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TKR 4 Years After TRK and Knee is Still Painful

JLP

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My original thread has been closed so I am starting a new one. I had a right TRK (revision, first surgery) on 16 Jan 2016. My knee is so darned painful. Ortho says there is nothing wrong but I believe it is more painful than before surgery which was due to avascular necrosis, not arthritis. Any suggestions on why it is still so painful? It is also still warm to the touch and quite a bit bigger than my non TKR knee.
 

sistersinhim

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@JLP, I'm confused. Did you have a revision in Jan. 2016 or was it an original TKR. Either way, you shouldn't be having pain this long after your surgery. It sounds like to me you need to see a new OS, one that is out of your area that has no connection with your current OS. You need someone fresh to look at your knee, someone that specializes in problem knees, a revisionist.
 
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Celle

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@JLP - I found your 2016 recovery thread and it sounds as if your recovery was rather difficult and you were still having some pain a year later.
That surgery, to remove the AVN was a primary TKR,not a revision. We reserve the name "revision" for a second operation, that corrects a problem with the original knee replacement.

I'm not sure if you've been back to your original surgeon with your new problem of a hot, swollen and painful knee, but someone should see it soon if you haven't. You could go to the ER - if these symptoms are new you do need to rule out an infection.

If the symptoms aren't new, then, I think you need to look for another surgeon and get a second opinion. You'll need to see a surgeon who specializes in fixing problem knees and who does revision surgery if necessary. It needs to be someone who has no connection, professional or social, with your original surgeon, so that you get a complexity independent opinion.
 
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JLP

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The ortho called it a revision since I have a long spike and lots of additional metal. I have been tested numerous times for infection with negative results. I am not longer in the area where I had my surgery so a new ortho looks to be in my future.
 

Celle

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It sounds as if your surgeon used the long stemmed tibial component that is often used for revisions, possibly because you had bone loss due to AVN. The bone loss would have made the surgery more extensive than usual for a TKR and that could also explain why your recovery didn't go as smoothly as you'd hoped.

You didn't say where you're living now, but if you give Jamie your zip code and tell her how far you're prepared to travel for a good surgeon, she may be able to suggest some people who are skilled at dealing with knees that have a a problem.
Just tag her, so she'll be sure of seeing your post:
https://bonesmart.org/forum/threads/tagging-other-members-and-answering-tags.56687/
 
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JLP

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Unfortunately, we travel (full time RVers) and am not sure where I will be long enough to see an ortho. As soon as I know, I will give Jamie my current zip. Can avn have reoccurring effects? I appreciate all the help you are providing. Thank you.
 

Jamie

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Your original knee surgery should have removed all the necrotic (dead) bone. Were you given any diagnosis as to why the necrosis appeared in the first place? Was it due to use of steriod medications (prednisone) perhaps?
 

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