Knee revision: How can I improve balance and numbness?

Posted by tacaropat @tacaropat, Jul 7, 2021

Has anyone had a successful knee revision after scar tissue, trouble with balance and numbness. I don’t want to make things worse, I feel like I’ve aged 15 years. I had Mako knee replacement two years ago and sorry! Nothing but trouble! I’ve gone to PT two different times in Maryland and Florida. I have better bend but balance, numbness, heaviness and just hurts! I’m so frustrated, I didn’t know a revision was possible.

Interested in more discussions like this? Go to the Joint Replacements group.

@tacaropat Before you think about revision surgery, one suggestion I could make is look at the possibility of an immune response to the implant materials as a source of the pain. There is a lab in Chicago that tests for implant material hypersensitivity. https://www.orthopedicanalysis.com/ I think I have a reaction to titanium plates I have on my ankle because of an ankle fracture a year ago. I have chronic hives and have to keep taking antihistamines to keep that at bay.

If you are having a reaction to your artificial knee, there are environmental allergy medicine doctors who treat this. You can search for a provider at https://www.aaemonline.org/. The blue provider search button is in the upper right corner on the main page. The practice that fathered this field of medicine is the Environment Health Center in Dallas. Their website mentions treatment for implant sensitivities and they have medical teaching volumes written for doctors. Here is the link. https://www.ehcd.com/

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Thank you! I do have a titanium knee. Don’t have rashes but will look into. Thanks!

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@jenniferhunter

@tacaropat Before you think about revision surgery, one suggestion I could make is look at the possibility of an immune response to the implant materials as a source of the pain. There is a lab in Chicago that tests for implant material hypersensitivity. https://www.orthopedicanalysis.com/ I think I have a reaction to titanium plates I have on my ankle because of an ankle fracture a year ago. I have chronic hives and have to keep taking antihistamines to keep that at bay.

If you are having a reaction to your artificial knee, there are environmental allergy medicine doctors who treat this. You can search for a provider at https://www.aaemonline.org/. The blue provider search button is in the upper right corner on the main page. The practice that fathered this field of medicine is the Environment Health Center in Dallas. Their website mentions treatment for implant sensitivities and they have medical teaching volumes written for doctors. Here is the link. https://www.ehcd.com/

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Have you had such testing done and found that you are in fact allergic to titanium?

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Sorry to hear this; I am in the same boat. I saw Dr. Perry at Mayo and he advised against revision because I could end up worse due to my tendency to form scar tissue. My knee makes me very unhappy indeed. I cannot fully straighten it or bend it. Because I cannot straighten my knee, I have trouble walking; maybe that is why you feel off-balance? I am still in physical therapy after a year and a half. I use a Dynasplint daily and take Celebrex. I have numbness but I don’t worry about that because it’s very common.

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@sharonbrenna

Have you had such testing done and found that you are in fact allergic to titanium?

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@sharonbrenna @tacaropat Hi Sharon. Thank you for your question. The problem with titanium is that it isn't pure. There are some other trace metals in it. I am a spine surgery patient, and prior to that, I did have my blood tested for allergies to several metals. At that time, the test did not show any problems which surprised me a bit. I had to make a decision on cervical spine surgery about fusion vs. artificial disc. I wasn't the best candidate for the artificial disc and I decided to have a fusion with no hardware, just a bone graft and avoid any potential issues related to hardware. I had also had some issues with dental crowns in my mouth, one of which was a titanium base and the others were metals of something else. With failing root canals under the crowns, I had the teeth removed and replaced with non metal implants of Zirconium that came a bit later. As soon as the teeth with all the metal was extracted, my asthma and breathing suddenly improved and I was breathing easily needing no medication or inhalers at all. There was less inflammation in my body. I do allergies shots for seasonal allergies. I had no metals in dental fillings because they had all been replaced with safer materials by a biological dentist several years ago.

All was well until I broke my ankle a year ago, and needed titanium plates to fix the joint. My asthma got worse again, and I do have some pain around the plates, and there is some pigmentation happening over the plates on my skin. 6 months after receiving the ankle plates, I began having chronic hives… not one or two, but whole patches covering large areas of my arms, thighs or belly. Nothing else has changed, so I suspect I have developed a reaction to them. I will know after the hardware is removed and they bother me enough to go through it. I have not been re-tested to confirm a metal allergy to titanium as my insurance won't pay for that. I did have to give up wearing pierced earrings completely many years ago because of contact allergies to the metals….. all of them including 22 k gold, silver, surgical steel and platinum. Inflammation ads up in the body and can come from lots of things like allergies or foods. I have a restricted diet because of food allergies and gluten so I cleaned that up years ago, and I can't eat a lot of the foods that are considered unhealthy. I have already decided to remove the hardware, so I don't feel a need to retest immune responses to metals.

Another suggestion I could make would be to consider trying to stretch the surgical scar tissue with myofascial release therapy. All surgery creates scar tissue and scar tissue and knots in the fascia which is tight holding everything together. If that gets stretched out, it can glide and move again which relieves pain. I do this therapy a lot with my physical therapist. Here is our discussion with lots of information on the first few pages. There is a provider search on the MFR website. See the discussion for that info. https://connect.mayoclinic.org/discussion/myofascial-release-therapy-mfr-for-treating-compression-and-pain/

Is myofascial release something new that you may want to consider?

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Thank you Jennifer I will consider!! Thank you!! It does makes sense!

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@tacaropat

Thank you Jennifer I will consider!! Thank you!! It does makes sense!

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This related discussion may also be of interest. Members provide suggestions of how to improve mobility post TKR
– What can you do to extend the life of your TKR and mobility?: https://connect.mayoclinic.org/discussion/what-can-you-do-to-extend-the-life-of-your-tkr-and-mobility/

@tacaropat, do you do any balance exercise? Are you still seeing a physical therapist?

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@jenniferhunter

@sharonbrenna @tacaropat Hi Sharon. Thank you for your question. The problem with titanium is that it isn't pure. There are some other trace metals in it. I am a spine surgery patient, and prior to that, I did have my blood tested for allergies to several metals. At that time, the test did not show any problems which surprised me a bit. I had to make a decision on cervical spine surgery about fusion vs. artificial disc. I wasn't the best candidate for the artificial disc and I decided to have a fusion with no hardware, just a bone graft and avoid any potential issues related to hardware. I had also had some issues with dental crowns in my mouth, one of which was a titanium base and the others were metals of something else. With failing root canals under the crowns, I had the teeth removed and replaced with non metal implants of Zirconium that came a bit later. As soon as the teeth with all the metal was extracted, my asthma and breathing suddenly improved and I was breathing easily needing no medication or inhalers at all. There was less inflammation in my body. I do allergies shots for seasonal allergies. I had no metals in dental fillings because they had all been replaced with safer materials by a biological dentist several years ago.

All was well until I broke my ankle a year ago, and needed titanium plates to fix the joint. My asthma got worse again, and I do have some pain around the plates, and there is some pigmentation happening over the plates on my skin. 6 months after receiving the ankle plates, I began having chronic hives… not one or two, but whole patches covering large areas of my arms, thighs or belly. Nothing else has changed, so I suspect I have developed a reaction to them. I will know after the hardware is removed and they bother me enough to go through it. I have not been re-tested to confirm a metal allergy to titanium as my insurance won't pay for that. I did have to give up wearing pierced earrings completely many years ago because of contact allergies to the metals….. all of them including 22 k gold, silver, surgical steel and platinum. Inflammation ads up in the body and can come from lots of things like allergies or foods. I have a restricted diet because of food allergies and gluten so I cleaned that up years ago, and I can't eat a lot of the foods that are considered unhealthy. I have already decided to remove the hardware, so I don't feel a need to retest immune responses to metals.

Another suggestion I could make would be to consider trying to stretch the surgical scar tissue with myofascial release therapy. All surgery creates scar tissue and scar tissue and knots in the fascia which is tight holding everything together. If that gets stretched out, it can glide and move again which relieves pain. I do this therapy a lot with my physical therapist. Here is our discussion with lots of information on the first few pages. There is a provider search on the MFR website. See the discussion for that info. https://connect.mayoclinic.org/discussion/myofascial-release-therapy-mfr-for-treating-compression-and-pain/

Is myofascial release something new that you may want to consider?

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Thank you for your response. I’m sorry that you have so many complications but it seems you are addressing them as best you can. I don’t think myofascial release will help in my case because the scar tissue is deep in the knee, But thank you for the suggestion. You never know when you might change a person’s life with one little tip! My best to you!

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@sharonbrenna

Thank you for your response. I’m sorry that you have so many complications but it seems you are addressing them as best you can. I don’t think myofascial release will help in my case because the scar tissue is deep in the knee, But thank you for the suggestion. You never know when you might change a person’s life with one little tip! My best to you!

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It must be frustrating to know the scar tissue is there, but beyond reach of traditional therapies. It looks like you have been trying for a long time to deal with the scar tissue – have you consulted with an arthrofibrosis specialist? My Mom also got some relief from acupuncture – it didn't completely get rid of the scar tissue, but seemed to "soften" it.
Sue

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@sharonbrenna

Thank you for your response. I’m sorry that you have so many complications but it seems you are addressing them as best you can. I don’t think myofascial release will help in my case because the scar tissue is deep in the knee, But thank you for the suggestion. You never know when you might change a person’s life with one little tip! My best to you!

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@sharonbrenna Thanks, Sharon. I wanted to explain a bit about fascia. Think of it as a cob web type net that is 3 dimensional. If I pull on one side of it, that pull extends deep into it and even affects the other side of it. Now imagine that inside this 3 dimensional net are your bones and organs. Your organs are held together by connective tissue and guess what.. fascia. The fascia extends through and around organs. When my PT is stretching fascia with shearing pressure on the surface of my chest, I feel the tingle and pull from that deep into my chest and internally even around my heart and lungs if that is where it was tight. It is like following a map around the body. My PT can feel with her hands where it is tight when she is trying to move it. If there were no problems and everything just moved as it should, she would not feel any tension, but when she does find it, she finds the pathway that connects it to other things. The fascia also conducts electricity and helps in removal of waste products. When it gets stuck, those waste products are stuck too held in the tissue. The picture you see in the video below is fascia.

Does this seems like crazy stuff? It is what happens at a more intimate layer in the body. If you try MFR therapy (myofascial release), would you share your experience of what you think about it?

Here is a video that shows living fascia that starts at about the 11 minute mark so you can actually see how it moves.

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@jenniferhunter

@sharonbrenna Thanks, Sharon. I wanted to explain a bit about fascia. Think of it as a cob web type net that is 3 dimensional. If I pull on one side of it, that pull extends deep into it and even affects the other side of it. Now imagine that inside this 3 dimensional net are your bones and organs. Your organs are held together by connective tissue and guess what.. fascia. The fascia extends through and around organs. When my PT is stretching fascia with shearing pressure on the surface of my chest, I feel the tingle and pull from that deep into my chest and internally even around my heart and lungs if that is where it was tight. It is like following a map around the body. My PT can feel with her hands where it is tight when she is trying to move it. If there were no problems and everything just moved as it should, she would not feel any tension, but when she does find it, she finds the pathway that connects it to other things. The fascia also conducts electricity and helps in removal of waste products. When it gets stuck, those waste products are stuck too held in the tissue. The picture you see in the video below is fascia.

Does this seems like crazy stuff? It is what happens at a more intimate layer in the body. If you try MFR therapy (myofascial release), would you share your experience of what you think about it?

Here is a video that shows living fascia that starts at about the 11 minute mark so you can actually see how it moves.

Jump to this post

Thank you, but I am familiar with facia and myofascial release. I have not tried it but if I ever need to do so, I certainly will!

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