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

Hello @okieshan1. This must be a frustrating choice facing you. I did some research because I was curious myself and was able to find an article from the NIH website that you may find interesting, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4726476/. In particular, there are a few passages from the abstract of this study that you may find relevant:

"Given the limitations of current testing methods, the widespread screening of patients for metal allergies before TKA is not warranted."

"Anecdotal reports suggest that, if metal hypersensitivity is suspected and nonsurgical measures have failed, then revision to components fabricated of titanium alloy or zirconium coating can be successful in relieving symptoms. Revision should be considered as a last resort, however, and patients should be informed that no evidence-based medicine is available to guide the management of these conditions, particularly for decisions regarding revision."

@okieshan1, I see that the above mentioned alternatives also showed mildly reactive in your test results, but it does suggest that there are alternative metals and coatings out there for replacements. If you don't mind sharing, did your surgeon discuss with you any other options for knees? I would have to imagine that they have more access to resources regarding devices.

Jan 2021, I had my 1st TKR on my right knee in Indiana at 53 years old. From the beginning I complained it felt like knee was coming out my right side of leg, unstable, and lots of pain. 6 months later Dr advised doing a manipulation, to break up scare tissue. I sought 4 more opinions in Chicago all said my glue had not bonded to bone they saw on x ray acknowledged why I felt that way, they also said do not let him do that you will have worse problems. Aug 2021 I had revision with Dr from Northwestern in Chicago. The Dr replaced the bottom stem but not the top knee cap area. He had spoke with Depuy my maker of implant and they said it would work. It would be less invasive on me as well. This go around lots of pain but it feels somewhat stable. Since day one I have felt foot pain (feels like finger nails coming up the bottom of my foot and like I have blisters on bottom as well but none) . My front and back of calf ache all the time feels like the implant is hitting my front of leg bone and knee cap area hurts even thigh / quad pain day and night. I also get unbelievable bottom of foot, ankle and toe cramping. This takes my breath away, I try to walk it out and sometimes it does not help. Dr said to give revision 12-18 months to really know how I would be. At 12 months pain so bad in all places and never goes away even when I am off my feet, Dr sent me to a Back Dr to rule out foot pain not from back, ankle and foot Dr, and a neurosurgeon. Not many answers. Back dr does not think foot pain from back. I then sought out 3 more neurosurgeon opinions. Orthopedic Dr in South Bend who works with Notre Dame athletes validated the feeling of hitting my bone as the new implant in his words is toggling back and forth. He said the implant was so long and bottom portion not glued so it is moving as I walk. He said he would have replaced with smaller implant and replaced the whole thing. He sent me for more testing. He asked me to have metal testing done. I found out I am allergic to nickel and my new implant is 10% nickel. He then had me see his senior orthopedic surgeon, back dr at practice and pain management dr. They decide they thought too risky to take out and redo. They could not promise I could be better and if not worse. 24/7 pain is pretty bad. I then sought Dr NY Mt Sanai for consultation. He recommended I find Dr local who understands the following 1. nickel allergy 2. Dr who does revisions 3 Drwho understands Complex Regional pain. I saw a Dr at Rush in Chicago a colleague of his. He agreed with Southbend Drs and recommended I go to pain management Dr.
I have gone to pain management Dr I can not take gabapentin, or any other pain meds I am super sensitive to medications. We recently tried two sympathic nerve blocks to see if they will work. I have had 10% relief in my foot the rest of my leg nothing.
I am trying to find an Dr who can help me. I am 55 now and was active and I can not ride a bike or walk very far or getting down on ground very hard. I have had two Dr say go to Mayo so, I have filed my paperwork for Mayo and just waiting to hear from Dr's office.
Has any one had similar situation? nickel allergy, 24/ 7 constant pain whole leg had a 3rd revision?
Thanks for anyone's advice!
Attached is a copy of my revision left side is new revision right side is the old one

After having two knee replacements on my left knee, went to Mayo, talked to Dr Clarke about it and because of family history (including my mom and sisters being allergic) he replaced my third time with ceramic…have been good ever since!

Hello, I had Tkr and revision on my right knee within 4 years and I'm in a lot of pain and on my left I have 5 surgeries including partial knee replacement within 3 years. Can you tell me where is Dr Clarke located

He is at Mayo Clinic in Arizona…love him! I now have my right knee also with TKR with Ceramic and I can stand from a sitting position without holding onto anything and I can’t walk up and down stairs, going step-by-step, instead of using the step up with my one leg and then with the other, and I am extremely happy.