TKR TKR after tibial plateau fracture

[Ayse]

If you end up having to come to London for a second opinion then I would strongly recommend my surgeon- Alex Liddle.
He is a senior lecturer at Imperial College and has done a lot of research on implants and the causes of failure/ need for revision.
He also did an amazing job of straightening my very crooked ( over 20 degrees valgus) knee and matching it with my good leg. He has a great manner and explains things well. Also he has seen a couple of my friends and doesn't always rush to surgery.
He is NHS at Charing X and private at Charing X and King Edward VII.

@EalingGran thank you so much I will check him out. I think I need someone who specialises in all aspects of knee surgery as this is not just a possible TKR problem.

 

[Ayse]

I had my patellactomies in 1991 and 1993. I'm sure things have improved tremendously since then and I know that now doctors don't like to do them now, but if your doctor suggests that, you will be fine without your kneecap. The main drawback is that your leg will be weaker than a normal knee, but with what you are going through now, yours is already weaker.

Back then one of my doctors cut and shortened the patella tendon, and the other doctor wired the second knee's tendon up so it would grow together shorter. I was put into an immobilizer on each leg for about 6 weeks to allow the tendons to heal. The recovery was very similar to a TKR pain-wise, though not nearly as long.

My TKR was actually simpler because my doctor didn't have to bother with tracking the kneecap, but he did have to do a medial release so my leg would bend correctly. This created pain in that area for many months, which is normal after a release.

I still suggest you see another doctor, one that has no contact with your current doctor and will look at your knee with new eyes!

If you have any other questions please feel free to ask them. I will be on and off this site all day and will get back to you.

@sistersinhim thanks so much for that information.

 

[Ayse]

@thanks so much for your kind support @Layla

 

[Layla]

Stopping by to say Hi and see how you're doing these days.
We're here for you and we care.
Best wishes only.
@Ayse

 

[Ayse]

Hi @Layla thanks for checking in. Things have been tough and depressing as there's no improvement unfortunately. My kneecap and around it is still so unstable and can only limp around for a few minutes at a time. Still got the big painful semi hard lump that runs along the medial side of my scar, half of patella and up to quad tendon. II'm including a pic of it now to see if anyone had similar. I was told it was scar tissue but doesn't really feel like it. It's also restricting my movement. Plus multiple other problems that haven't been fixed by the TKR.. and my knee is very loose. Tibia moves a lot and I can feel is moving even sitting or lying when I move my leg slightly. Because of the pain swelling instability etc it's hard to do many exercises to strengthen muscles.

It's a bit difficult as I'm in Cyprus and my surgeon in UK. I spoke to him re the problems and he looked at xrays and said my patella was in the right place and that he'd need to see me. Which is understandable but I don't feel he's really listening to me.

I then spoke to another OS via video to get his opinion. He listened well and with a caveat obviously that he needs to see it and do some more scans he thinks I have malfunction/tracking/misalignment of kneecap and poss misalignment of TKR. It maybe that I may need more surgery to improve things. Poss tibial tuberosity transfer and maybe revision TKR. Will be flying back to UK hopefully soon to get some concrete answers as to what can be done if anything.

As you can imagine the thought of more surgery etc is pretty depressing and scary.

 

[EalingGran]

Sorry to hear of your troubles. I was wondering how you were getting on.
Hope you can find some answers and get some progress.

 

[Layla]

Thanks for updating. I am really sorry you're still struggling, feeling down and possibly facing more surgery.
I hope you get some answers soon, followed by a plan that resolves the issue and results in perfect healing.
Please stay in touch. We're here for you always.
@Ayse

 

[Ayse]

Sorry to hear of your troubles. I was wondering how you were getting on.
Hope you can find some answers and get some progress.

Thank you so much @EalingGran me too! I'm seeing the OS esrly June and beforehand having more in depth scans etc so hopefully he can gvie me a beter picture when I see him.

 

[Ayse]

Thanks for updating. I am really sorry you're still struggling, feeling down and possibly facing more surgery.
I hope you get some answers soon, followed by a plan that resolves the issue and results in perfect healing.
Please stay in touch. We're here for you always.
@Ayse

Thanks so much @Layla hopefully when I see him after the rotational CT, long leg xray, and metal reduction MRI he will have a better picture. Just got to persevere another few weeks before I hopefully get real answers as to what they can do.

 

[Ayse]

Wondering if anyone has any advice re possible infection. So... as well as the other problems I have, the semi hard lump along the side of my scar has been getting increasingly more painful. My surheon said it was scar tissuebu it has never felt like that and appeared a cpuple of weeks after surgery. My physio suggested I get blood test for possible infection. CRP levels are normal but ESR is high which could indicate infection I believe. My knee is always really hot except when icing it as well. Obviously I need to speak to OS and my new OS I'll be seeing soon but does anyone have any opinion on the results?

 

[sistersinhim]

@Ayse, you need your doctor to explain these numbers to you. Hopefully, everything is OK and it's not an infection. You are not that far out from surgery and swelling, aches and pains, and warmth are normal at your stage. If your knee is hot and red, then you need to let your doctor know.

 

[JusticeRider]

Hi @Ayse , I hope those scans and speaking with your OS will shed some light on things. You’ve been through so much and I hope they can get to the bottom of these issues you’ve been dealing with. Just a few weeks now and hopefully then some answers!

 

[Ayse]

Hi @Ayse , I hope those scans and speaking with your OS will shed some light on things. You’ve been through so much and I hope they can get to the bottom of these issues you’ve been dealing with. Just a few weeks now and hopefully then some answers!

Thanks @JusticeRider fingers crossed! I'm sure you know how I'm feeling after your own experience.

 

[Ayse]

@Ayse, you need your doctor to explain these numbers to you. Hopefully, everything is OK and it's not an infection. You are not that far out from surgery and swelling, aches and pains, and warmth are normal at your stage. If your knee is hot and red, then you need to let your doctor know.

Yes absolutely @sistersinhim I will be. Thank you

 

[Layla]

We're behind you, Ayse, and hoping for the best. I hope this all resolves on its own soon.
Please stay in touch. Hugs
@Ayse

 

[Ayse]

We're behind you, Ayse, and hoping for the best. I hope this all resolves on its own soon.
Please stay in touch. Hugs
@Ayse

That's so kind thanks so much @Layla

 

[EalingGran]

Thinking of you.
When I had septicaemia a while ago it was the CRP that was the marker for infection and it went up dramatically to 250! Not sure if they even measured my ESR but have the results on my NHS app- so will check.
I think CRP is the more reliable of the two for infection but you definitely need the ESR explained. Will pray it is just some post- op inflammation. Understandable that you must be worried though.

 

[Ayse]

Thinking of you.
When I had septicaemia a while ago it was the CRP that was the marker for infection and it went up dramatically to 250! Not sure if they even measured my ESR but have the results on my NHS app- so will check.
I think CRP is the more reliable of the two for infection but you definitely need the ESR explained. Will pray it is just some post- op inflammation. Understandable that you must be worried though.

Yes there is definitely a lot of inflammation in my mess of a knee. Really had enough of all the pain for the last 18 months that is worse since the TKR. Thanks for your kind thoughts @EalingGran

 

[EalingGran]

How's it going?
Saw you posted on another thread today and wondered if you had any progress and understanding of the raised ESR.
Hope things are improving.

 

[Ayse]

How's it going?
Saw you posted on another thread today and wondered if you had any progress and understanding of the raised ESR.
Hope things are improving.

So...the ESR is more inflammation the CRP was normal so no infection. I'm flying back to UK tomorrow to have the new imaging done and see the second opinion surgeon who works with another surgeon who both apparently deal with complex cases. Fingers crossed they can do something as I can't cope with the pain and lack of mobility much longer.
Thanks so much for asking @EalingGran