Revision TKR 2 failed revisions & a stress fracture, all in 14 months

@Ilovecruising It was something a doctor said to me when I was diagnosed with breast cancer. It was like a light bulb moment and really helped me to understand and deal with my emotions, so I hope it might help you too. Have another :console2:Take care.
 
@Ilovecruising I’m a fellow paint by numbers person. I took it up last fall to have a hobby that I could do with my granddaughter and I love it. Yesterday was the first time since this surgery that I could sit up and paint for any length of time.
 
@rustic . You stated that your knee was more stable at 6 months than it was at two. What kind of instability did you have and what did you do to improve it? I appreciate your help as i’ll take any advice I can get. Thank you
I'll make an attempt at describing what mine feels like: Sitting down, with my knees at 90º, I try to push my feet together against the friction of the floor, and then try to move them apart (my feet and legs don't actually move anywhere). I can feel some side to side shifting in the knee joint itself, along with some pretty loud clacking. Totally painless. As things firm up, the amount of shifting has been getting less as each month goes by. Still pretty loud though, so I'll always a cute parlor trick to pull off when I'm in a quiet room ;) I like showing kids my scar too, lol.
I'd like to hear other's description of their "instability" as well. There might be many sorts.
 
@Ilovecruising ... I like the idea of you getting the heck out of Dodge at the appropriate time, heading to California and getting your second opinions there under the loving care of your daughter. I hope you work on that as a plan. Obviously it's too soon to attempt all that right now, but there are excellent surgeons in that area. I'll be ready to help you when you're ready.
 
@rustic thank you for your response. My instability comes when I’m walking on it. If I put my entire weight on it, I feel the knee joint shift to left. It’s like my knee can’t hold up my weight. (And I am normal weight). It feels like it’s giving away with me. Because of this I don’t put full weight on it and it causes me to limp.

If I am just standing and put weight on that knee, if you watch you can see that knee joint slowly shift to the left. It’s really weird to watch a joint go to a position that it’s not designed to go.

I am really afraid it’s going to cause me to fall one day. But I am very much aware of it so am extremely careful when I walk
 
You've got me wondering now. Before my op my left valgus knee shifted quite considerably to the right when going upstairs or doing squats. It was one of the trainers at the gym who noticed it first several years ago when I was doing squats. Now it feels as if it's shifting to the left slightly when walking or going upstairs etc. I put it down to the correction of the valgus. It doesn't feel as if it will give way, just a little disconcerting. I do get pain on that outer edge of the knee at times when putting weight on a bent knee. I mentioned it to the surgeon when I saw him at 8 weeks, but he thought it would probably settle as the tissue around the knee became used to the difference and said the x-ray at 12 months would indicate if there were any problems. I'm hoping physio will help - time will tell I guess.
 
@rustic thank you for your response. My instability comes when I’m walking on it. If I put my entire weight on it, I feel the knee joint shift to left. It’s like my knee can’t hold up my weight. (And I am normal weight). It feels like it’s giving away with me. Because of this I don’t put full weight on it and it causes me to limp.

....
Your problem sounds more serious than mine. I have to be careful with mine when it is bent, but the weighting-unweighting thing that occurs in walking doesn't cause problems.

Before surgery, my knee was fine when it had weight on it, but was totally loose when not weighted. When it started shifting back and forth with each step, that was the end of my walking. There is continuous pressure on your leg when biking though, so I got a bike and biked every day for four months while waiting for surgery. I still had to endure the bone-on-bone pain, but there wasn't any shifting around while pedaling. I think the biking helped not lose quite as much muscle. But, I lost a lot of muscle after surgery.
 
Maybe it is better to allow yourself the time to mourn your loss of mobility. I cried for months after my husband died and I remember posting on facebook that I cried every night before I went to sleep. A friend, who had lost her husband posted back, "yes we do, until we don't" That was good advice. Eventually we stop mourning and move on with our lives. It took me a year, I hope you can do it in less time. But trying to tell yourself that you should not be crying is pointless, we have the right to experess our emotions for as long as it takes.

I would cry too---but don't forget that this situation is not forever. When we are in the midst of pain and loss, we forget that there are some days ahead of us. He is not the only doctor in the world, I agree with Jamie that I think I would also go to San Francisco and find a surgeon there.

Yes, you cannot go to Venice now---but that does not mean that you can never go to Venice. It was hard for me to see that there was still life to be lived. I can only tell you that as your grief lessens, the world is still waiting for you and it will be easier to make decisions. In the meantime, don't give up painting!! I am an artist and painting is like meditation to me.
 
@skigirl Not sure why, but your post really touched me and I cried all the way through it. (A good cry)

Maybe it was what you said about having the right to express our emotions. Maybe it was the part where you said there is still life out there for me. Today has been another emotional day for me. I cried in rehab when my therapist brought up my surgeon. I cried when talking with a friend on the phone tonight (my cruise buddy) and now I’m still crying.

I do have hope that what you said will happen for me. It’s just so hard to get past this pain and knee instability right now. Thank you so much for your post and encouraging words! Really means a lot to me!
 
Another setback for today. My flexion had gone from 116 2 weeks ago to 100 today. It’s like when it gets to a certain point the pain is unbearable and I can’t go any further. Ive noticed when I’m in bed at night and I roll from side to side that moving it is more painful than it had been. And my instability just gets worse instead of better. It’s almost every step now that I feel the shifting where after first surgery it wasn’t this often.
 
Question for y’all: If I moved to California would the “wait one year after surgery before another doctor would see me” still apply? What would be the best way to find out? Maybe get my daughter to call a few surgeons in San Francisco and ask? I know I would want to wait at least 6 months but sure hate to wait a full year.

I am on viva Medicare which is only good at hospitals in Alabama. But if I were to move out of state, I believe I could go ahead and change to regular Medicare and pick up plan F as a supplement and would be covered in California.

Anyone have any insight on this?
 
Do you have presently a medicare advantage plan, Part C?
 
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I think @Jamie can also answer Medicare questions.

I cried buckets during my recovery. I think it’s part of the side effects of major surgery. :console2:
 
Your idea to have your daughter contact a few surgeons to find out if they would see you is a good one. Here are some suggestions for surgeons to interview:

broken link removed: https://www.pamf.org/orthopedics/services/hip/resurfacing/ at Sequoia and Stanford. Clinic is at 795 El Camino in Palo Alto. Only does hips and knees. His associate is broken link removed: https://www.pamf.org/dr-john-v-lannin.html who only works at Stanford.

Revision specialist:

broken link removed: https://orthosurgery.ucsf.edu/about/faculty/erik-hansen.html
Assistant Professor
Arthritis & Joint Replacement
1500 Owens Street
San Francisco, CA 94159

415-353-2808

About Erik Hansen, MD
Dr. Erik N. Hansen is an Assistant Professor of Clinical Orthopaedic Surgery in the Arthroplasty Division at UCSF and serves as the clinical fellowship director. His clinical and academic interests revolve around primary total joint arthroplasty, including the direct anterior approach to hip replacement surgery, as well as complex revision surgery.

Apart from his clinical practice, Dr. Hansen has a strong commitment to clinical research dating back to his medical school education. At that time, he took an additional year off to work in an orthopaedic basic science laboratory to understand the fundamentals of fracture healing. In residency, he was selected from his class to do an extra year of research, during which time he worked on several clinical projects focused on total joint replacement, orthopaedic trauma, and medical education. Over the past several years, multiple projects which he has collaborated on have been recognized for prestigious national awards, including the James A. Rand Young Investigator Award, the Mark Coventry Award, and the Chitranjan Ranawat Award. He currently serves as the UCSF lead investigator collaborating with several other major academic institutions on multicenter, prospective randomized clinical trials focused on improving outcomes following revision joint replacement surgery.


Dr. James Huddleston

Stanford Medical Outpatient Center
Redwood City, CA
Hip and knee revisions
Speaker at 2018 ICJR workshop on problem hips and knees


As for Medicare, i you’re enrolled in a Medicare Advantage plan or a Medicare Part D Prescription Drug Plan, a change in residence, such as moving to another state, could qualify you for a Special Election Period (SEP). During your SEP, you’re allowed to enroll into a new plan that is offered in your new service area.

If you decide to permanently move somewhere that’s not covered by your current Medicare plan (that is, outside the plan’s service area), you need to tell your plan immediately. If you notify the plan before you move, your SEP timeframe is four months long. It begins one month before the month you move and lasts for three more months after that. If you notify your plan after you move, you can switch plans the month you provided notice of the move and up to two months after that.

You can switch to a new Medicare Advantage plan or Medicare Prescription Drug Plan during this period of moving to a different service area. If you prefer, you can return to Original Medicare.

If your current Medicare Advantage plan is not offered in your new service area, your Medicare Advantage plan is required by Medicare to disenroll you. If you don’t enroll in a new Medicare Advantage plan during your SEP, you’ll return to Original Medicare (Part A and Part B). If you’d like to sign up for a new Medicare Advantage plan after you moved and your relocation-based SEP is over, you generally have to wait for the Annual Election Period (October 15 - December 7).

If you don’t enroll in a new Medicare Prescription Drug Paln during your SEP, you might find yourself without Medicare prescription drug coverage, and you could face a Medicare Part D late-enrollment penalty if you decide to pick up this coverage later on. You may be able to enroll in a stand-alone Medicare Part D Prescription Drug Plan, or to get your Medicare coverage through a Medicare Advantage Prescription Drug plan — but outside of an SEP, you generally have to wait for the Annual Election Period (October 15 – December 7).

It's great that you're thinking about all your options. I know a move a a big undertaking, but it may be a really good plan for you.
 
I would make sure to get your records and x-ray films to bring with you. It is a lot easier than requesting them when you get there.
 
Okay this is a long post but I wanted to update you guys on my newest problem: I still have pain and instability 7 months post op. But in June, I was just walking across room with my cane when I had excruciating pain in my left lower lateral leg with every step I took. I had a follow up appointment in two days with my original surgeon. He said it could be a stress fracture and set me up for a MRI about 10 days later. In the meantime I resorted to using my wheelchair in my home to keep weight off it.

My surgeon’s nurse sent me a message through the nurse portal that the MRI showed swelling and inflammation on the tibia.But there was no definitive stress fracture. Said he was ordering prescription for calcium and vitamin D.
Also said they could contact a company that sells bone stimulators to see if my insurance would cover “if I wanted them to” I knew that there was more wrong with my leg than swelling and inflammation. I got a report on the MRI and it stated that the findings were
“Concerning” for a stress fracture. I continued to use my wheelchair and also went to see my PCP to see if he could get me in with another ortho doctor. I waited 2 weeks but never heard from the clinic they called and then I went to ER at different hospital. An X-Ray showed a “stress fracture” they put me in a boot and told me to follow up with ortho. I left two messages and after another three weeks or so, they finally called me today and want my records of the stress fracture only. Of course they will have nothing to do with the knee.

I was just wondering if anyone has had a stress fracture following TKA, have heard if it happening or have any insight on why it might have happened. Thank you so much!
 
Not sure who I should tag to change the title of my thread but maybe someone can help! I’d like to change it to
“Two failed knee revisions and now a stress fracture, all in 14 months
 
Not sure who I should tag to change the title of my thread but maybe someone can help! I’d like to change it to
“Two failed knee revisions and now a stress fracture, all in 14 months
I will ask a moderator to change this for you.

@Motherbone has a stress fracture, also.
 
What a nightmare you are having with your recovery. When do you see your OS again? Actually, if I were you I'd find a different OS since it seems like he overlooked your fracture. Are you non weight bearing? If not, you might should be. When I broke my foot and ankle I was NWB for 6 weeks. Using a wheelchair is a good idea until you see an OS.
 
I have healing stress fractures of the left fibula and tibia. If it had been only the fibula I could have gotten by with a boot and weight bearing as tolerated, but when the tibia became involved it was a whole different story because the tibia is the weight bearing bone of the lower leg. So now I am finishing up week 3 of 6 weeks of non weight bearing and my left leg is casted from toes to a few inches below the knee. The working theory is that the stress fractures were caused by my left leg having to bear most of the load since October of last year. I had a right TKR last Sept. and during a PT session in October the kneecap on that side broke into several pieces, necessitating extensive repair surgery and limited weight bearing for 8 weeks. In essence, one problem begot another one and, like you, I have not reaped the benefits of the TKR that I had hoped, but instead have acquired other difficulties.

My fractures were diagnosed the week before I was scheduled to have a left TKR, and that procedure, which I had been looking forward to despite my terrible experience last Fall, had to be cancelled and is currently on hold until my fractures heal. It was very difficult for me to accept and this whole thing has been a lesson in patience but I am doing better with it now. My suggestion (which you of course are free to ignore) is to let go of your concerns about your knee right now and just focus on healing the stress fracture because you can't do anything else until that happens. If the clinic you were referred to is willing to address the stress fracture, go with it. You never know, maybe that referral will lead to someone who can ultimately address your knee later on.

Being non weight bearing is not a picnic but once I was casted, the pain went away almost immediately. Follow up for the stress fracture and see where it leads you otherwise.
 

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