BoneSmart® Hip / Knee Replacement Forum
The world's leading knee and hip replacement
patient advocacy organzation & online community


Scarring/Adhesions

Discussion in 'Knee Replacement Pre-Op Area' started by Dianesmom, Jan 19, 2012.

Thread Status:
Not open for further replies.
  1. Dianesmom

    Dianesmom New Member

    Offline
    Member Since:
    Jan 19, 2012
    Age:
    Messages:
    4
    Location:
    United States
    Hi Everyone!
    I am considering MAKOplasty for my right knee. I had my right knee scoped in late October. My OS cleaned up my torn meniscus but apparently that has accelerated the arthritis and I'm now having more pain than ever. My biggest concern with the surgery is the possibility of scarring and/or adhesions that might cause their own pain. My mother had these problems after spinal surgery and I ended up with a pinched nerve after plantar fasciitis surgery. (Fortunately, my excellent PT was able to break up the scar tissue. :yes 4:) After some abdominal surgery adhesions formed around the drains which caused excruciating pain when the drains were removed.

    Also, my knee pain comes and goes when I'm up and around and I have very minor, if any, discomfort when sitting or driving. I do keep my cane handy at all times... What confuses me is that some of the worst pain, throbbing and stabbing, is at night when there is no weight on the joint. What gives???

    I'm getting ready to set up an appointment with my OS to discuss the PKR but would appreciate any advice so that I will have the right questions to ask!

    Thanks much!
    Sarah
  2. Josephine

    Josephine Administrator

    Offline
    Member Since:
    Jun 8, 2007
    Age:
    72
    Messages:
    50,690
    Gender:
    Female
    Country:
    United Kingdom United Kingdom
    Well hello and welcome to BoneSmart! You can rest assured that none of those instances of adhesions indicate that you or you have a propensity to adhesions. They happen to a lot of people in those particular situations. Apart from which, PKRs are no more or less inclined to get adhesions than totals.

    As for the MAKO PKR, are you certain, beyond doubt, that you have arthritis in only one compartment of your knee? Because thats the caveat with partials. The other two compartments have to be pristine and devoid of any degenerative changes in order to get the best from them. Otherwise the outcome could be that you end up having to get the partial converted to a total and that happens all too often.

    I actually know of some surgeons who have given up doing partials because of the unacceptably high rate of conversion. 'Unacceptable' being within 3 years. From chatter I've heard at conferences, they don't seem to be the only ones.

    On the other hand, there are people who have had their PKRs for some years and continue to be perfectly satisfied with them - my sister-in-law is one!

    My warning is this: there are surgeons who are 'unicondylar enthusiasts' meaning they only see treatment of OA knees in terms of partial replacements. One surgeon I know actually subjects his (willing) patients to sequential surgeries doing first one compartment, then the other and lastly the central one between the femur and the patella!

    My suggestion is: make sure your surgeon does both partials/MAKO and totals and that when he gets a look into your knee, he is prepared to be sensible and do a total if the conditions are not suitable for a partial.

    Finally, don't be fooled into thinking that just because you've had a partial, your recovery is going to be a breeze. It's still a knee replacement and an awful lot of patients find that recovery is every bit as tough as for a total, has the same pain issues, the same struggles with PT and energy drain. I know there are some who get up and run but my experience on here is that they are, if not the exception, certainly not the most common stories.

    Hope I haven't put you off too much. It's still a decent op provided the situation is 100% appropriate.

    Also, if you go into the Knee Recovery forum, you will be able to see who has had a PKR by the prefixes on the thread titles.
    • Like Like x 1
  3. Dianesmom

    Dianesmom New Member

    Offline
    Member Since:
    Jan 19, 2012
    Age:
    Messages:
    4
    Location:
    United States
    Thanks, Josephine. My surgeon did mention that the final decision about whether to do a partial or total is made during the surgery. I will definitely discuss this further when I see him.

    One other question- I have insurance under COBRA due to divorce. (I am not working.) Will having any knee surgery cause insurance companies to refuse to cover me due to a "pre-existing condition"? I have COBRA coverage for only the next 11 months.
  4. Josephine

    Josephine Administrator

    Offline
    Member Since:
    Jun 8, 2007
    Age:
    72
    Messages:
    50,690
    Gender:
    Female
    Country:
    United Kingdom United Kingdom
    That's a question for Jamie, I think! @Jamie:
  5. Jamie

    Jamie Administrator

    Offline
    Member Since:
    Mar 24, 2008
    Age:
    65
    Messages:
    35,429
    Gender:
    Female
    Country:
    United States United States
    Location:
    Kansas
    Diane.....that's an excellent question about whether having a PKR would mean that you have a "pre-existing condition" that might not be covered under a regular insurance policy once you convert from COBRA.

    As a part of the new Affordable Health Act, exemptions for adults as a result of a pre-existing condition will not be permitted starting in 2014. Of course, that doesn't do much to help you now.

    Each insurance company has their own rules regarding pre-existing conditions and you'll have to find out what they are when you know what company or companies you are considering signing up with. Most have a "waiting period" for pre-existing conditions of 12-18 months before you can begin to claim benefits for that condition or procedures related to it.

    Since you have already had treatment on your knee, it is possible that you are already in that "pre-existing condition" category as far as insurance goes. As I said....it really depends on the company and what their rules are.

    If you haven't started looking into an insurance company, you need to do that. Be honest with any you consider about what treatments you have had. It never pays to "leave out" any details of past treatments because if it is later discovered, you will likely be liable for all of the payments they covered plus you risk losing the policy.

    I suggest you Google for insurance companies offering products in your state. Sometimes you can get in on a group rate even though you are an individual. Ask a lot of questions, compare costs and benefits and do your research. Hopefully you'll find something that will work for you at a price you can afford.

    I don't know what your income level is, but since you are not working you might be covered under your state's Medicaid program (low income) or eligible to receive Social Security Disability Payments (if you are unable to work).
    • Like Like x 1
  6. RunA42K

    RunA42K Forum Advisor

    Offline
    Member Since:
    Feb 2, 2011
    Messages:
    1,429
    Gender:
    Female
    Country:
    United States United States
    Location:
    Houston, Texas USA
    Hi Sarah, so glad that you found us here on Bonesmart. I just wanted to mention to you my experience with PKR vs TKR. I had been seeing one doctor for over 3 years. Cortisone injections every 6 months, pain due to arthritis. Finally the cortisone didn't work any more than I had Supartz fluid injections. That did not help, then I had the scope surgery and that didn't help. My doctor started talking about PKR. I couldn't believe that I could be a candidate for such an extreme surgery so I sought out other second opinions. Everyone agreed that there needed to be a replacement, but a TOTAL Replacement. Only the one doctor talked about PKR. Of the other doctors I interviewed I was told each time that yes, I had arthritis and it was the very worse on the medial side, if that alone was replace then it would only be a matter of time until the arthritis crept over into the lateral side and then the PKR would have to be redone into a TKR. I was very glad to get these other 2nd opinions because I truly only wanted one surgery, as I am sure that you do too. So ask away and make sure that they understand that a TKR may be the best choice for you! Good luck :thumb:
    • Like Like x 1
  7. Dianesmom

    Dianesmom New Member

    Offline
    Member Since:
    Jan 19, 2012
    Age:
    Messages:
    4
    Location:
    United States
    Thanks, Bonnie! I sure have a lot to think about, :rolleyespink:, but it is very helpful to hear about real patient experiences and not just what is out there in the marketing material!
    Sarah
  8. Dianesmom

    Dianesmom New Member

    Offline
    Member Since:
    Jan 19, 2012
    Age:
    Messages:
    4
    Location:
    United States
    Hi Jamie,
    I will definitely start looking into my options for insurance. I don't qualify for the low income options. In Wisconsin, you can't apply for the state insurance until you have had no coverage for 6 months. Maybe I will be able to find a company that will cover me with an exclusion for knee problems. I am generally very healthy (except for some extra weight- arghhh) so I am mainly concerned with having coverage for "catastrophic" events like a heart attack or being injured in an accident.
    Thanks so much for your input and good advice!
    Sarah (Dianesmom)
Thread Status:
Not open for further replies.

Share This Page

Open
Close X