Revision TKR Here I go again - Round three

midwest girl

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Didn’t think I would be back on this forum for many more years or if ever. I have been having pain in my left TKA for several years, always in the same spot - medial side of the knee in the front. Dec 2019 I had a scope done to see what was going on, if it was just scar tissue causing the pain. Surgeon said it didn’t look good and the implant was failing. Cleaned up any scar tissue and said he maybe bought me a year, but it would have to be redone. I had this TKA in 2015 so I wasn’t too thrilled with that news. Since the 2019 surgery the knee was ok but as the months and years went by I was having more and more pain. During that time my surgeon moved out of state, so I was on the search for a new surgeon. I met with one surgeon who said yes, it’s the tibial component that is loose - in the exact spot that I was always complaining where the pain was and that the entire components had to be replaced. This surgeon referred me to another surgeon in a city 90 miles from where I live. Met with him 2 weeks ago and he agreed that it was a loose tibial component and that I only had to have that piece replaced, unless he saw something different once the knee was open. He also said I could go home the same day but then said since I lived 90 miles away that may be too much. I could go home the next day if ready. Friday I received the call with the surgery date and time. July 14th, his first surgery for the day and to be at the hospital at 5:30am. Although this isn’t my first time experiencing this, I‘m still nervous. So much has changed since the last time I did this. Same day dismissal, no tourniquet, no Coumadin, new hospital, new surgeon, I’m older, more out of shape and gained some weight. The thought of going through this again gives me anxiety. I’m praying this will be successful and will be an uneventful recovery, not like the RTKA and LTKA. One day at a time.
 
Welcome back, @midwest girl, although I'm sorry it's under these circumstances.

Because it has been a while since your last surgery -- and since, as you note, things have changed -- I'll share BoneSmart's helpful pre-operative guide as a refresher.

Knee Pre-Op Guide
Choosing a surgeon and a prosthesis
Longevity of implants and revisions: How long will my new joint last?
Recovery Aids: A comprehensive list for hospital and home
Recliner Chairs: Things you need to know if buying one for your recovery
Pre-Op Interviews: What's involved?

The website and app My Knee Guide can help you stay organized and informed. The free service keeps all the information pertaining to your surgery and recovery in one place on your smartphone. It is intended to be a personal support tool for the entire process.


As you know, we try to keep the forum a positive and safe place for our members to talk about their questions or concerns and to report successes with their joint replacement surgery. So feel free to ask any questions you have. We're here to help.
 
Yesterday I received in the mail the Joint Academy Patient Education manual and the cleansing solutions for pre-surgery showers. And all the necessary paperwork and appointment reminders. Because I live 90 miles away from where my surgery will be, and because this isn’t my first rodeo, the education will be a 30 min course via telephone. Just the thought of going through all this again gives me anxiety and a little dread. I know whats on the other side once recovered Is good. I just remember all too well the struggles during recovery. Less than 2 months to go.
 
Sorry to hear that you are having to face more surgery, the only plus is that once it is done you will recover and be pain free, this time you can better prepare yourself, you know what you need and what works and more importantly you know you will improve each day, I had two full replacements on both knees ( 2 years apart ) the first I was scared to death, not knowing what to expect, the 2nd albeit scared as any operation is scary, I found the recovery easier as I knew what and why, and yes all recoveries from a replacement surgery is tough and painful but they do get better with time and patience.
 
@Sara61 I agree with the fact that you do know what to expect when having a second TKA. When I had my second one I knew that the morphine, hydrocodone etc given in recovery/post op. would make me sick. I wasn’t ready for the intense pain I would be feeling in my knee in post op with the second TKA. First TKA I had a femoral nerve block so there was no pain. No nerve block the second TKA. Even though we knew the issue I had with narcotics and constipation the first go around, and we prepared for the second time, it still didn’t work. Just a lot of “new“ things this time. new surgeon, new protocols, new hospital. I know it will be fine, and I know it will be worth it in the end, but it still gives me some anxiety. These surgeries definitely aren’t a walk in the park. But I do agree that it helps having been through the experience before. Thanks for the encouraging words!
 
Are there any positive revision TKA threads? I did the prefix search and it seemed like the majority of the threads have negative titles. I’ve read some of them and was getting discouraged so quit reading. I think like most things/experiences, people tend to share the negative review. I think those with positive experiences just go on with their lives and don’t or rarely post.
 
I think those with positive experiences just go on with their lives and don’t or rarely post.
@midwest girl I think this is the case with any forum. The members who have problems and concerns tend to stay and post. Members who have a smooth recovery post for a bit and then get back to living life again.

There are plenty of positive revision stories. But as you know, every recovery is different - even on the same person. Stay positive, and keep your eye on the prize.
 
Last week the pain in my knee has increased. Makes me wonder if a little bit more of the tibial component has loosened. Before then I typically only had pain upon standing and walking. No pain at rest. Now there’s pain when I’m not weight bearing and while sleeping. My knee doesn’t like any position I lay in. A couple of times I’ve had to use a hydrocodone at bedtime. Tylenol wasn’t cutting it. And last week I had a lot of edema in my calves/feet. I saw my regular dr and he prescribed lasix and potassium to use as needed. So far haven’t needed to use it. Today I wore a compression sleeve on each leg. That helped with the edema but I found the band at the top sat right on the area that the tibial component is loose and caused some pain. And on the right knee it was irritating the lateral side of the area where the tibial component would be. It was a relief to take them off when I got home from work. It’s going to be a long month before my surgery. Tomorrow is my joint replacement class that will be a 30 min review with an orthopedic educator. So things are progressing. Still dreading going through all of this again.
 
Are there any positive revision TKA threads? I did the prefix search and it seemed like the majority of the threads have negative titles. I’ve read some of them and was getting discouraged so quit reading.

YES! Please have a look at my story, which you can find here: https://bonesmart.org/forum/threads/benne68-in-recovery.67226/

Also, here are threads from two other members who had their TKRs about the same time as I did and have had positive outcomes as well:
https://bonesmart.org/forum/threads/susie-qs-2nd-tkr-recovery-thread.66996/
https://bonesmart.org/forum/threads/hawkies-2nd-knee.67316/
 
Hi midwest girl,
I hope your joint replacement class went well today and your confidence in the procedure increased, you feel reassured all will be well, and more at peace with each passing day. We're rooting for you all the way!
Best wishes for your comfort as you wait.
@midwest girl
 
@Layla thank you for the kind words. The class went fine. It was to be a 30 min informational call but lasted 50 min. She spent some time encouraging me. I told her I was dreading this one for some reason. I know what to expect having gone through it twice, but that’s it - I remember the hard days. The day of surgery and how miserable I was with all the vomiting (from narcotics), remembering how anesthesia shuts down my digestive system for days. Remember the mental aspect of it. I live alone so you do run into those days of weepiness and having to be your own cheerleader. And figuring out a pain regimen that works for you, and arranging rides to PT. And everything is different. New surgeon, new hospital (both 90 miles away), getting rides to those appointments lined up. I know it will all work out. It’s just the things like today - the class - that reality and some fears creep in. It’s a tough journey. But I know it will be worth it. I’m glad I have this site that I can express my thoughts, questions, fears with those who understand because they have been there.
 
Could any of the admin tell me what is the recommended schedule for taking Tylenol and tramadol? My last knee replacement in 2015 Josephine gave me a schedule of when to take Tylenol and then Tylenol + tramadol and how much and what hour intervals. I could go back through all my threads from 2015 but didn’t know if someone knows it. Thanks so much!
 
Last edited by a moderator:
@midwest girl I deleted your tag for Josephine as she retired from the forum several years ago.

Here is the chart you were asking about:

The first is for 4-hourly doses and the second for 6-hourly:
aa-tramadol-routine-2-jpg.51125


If you use this schedule, do check to make sure you're not taking any other drugs that contain Tylenol (Acetaminophen) You need to stay within the safe limit of no more than 4,000 mg of Tylenol in a 24 hr period. If any other medications you're taking contain Tylenol, add their amount into your daily calculations and reduce another of your doses, so you stay within those limits.
 
You’re very welcome, midwest girl.
I am happy to read they spent some time encouraging you in your joint class. You will carry bits and pieces of the encouragement you receive here and there with you. At least I did. One of my biggest takeaways from the encouragement I received was that this will be just another day at the office for the medical professionals that will tend to you on your day of surgery. This is what they trained to do, and what they do best. They all want the same perfect outcome that you do and will work toward that.
Remember the mental aspect of it. I live alone so you do run into those days of weepiness and having to be your own cheerleader.
This may not be the case this time, but if it is, remember it’s temporary and know that we are always here to uplift and console, any time, day or night. So lean on us as often as you feel the need. We’ll be here and we care. :friends:
 
So this weekend I went through and read the threads from both of my TKA. Don’t know if that was a wise decision or not.
 
What does the OP banner across my profile picture mean?
 
It means you’re the Original Poster, it’s your thread.
 

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