Revision TKR 4 knee surgeries

TAlex

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I had an unstable knee for a few years so I decided to see an orthopedic surgeon. He said I had a partial tear in the meniscus and he operated on me in November 2020. My symptoms didn't improve and an additional MRI showed that the real problem was that my kneecap was sitting in a very shallow groove. In June of 2021 I had a patella realignment surgery which for some reason didn't stabilize my knee. I was told that eventually I will need a knee replacement, so I had a TKR done in January of 2022. The first 3 months following the surgery I was able to walk without assistance, but with a limp and still was unable to put full weight on my leg. My condition got worse but the imaging didn't show any abnormalities and everything looked correct. My fourth surgery, in August 2022, replaced all the components including putting in a mobile bearing device instead of a fixed bearing device for the components in the tibia. 6 months later, I am walking with 2 canes and I am unable to put full weight on my leg and each step goes into a limp. I can't take a continues step with a smooth glide. I know I had a lot of surgeries in a short period of time, but I think there should more improvements by now. I also had knock knees before, which was corrected when I received the knee replacement. I am very concerned that I might have a problem that can't be diagnosed with MRI's or X-rays. I am reaching out to see if anyone else might have gone through similar to what I have been through and might have some suggestions for me.
thank you for reading my post.
 
Oh my goodness, @TAlex, you've had a rough time of it. I'm so sorry to read this.

While full recovery from knee replacement surgery can take a year or longer, it doesn't seem right that you are unable to weight bear six months after surgery.

Did the same doctor do all four surgeries? What does he/she say about your condition? Has he/she suggested any additional course of action?

Also, was this your left or right knee? Let us know so we can create a signature for your thread. The information will help others help you.
 
Thank you for the quick reply! I had 3 different surgeons. One did the meniscus repair, the second did the patella realignment and the third did the last 2 surgeries. I did PT for 3 months and now I do my own exercises at home. I even started going to the gym but it's not easy to move around with the 2 canes. After the last surgery I went to get a second opinion and they couldn't find anything wrong with the surgery. I am going to see him at the end of this month and see what he has to say.
The surgery was on my left knee.
The more I try to strengthen it the more wobbly it gets. It seems that there is a rotational issue as well. My femur turns out words when I take a step. I am very scared that I might not get better since they can't see any problems
 
While I am sorry for all you've been through and regretfully don't have any suggestions, I am happy you joined us and with any luck you'll get some good responses here. I wish you comfort and peace of mind as you wait to see the surgeon again at the end of the month. I hope he has answers leading to resolution for you. Please keep us posted. We're here for support always.

Please share the exact date of your August 2022 revision surgery for your signature. Thanks in advance!
 
Thank you Layla. I will keep you posted. My last surgery was on 8/15/22.
 
After the last surgery I went to get a second opinion and they couldn't find anything wrong with the surgery.
If you are not satisfied with this next appointment, maybe consider contacting HSS, Hospital for Special Surgery, in New York City. We’ve had members get good results there.
now I do my own exercises at home. I even started going to the gym but it's not easy to move around with the 2 canes.
The more I try to strengthen it the more wobbly it gets. It seems that there is a rotational issue as well.

I think I would take a break from all this and give your knee more time to heal and settle down. You’ve had 4 surgeries in a short time, each one causing a certain amount of trauma to the area. Sometimes in this situation we just need to let our knee “be” and let our daily activities be it’s “exercise“ so we don’t aggravate it further while it’s healing.

I hope you can find someone who has a solution for you. I know how hard second opinions are, I‘ve had 3 in the 6 years since my PKR, and no solution yet. :console2:
 
Thank you very much for the advice. I also tried to take some short walks using one cane but it was very difficult since I couldn't take a "normal" step. Unfortunately, I lost my motivation because it was such a bad experience. I was hoping each day it would get a little bit easier, but it didn't. I will definitely consider HSS if I am not happy with the outcome of my next appointment.
 
Hi @TAlex, some of your story sounds familiar to me. I had TKR in early December, 2021 and it was placed incorrectly. I wasn’t able to walk without a cane and the further along I got in recovery, the more valgus (knock knee) my knee became. I had a revision in late June, 2022. Recovery has been slow going but I’m getting there. My advice to you is to sell another opinion if you’re not happy with what your surgeon Has to say after the next visit. Good luck!
 
Thank you and thank you for sharing your story!
 
I also had knock knees before, which was corrected when I received the knee replacement
I was increasingly knock kneed ( over 20 degrees) due to lateral compartment arthritis before my lateral pkr 4 months ago. My surgeon did a good job of straightening my leg and I have pretty good function ( walking up to 3 miles with no limp)- although I still get some medial twinges from my chronically overstretched MCL.
I have done a lot of reading about valgus knees and knee surgery, to try to figure out why I had slight residual pain on the the medial side of my knee.
It seems that knee replacement in the valgus knee is particularly challenging and prone to complications.

Total knee arthroplasty in valgus knee deformity: is it still a challenge in 2021?​

This article is rather technical but gives you the gist. If you put the title into Google the full article will come up.
I agree with the suggestions of others above to get a second opinion from a specialist team recommended by BoneSmart staff.
 
Thank you for responding and for sharing your story!
 
My surgeon requested a new MRI and a nerve study after I had my follow up visit with him. The results all came back normal and once again there was no indication that there is anything wrong with the surgery results. I exercise everyday and go for a half a mile walk. There is no change in the mobility. There is a rotational issue with each step and I can't put full weight on my leg. My knee "buckles" meaning I can't take a step with a "smooth glide" it breaks each time and goes into a limp. It must look pretty bad because a couple of people asked me on my walk if I needed to get help to get home. I am still walking with a cane. My doctor thinks it's still a strength issue since I can't do the single leg balance at all. My muscles feel strong when I do all the other exercises and I am able to do them all, except standing on that leg. August will be the one year anniversary of my last surgery and it seems like I will have to see some other doctors for second opinions. My fear is that they will look at the same imaging and will come to the same conclusion that there is nothing wrong. I am curious to hear if anyone else had similar experiences or know someone who went through extreme difficulties with recovery after total knee replacement.
 
My surgeon requested a new MRI and a nerve study after I had my follow up visit with him. The results all came back normal and once again there was no indication that there is anything wrong with the surgery results. I exercise everyday and go for a half a mile walk. There is no change in the mobility. There is a rotational issue with each step and I can't put full weight on my leg. My knee "buckles" meaning I can't take a step with a "smooth glide" it breaks each time and goes into a limp. It must look pretty bad because a couple of people asked me on my walk if I needed to get help to get home. I am still walking with a cane. My doctor thinks it's still a strength issue since I can't do the single leg balance at all. My muscles feel strong when I do all the other exercises and I am able to do them all, except standing on that leg. August will be the one year anniversary of my last surgery and it seems like I will have to see some other doctors for second opinions. My fear is that they will look at the same imaging and will come to the same conclusion that there is nothing wrong. I am curious to hear if anyone else had similar experiences or know someone who went through extreme difficulties with recovery after total knee replacement.
I'm sorry I dont have any advice other than to get another opinion from someone who deals with complex cases. Has anyone done in depth scans for rotational issues? I think rptational CT scans and nuclear scans might detect this? I'm sending hugs and really hoping you get some answers soon as I can totally relate to what you're going through.
 
Thank you! I have to look into the other types of scans you mentioned. I think that's a great idea. thank you for your support!
 
So sorry you still have such problems and can't seem to find an answer.
I wonder if there is some way to distinguish whether it is a strength issue?
Could a really good physio or pilates teacher help figure out whether it is a muscle imbalance or something more structural with the new joint?
Can you lift the leg as easily and hold a single leg lift for the same time as on your good leg?[
QUOTE="TAlex, post: 1600802, member: 43309"]
My doctor thinks it's still a strength issue since I can't do the single leg balance at all
[/QUOTE]
 
Yes, I can lift my leg, hold it for 10 seconds with 6lb strapped to my ankle. It feels strong until I try to walk. Sometimes my knee locks in, won't bend when I take a step and I have to catch myself so I won't fall over. It's really horrible and very depressing. I might have to go back using two canes so the impact of taking a step won't put all the stress on my back and hip. thank you for taking the time to respond to my post.
 
Hello Everyone.

Well, now it's been a year and a half since the last surgery and I am still walking with a cane. I can't really hold my weight on that one leg, every time I stand, I have to keep constantly shifting my weight from one leg to the other. It's very tiring. I have been going swimming and that seemed to help my gait somewhat, but not enough that I could walk without a limp and assistance. I even went to HSS to NY for a second opinion and after a long exam they couldn't find anything wrong surgically with my knee. I am not sure where to go from here. I can't really believe the problem is with me. If my gait was the only issue, I would consider the idea, but the fact that I can't hold me weight on it when i tighten all the muscles tells me there is something else wrong. I am very frustrated and depressed. :-(
 
I am so sorry that even HSS can't seem to find an answer. Did you get any report from them as to what they rhink is causing your ongoing weakness?
Are you seeing any improvements at all in your strengthening? How far can you swim and with what strokes?
I do wonder what the issue is- because presumably if you can swim well- then the muscles and alignment must be working OK in a weightless environment.
 
@TAlex , did any of your doctors consider that you might have some kind of neurological problem, like a nerve compressed near your spine? Total speculation on my part, but some people have had spinal nerve issues whose only symptoms are problems with the knee or hip (my father is one such person - he gets regular shots in his spine to relieve the pain in his hip).
 

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