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Revised PKR to TKR 12 months later but can’t find my thread

I was just wondering, given the choices I have been given, what others would choose if they found themselves in the same predicament. I found out that my knee is misaligned. Tomorrow I will have a CT scan to determine by how much. If significant I have two choices, wait three months and if the knee improves and I can tolerate the pain, live with it and do nothing. That would mean that I would have to contend with a noticeably crooked knee that appears very knock kneed and affects my gait, hips and back. Not to forget that I’m already very self conscious about the unsightliness of my legs and this will just make the situation a whole lot worse.

Or, wait three months to allow it to cool as it’s still recovering from the last surgery eleven weeks ago, then have a revision to correct the part that was put in incorrectly, which I’m pretty sure was the femoral part. They were the choices I was given. This will result in a 20% drop in pay if I don’t return to work by the end of July.
If I choose that option I will have to move house as that drop in pay makes my current housing unaffordable. And then, that’s going to cost heaps too as I will need a removalist etc.

@Josephine if the CT scan comes back and the knee is significantly misaligned, would it be too risky to request surgery sooner rather than waiting three months to allow it to cool from the trauma and inflammation of the past two surgeries (these were only eight weeks apart)? I have been sitting around for nine months already, since my initial fall on 22/7/17. It would just mean getting it over and done with so I could go back to work sooner. I just fear that I’m going to traumatise an already traumatised knee and will that slow recovery and risk delaying my return to work anyway? I have a feeling this is a how long is a piece of string question lol.

I value the opinions of others and would be interested to hear your thoughts thank you.


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@shelli22 - It sounds like the core issue is can you live with the knee the way it is now? If not then you have some other options that flow from that decision, ie., wait 3 months or do it now. The best place for that decision to be made is with your medical provider, ie., treating and/or os.

Also, in terms of whether it will improve over the next 3 months, is there some reason that makes you think this. In other words has your doctor said it might?

The reason I felt compelled to respond to your post is I found myself with the same type of dilemma, with differing circumstances, last spring. I was scheduled for a RTKR for August 1 when my left knee went out. Eventually, after tests and other things, it was determined that the left knee needed replacing as well.

I had to decide whether to do them both at once and take the risk that the bilateral surgery would be very difficult to recover from, or do them one at a time. I was faced with losing income either way, but doing them both meant, if all went well, I would be back to work sooner. Also as I lived alone, my family had to pitch in to help, which meant a lot of disruption in their lives, not to mention expense of travel. I was hesitant to put them through it twice.

One way to help me decide was to get some paper and pen and make two columns on the page, one for the pro's and one for the con's. And I did that for both options, i.e.., bilateral vs. one at a time. I wrote down every pro and every con I could think of for both options., including the input I had received from my doctor and family And then, after talking it over with everyone, journaling and asking my higher power for guidance, I made my decision.

Lots of luck and keep us posted.
 
@mlreader thank you for responding. To be honest, I can’t live with it the way it is now as I can’t even walk around the block without stopping midway and thinking omg I have to get home yet. The pull on my hip and back is horrid. I’m a nurse. If I can’t walk around one block then I won’t be able to do my job. So that’s a no lol. To the wait three months or do it now option, it wasn’t anything to do with improvement but more to do with allowing an already traumatised knee to cool ie decrease inflammation and allow it to heal. Whether or not it will improve will depend on the degree of misalignment I guess though I don’t hold out much hope of this.

When I woke from surgery the pain in my hip/butt was excruciating. The surgeon put it down to my ongoing sciatica saga and prescribed lyrica and upped the pain meds. I didn’t think anything of it as under the influence of post anaesthetic haze and strong opioids I just wanted the pain gone as it was ten times worse than any sciatica I had had previously. But the lyrica had little to no effect and I have been weaning myself off them after increasing them over time didn’t work. I’m down to 75 mg every other day. In hindsight it was pain from the misalignment that pulled on my hip. I have had no end of issues with hip and back pain which keeps me awake all night as I cannot release the tension in that area. I’m forever trying to stretch that leg away from me. It’s getting worse over time not better. So I can’t see how waiting for improvement is going to affect that pain.

The surgeon wanted the swelling and inflammation to decrease. He wanted the knee to cool. Therefore once I have had the scan and waited two weeks for them to report on it (standard for this particular report) then I will know whether the degree of misalignment is small enough that just time will perhaps improve the pain (how when it is getting worse I don’t know). If not, then the question is whether he is willing to do it on a hot knee (inflamed and swollen). That I am not sure of because when I was there, I was shocked because by the time I went to the appointment I had almost convinced myself that I was seeing things and there was no crookedness. I almost lost it and found it all hysterically funny (while wanting to cry) my stress response I think at the prospect of having a fifth operation on the same knee.

I won’t find out whether he will even consider doing it for another two or so weeks. But I’m just putting it out there.

I will lose more income if I wait. I also live alone and rely on family to help me and they’re sick of me and my knee. My mum did heaps but my dad has just had his knee replaced and it has been really hard on her as he can be very, um non compliant and a bit of a cranky pants. I don’t want her to have to do it all again for me as they live forty minutes away and my surgeon is another forty minutes in the other direction. One of my sons partner just had a baby on the weekend so I can’t ask them and the other one has a child that requires a lot of extra help so I don’t like to ask them too much either.

The pros and cons are about even either way. Ultimately I would really just like to run away and not deal with any of it.


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I understand wanting to run away from it. You shouldn't have been put in this position. What you have. I will pray that God tells you what to do and for your comfort.
 
Writing here is like maintaining a journal. Down the track for one reason or another I may need to refer to it. It’s also a great way to organise my thoughts and try and focus. Not only that my journey has been long and difficult and from one day to the next I have no idea what to expect. If there are any others who have a journey that is not so straightforward they may find answers here, or at least feel like they’re not alone.

Today was another day of appointments. I had a long appointment to discuss my return to work when I am cleared. Today was an introductory meeting, nine months after my injury. It was odd as I found speaking out loud all the issues and fears of the past nine months and the uncertainty of my future work prospects and I found I was highly emotional. That meeting took about 1 1/2 hours.

I came home and took the dogs for a walk around the block to destress. On Monday I have to organise a GP appointment for a referral to a psychologist and also organise an exercise physiologist for upper body work and stationary bike. Later in the afternoon i has a CT scan. The scan involved tying my feet together and then stretching my toes towards my head. I cannot extend my TKR leg. It just won’t. If I try to extend, it pulls on my hip and that then pulls on my back. The position I had to hold pulled on all of my left side from my hip to my knee. The scans are sent of to different radiologists who do measurements to determine the extent of misalignment. Thankfully it’s not like an MRI and only takes about five minutes because I felt I had a hot nail in my back, hip and knee and couldn’t have held that position for much longer. The results take about two weeks to complete so it’s a waiting game again.

I drove home, walked in the door, said hello to the dogs and burst into tears. The pain at this point was unbearable. I took some pain meds and elevated my knee but it took a long time to get the pain under control. At least it’s the weekend and a break from appointments. That’s about it for now.
 
:console2:Hugs to you for a weekend that is as restful as possible.
 
My heart goes out to you...I'm so sorry that you are facing yet another surgery.:console2:
 
shelli22 said:
At least it’s the weekend and a break from appointments. That’s about it for now.
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@shelli22: I think you need a complete break for the week-end. There's not a darn thing you can do in terms of appointments and tests, so please try to put it all on the back burner.

When I was on disability in the early 2000's, I was an emotional wreck talking to the doctors who were working for the worker's comp defense. The atmosphere was hostile and they looked for anything to see if they could put a pin in my claim for workplace injuries. I shed many a tear during those interviews/exams. I was sick, in pain, emotionally terrified of what would happen to me, my employer was a law firm, and I had to go to a town 50 miles from where I worked to find a lawyer who would represent me for my claim. Your circumstances are not mine, but I share your feelings because I experienced them as well.

It is so hard to advocate for oneself when you are sick and in pain. You are doing a great job. But take the weekend off. Do you have Amazon Prime or Netflix? There are so many good shows right now, there almost isn't time enough to watch them all.

Or, if its too hard to concentrate on a tv show or movie, have you ever listened to audio books? They saved my sanity when I had my knees replaced. I could just lie there with my ear buds in and listen to someone read me a story. I felt like a little kid again. It took me out of my pain and discomfort and fears and often even lulled me right to sleep.

Anyway, Shelli22, hang in there. TGIF. And stay close to bonesmart this weekend too. Hugs.
 
I have said this before, I watch so many movies on netflex, I lost track of what was real life or Netlfex! It was a tool to help get my mind off the discomfort, fear, anxiety during the initial post op period.
 
Baby that knee this weekend. You both have earned it!
 
@mlwreader you’re right. The stress of external factors caused by this injury is horrid . I have to wait three months before doing anything. However, from that point on I lose 20% of my income. So I now have to relocate because losing that much of my income is half my rent. That means I have to pack. Well that’s going to cause swelling and pain. Ideally I need to make a decision sooner rather than later so I can pack slowly over time if I do choose to move. Next I will need to get a removalist. That is going to cost money. Unclaimable. And it has this domino effect.....

Mutti3 I try very hard to lose myself in TV shows so I don’t have to think and for much of the time it works but in reality I do have to work through all the issues as I have no option but to come up with alternative options.

Sistersinhim I’m doing precious little this weekend. My puppy, Ollie turns one today. I took him to a pet shop and let him choose his own toy, then bought him three kong balls as he chewed his others to bits. He loves going shopping.


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shelli22 said:
My puppy, Ollie turns one today. I took him to a pet shop and let him choose his own toy, then bought him three kong balls as he chewed his others to bits. He loves going shopping.
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@shelli22 Happy birthday little Ollie. That is so cute - you let him pick his own toy and he loves going shopping. Love it.

Last night I was at my son's house for a movie night. They have a large family room and a big "playpen" sofa with comfy pillows, etc. My son is a techie and has surround sound and all manner of stuff in that room. Anyway, their dog Buddy, a big half lab half shephard, is quite elderly, unlike your Ollie. He is really a very senior dog, and has lived well beyond his life expectancy for a big dog at 14 plus years. We all love him so, he is a wonderful boy. They have put a blanket on the sofa on the chaise end, and Buddy can just barely get himself up on it, but he does manage. So last night he had to rest a little bit before attempting to get up there, but he managed to do it. So he could join in and watch the movie too.

Love our fur friends so much!
 
Ollie and Karma, my ten year old cavalier are my world. They keep me from losing it. Karma has arthritis and her back legs are weak but we cope. She’s my angel. Ollie is my happy pill. He’s cheeky and gorgeous. I’d be lost without them. I love how they want to join in with the family stuff. Beautiful Buddy. Just wanting to join in.
 
@Josephine hello. I haven’t been on much as I have been awaiting for the results of the CT scan and subsequent measurements. They have been reported on and I had my OS appointment today for discussion. The results indicate that the knee is misaligned 3 degrees from zero and 5 degrees total as my knees are naturally 2 degrees valgus.

While the surgeon is not happy with this amount of misalignment, a revision is only indicated if the misalignment is over 5 degrees. The surgeon now believes rather than the misalignment of the knee causing the hip to rotate inward, it is more likely the other way around. He thinks that whatever is causing the hip pain is causing the knee pain. I had the excruciating hip pain on waking from surgery. It was so bad I couldn’t tolerate the CPM and yet I have loved that following both previous surgeries and found it odd that I couldn’t this time around.

I now have to have a SPECT bone scan and then an MRI. The first is booked for Wednesday, the second Friday. Edit: actually they have both been changed to the same day next Tuesday.

I am just about at my wits end. The hip pain is felt posterior to my hip bone and I feel a lump where the pain is. I also experience pain in my upper thigh. It is there whenever I do any activity or while standing and is also extremely painful at night especially if I lie on my side.

Josephine do you have any thoughts or suggestions? I have no idea.

The whole saga has affected every aspect of my life. As there is still no diagnosis for the horrific pain I have had to endure and investigations are still ongoing with no return to work in the foreseeable future, my income will drop by 20% once I have been off work for 12 months - in 10 weeks. As a direct consequence I will have to move house as the landlord said the rent was increasing. Packing etc with an extremely painful hip and knee is interesting but I have no option, it has to be done. I have two weeks and two days until my lease is up.

That’s the update for now. I still have no definitive diagnosis or treatment options.
 
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shelli22 said:
The surgeon now believes rather than the misalignment of the knee causing the hip to rotate inward, it is more likely the other way around. He thinks that whatever is causing the hip pain is causing the knee pain. I had the excruciating hip pain on waking from surgery. It was so bad I couldn’t tolerate the CPM and yet I have loved that following both previous surgeries and found it odd that I couldn’t this time around.
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Well that's a worry for sure.
shelli22 said:
1) The hip pain is felt posterior to my hip bone
2) I feel a lump where the pain is
3)I also experience pain in my upper thigh.
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Well can you show me where these three points are using this chart?

[Bonesmart.org] 12 months later but can’t find my thread
 
@Josephine

1) Hip pain is L2Bs
2) Lump is in the same place as above
3) Upper thigh pain is L2Fw and L2Fx


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