TKR revision surgery and problems

@contentandwell I had bilateral Jan 2019. MUA Feb 2019. Active, healthy, 125lbs, 61 yr old. No health issues at all other than bad knees. Should have been an excellent candidate for surgery. After the manipulation things never got better. I was diligent with PT at home and I still go once a week at 6 months post op. By April I felt frustrated and so did my PT's with the little progress I was making. The pain was unbearable, still is. I still can't walk very well, people tell me it's painful to watch me walk. I can't stand for more than 10 minutes due to pain. At 5 months my surgeon said "just part of recovery". My PT's didn't agree and suggested a second opinion. It was with a top surgeon who specializes in failed implants and revisions. He said they appear to be too big for me, along with knee caps that were not placed back properly. I have 3 different sizes ranging from 3-5 in the surgical notes. 2 nd opinion Dr. suggested revision on right femur that is a size 5, tibia size 4, he could shave the plate and use the tibia implant. On my left knee I have a 4 femur and 3 tibia, so not as big nor as painful, but still not the right fit. He said to revise right and if I was pleased with the outcome I could consider the left or just live with it. I asked about custom fitting before surgery and was told no one in the area did that, would have to travel out state. I'm trying to decide how long to wait, Dr said within 18 months (which would be 24 months post op). The pain and rehab are still pretty fresh with me, so I want to know if those that had revisions were satisfied with outcomes.

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<p>Problem 2 1/2 years post tkr</p><p>After I was ok 2 1/2 years post surgery, I awoke one morning unable to put weight on my leg. There was significant swelling. In the 6 months since this developed, I have had about 8 flare ups, which only occur during the night, while I am sleeping. I need to use a cane for several days after a flare up. During the other times I am able to resume my other activities, though with caution. Nothing showed in x-rays and original surgeon isn't sure what is the cause. His assessment is for revision surgery is to consider putting a thicker poly in verses changing the tibial component and using constrained poly. Infection has been ruled out. Possibility of allergy to metal or cement, though I've been told that allergy testing has many false positive results. I am doing PT to strengthen the muscles around my knee, using an exercise bike. Second opinion by another surgeon: possibility of some early reaction to the polyethylene debris. It has not gone on to loosening but these episodes of effusions could be in response to the plastic. Both surgeons have conferred and are encouraging me to wait until more flare ups before having a revision replacement. I'd welcome any input from others, particularly in regard to why the problem develops only while I am sleeping.</p>

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<p>Problem 2 1/2 years post tkr</p><p>After I was ok 2 1/2 years post surgery, I awoke one morning unable to put weight on my leg. There was significant swelling. In the 6 months since this developed, I have had about 8 flare ups, which only occur during the night, while I am sleeping. I need to use a cane for several days after a flare up. During the other times I am able to resume my other activities, though with caution. Nothing showed in x-rays and original surgeon isn't sure what is the cause. His assessment is for revision surgery is to consider putting a thicker poly in verses changing the tibial component and using constrained poly. Infection has been ruled out. Possibility of allergy to metal or cement, though I've been told that allergy testing has many false positive results. I am doing PT to strengthen the muscles around my knee, using an exercise bike. Second opinion by another surgeon: possibility of some early reaction to the polyethylene debris. It has not gone on to loosening but these episodes of effusions could be in response to the plastic. Both surgeons have conferred and are encouraging me to wait until more flare ups before having a revision replacement. I'd welcome any input from others, particularly in regard to why the problem develops only while I am sleeping.</p>

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

To have swelling suddenly 2.5 years after surgery and continuation since this is obviously concerning and you are looking for answers and support.

I moved your question to an existing discussion where members like @doodles418 @cobweb @amberpep @contentandwell @debbraw have previously discussed this topic.

A revision is a major surgery, especially since you are unsure of the problem. You said that you met with 2 surgeons. May I ask if either of these surgeons were at a specialty or teaching hospital system? If not, have you considered getting a third opinion from a specialist?

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Your situation has many similarities to mine. I am almost five years post- op after 5 surgeries on the same hip. After considerable research I am not rushing into any more. I am allergic to nickel, chromium and cobalt all of which were put in my body in the first Surgeries. I tested positive with blood tests from Melisa testing in the US. Unexplained pain will not be a reason for surgery for me at this point. I do know their is some lucency tho but still doing my research. Am investigating neuropathy now. Happy to connect any time.

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Wife was diagnosed with metal allergy to replacement knee joint which was then removed and replaced with a Smith & Nephew alloy unit which didn't solve the problem. Doctor is now recommending another replacement. We are wondering if treatment by an allergist could lessen her bodies reaction to titanium?

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<p>Problem 2 1/2 years post tkr</p><p>After I was ok 2 1/2 years post surgery, I awoke one morning unable to put weight on my leg. There was significant swelling. In the 6 months since this developed, I have had about 8 flare ups, which only occur during the night, while I am sleeping. I need to use a cane for several days after a flare up. During the other times I am able to resume my other activities, though with caution. Nothing showed in x-rays and original surgeon isn't sure what is the cause. His assessment is for revision surgery is to consider putting a thicker poly in verses changing the tibial component and using constrained poly. Infection has been ruled out. Possibility of allergy to metal or cement, though I've been told that allergy testing has many false positive results. I am doing PT to strengthen the muscles around my knee, using an exercise bike. Second opinion by another surgeon: possibility of some early reaction to the polyethylene debris. It has not gone on to loosening but these episodes of effusions could be in response to the plastic. Both surgeons have conferred and are encouraging me to wait until more flare ups before having a revision replacement. I'd welcome any input from others, particularly in regard to why the problem develops only while I am sleeping.</p>

Jump to this post

Wife was diagnosed with metal allergy to replacement knee joint which was then removed and replaced with a Smith & Nephew alloy unit which didn't solve the problem. Doctor is now recommending another replacement. We are wondering if treatment by an allergist could lessen her bodies reaction to titanium?

Jump to this post