ROM. I did months of therapy. I also biked and went swimming. NOTHING helped. I went back to my original surgeon who had previously done ALL my replacements and I had gone to him for 30 years. I was tested for infection and unusual inflammation and had new Xrays. Everything tested okay. I went back to therapy to see if that would help the pain. I also biked and went swimming some more. Nothing helped. I went back to my surgeon late last summer and he blew me off without even looking at it. At that point it was almost a year. I went to another surgeon who was less experience but I thought he might take more of an interest. He redid the infection and unusual inflammation test and Xrays, but again they were okay. He also sent me to any allergist to test for metal allergies. They just slapped something on my back for 2 days, charged me $350 and found nothing. I've since read multiple times that skin allergy tests don't really indicate an allergy to artificial joints. I also wonder given all my other artificial joints whether I would have an allergy but none of my other joints have nickel plus the tests didn't test for cements. I got the records for my previous replacements and the cements used were different. Plus the body can change and become allergic to different things as you get older. My knee replacements are from different manufacturers. The one I'm having problems with right now is a Stryker Triathalon. My other knees is a DePuy PFC Sigma. I have gone to a pain specialist for years due to the damage to my right leg from the basketball injury when I was in my 20s. My pain specialist did a Nerve Ablation on my left leg/knee to block the pain. This helped somewhat for about 4 months but I have again been in severe pain for months. No pain medication helps as I am considered to be a rapid metabolizer of pain meds. Basically meaning Ive been using pain meds so long my body no longer responds to them. Although I have only used extended release pain meds for the last few years. No immediate release meds as they don't work. So last week I went saw another surgeon at the University of Wis. He also tested for infection, unusual inflammation and did Xrays. Again these showed nothing. He also told me there was no such thing as allergies to the metals or cements in knee replacements which I though was weird as I've read dozens of studies saying that it is a possibility. I still wonder about this as I keep getting rashes on my stomach and abdomen area for no reason. Some of the literature says a rash can indicate an metal allergy. This surgeon told me he couldn't help me and once I told him that I had a recalled hip on the same side as my knee, he blamed the pain on my hip and walked out. I'm not having any problems with my hip. I found a blood test for metal and cement allergies called an LTT test from a Orthopedic lab in Chicago but its $550. My insurance won't tell me whether they'll will pay for it as I have to pay for it up front and then submit the bill back to my insurance. I'm at a total loss as to what to do. It will be two years in Sept. I can't walk much. I can't do steps at all. I'm in pain 24/7/365. I can't do anything I used to enjoy and quite frankly I can't live like this much longer. My dog hasn't been on a walk in 21 months. So has anyone actually been allergic to a Stryker Triathalon or a specific cement, called Simplex P Speed Set w/Methymethacrylate. Does an x-ray test for malposition of the components, soft tissue imbalance or problems with the knee sleeve? Or how does one get tested for for those things. Does anyone else have any other ideas or suggestions of who to see? I am beyond frustrated and really don't want to live like this. I was teaching but I retired early last year as I can't stand or walk. I can't take this any longer. I'm sorry I ever had this knee replaced. It was starting to be bone on bone but it was never as bad as all of this. Its like a rat gnawing on my brain all day, every day. ( I should mention my original surgeon retired.)

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Replies to "Severe Knee Pain for 21 months after Knee Replacement. Sorry in advance for this being so..."

Hello @psg25, Welcome to Connect, an online community where patients and caregivers share their experiences, find support and exchange information with others. I have had my right knee replaced but I don't have any experience with metal allergy testing. I did find some information that may be helpful though.

Diagnosis of Metal Hypersensitivity in Total Knee Arthroplasty: A Case Report: https://www.frontiersin.org/articles/10.3389/fimmu.2019.02758/full

There is another discussion you might find helpful where other members are discussing this issue.
-- Severe metal allergy to titanium, nickel need joint replacement: https://connect.mayoclinic.org/discussion/severe-allergy-to-titanium-nickel-need-tkr-in-severe-pain/

You might also appreciate the information shared by members in this related discussion --
Need TKR and had positive allergy testing / Bone Cement and Metals https://connect.mayoclinic.org/discussion/need-tkr-and-had-positive-allergy-testing-bone-cement-and-metals/

@grandpacb, @debbraw, and @sueinmn may also have some suggestions or thoughts to share with you.

You mentioned your insurance company won't tell you if they will cover the allergy testing until you submit the bill. Here is some information that may help - Tips for When Your Medical Insurance Company Will Not Pay: https://www.verywellhealth.com/health-insurance-company-wont-pay-3231743

Does your insurance company have any arbitration information on denied claims?

psg25, I too am stuck in this unbelievable pain after TKR with no answers. My pain is in knee and below, I had it done in 2018 and revision in 2020 with no relieve . I have tried numerous shots , test , cut nerves with no answers. Doctors check alergries, xrays nothing. By far most doctors tell me it;s nerve damage or nerve condition after 1st replacement and there is nothing tat can be done since I have tried many different things. When sitting or lying down I am fine , stand up and walk pain goes right to a 9. I just want to be able to walk. New doctor says last resort will be DRG implant. I have a meeting with him june 2 to go over a plan. PRACTICING MEDICINE HAS A WHOLE NEW MEANING TO ME Hang in there, keep searching. Steve