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Revision TKR Against the wind

I've kept a log and journal over the last several years on my rehabs after knee replacements. If I overlooked some info. that's important in this RTKR, it's inadvertent. This RTKR has never healed properly. I was able to overlook and compensate for the incomplete healing because I'd regained a lot of my activities (golf) at 4 months and I was hoping that it would heal and settle in by a return to everyday activity. Hiking was my other activity after golf. I started adding in light hiking/walking in the preserve areas by my home at 7 months. Walks of 2 to 3 miles on rocky trails and uneven ground once or twice a week. With that added in, plus regular household activities, store trips plus golf the knee would not hold up. Now I've cut out hiking/walking, golf and a great deal of my normal household activities plus trips to stores to see if I can get leg to heal. Giving this 3 more weeks.

Another surgery and rehab...... nightmare but I'm not ready to concede to a life of a disabled person yet. Maybe that's my fate..... time will tell.
Thanks for all advice and support.

PS: This is new information. I'm using a medical prescription salve on my knee 3 or 4 times a day + a blended oil that has had a lot of success with healing inflammation and muscle spasms. I take the oil in micro doses 3 times a day. The impairment is negligible with this dosage. I've been using this for about 10 days. Info says 8 to 12 weeks of treatment. I've noticed no improvement as far as knee swelling & inflammation but it has helped with mood and depression, pain relief and improved sleep. I'm taking no other pain medication, either OTC or prescription.
 
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I've gone 7 days without a "swelling/stiffening episode". I think it (leg) has made a slight improvement as far as swelling. My wife thought my leg looked like it was slightly less swollen. It feels like I have an improvement in ROM. When I do heel slides I can feel like I have more movement and strength. If i keep improving over the next 4 days I'm going to add in a bit more activity. Probably 8 to 10 minutes on stationary bike and or pitching some golf balls. I'm paying very close attention to how my leg feels. I'm very fortunate that I'm retired so I'm not struggling with work and pressures associated with it. I realize my problems and life disruptions are minimal compared to many who are suffering far more than I. A grateful attitude is a gift.
 
skippyhak said:
When I do heel slides I can feel like I have more movement and strength.If I keep improving over the next 4 days I'm going to add in a bit more activity
Click to expand...
Oh dear - did my words of wisdom (below) fall on deaf ears?
Josephine said:
I think you should stop all exercising. It will only improve if you stop it all and allow the swelling and pain to subside.
Click to expand...
 
Saw my surgeon today. Ordered MRI bone scan and CRP & ESR blood tests. See him after result of tests. I also have scheduled a 2nd opinion with a revision specialist after I receive the test results. I've made a small improvement since I stopped all exercise 4 weeks ago. I'm going to get another 3 or 4 weeks of rest, ice etc. while I chase around with tests etc. so I still have time to see if more rest will result in more improvement. I do worry about going from being very active to sedentary. Patience over panic.
 
I saw my surgeon today to review results of bone scan and CRP and ESR blood tests. ESR result 30; the way I understand it indicates a possible infection. 3 phase bone scan - " ...findings would be compatible with loosening or even a mild infection".
Dr. ordered "white blood bone scan" to gain more information.
Seems to be pointing towards infection & revision? He's referred me to a revision specialist + I have a 2nd opinion scheduled with another revision surgeon.
I've rested the knee for the last 5 weeks and it has improved but still the same nagging soreness and mild swelling in spite of very little activity.
I'm open to any and all advise and suggestions.
Pretty overwhelmed at the moment.
 
I think it would be wise to have an infectious disease dr take a look at the labs, especially if you're worried about infection. Analyzing blood in reference to infection and knowing which antibtiocs are sensitive to particular infections is an ID specialty. My OS and ID worked hand in hand, I still see my ID at least once a year for blood work/analysis.
 
I hope it's not an infection. It's a good thing to get it checked.
 
How do I change my thread title? I'm headed down the "infection" or "revision" path at this point.
I've rested my knee for about 7 weeks hoping that it would heal. It's better, but still not right. I'm going to gradually increase my walking and activity to see what the knee will handle. If the diagnosis is "infection" then my path is settled as far as I understand it. Old stuff out and redo the whole mess. But if no infection then I need to find out what this knee will allow me to do? Back in March, it wasn't letting me do very much without swelling up and stiffening. So I need to know. I'm seeing 2 revision specialists over the next 3 weeks and a white blood cell scan test. I've gone from an active hiker and golfer to a sedentary lifestyle. Huge change and I'm not ready to give up the dream of becoming an active person again.
 
We'll change your thread title prefix for you when either Infection or Revision are confirmed. If you'd like the wording of the rest of the title changed at any time, just tell us what you'd like and it will be done.

I'm sorry your knee is giving you so much trouble. I agree with you. You're far too young to accept being an invalid. There's every chance that something can be done to improve your knee.

Do let us know what the revision surgeons say, won't you?
 
Is this the same type of prosthesis as your first knee. I was wondering if it could be a metal allergy?


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I've not had the metal allergy checked, yet. It's on my list of possibles. Thanks for the tip!
Thanks also for changing my heading and I'll think about my wording in the title.
 
The revision specialists should be able to tell you exactly what needs to be done to get your knee functional. I had a revision on my left knee (changed out the prosthesis) and it has been great! My ROM is 0 to 130! That's with minimal amount of exercise. You will be able to get back to what you have enjoyed in the past.
 
I'd take 50% of my activity level of 3 years ago!! Right now I feel 1000 miles away from that type of activity. Discouraged today, nothing new has happened, just reacting to bad news of last week of infection/revision path.
I'm overwhelmed presently with the whole mess.
 
Hang in there! It may take a little while, but there will be something that helps your knee.
 
Had my 1st, 2nd opinion. Dr. reviewed x-rays, blood scan report, blood test results, thorough exam of both knees and then asked me about my experience since the replacement surgery. He drained the knee and took samples for testing and for cultures. His initial opinion is "does not think it's an infection but that needs additional testing to rule it out". The problem is resulting from the femur was not cut or shaped at the correct length to accommodate the appliance. So the knee essentially bangs into itself. So that's why I was unable to improve extension beyond 12 to 15 degrees. All this creates soreness, inflammation and has no chance of healing unless you stop using the leg. So bottom line the right knee needs a revision. He thinks the kneecap is OK (whatever that means), and the lower leg at tibia appears to be OK but doesn't completely rule out loosening in that area.
Huge difference of opinion between my Dr. who performed the surgery and this Dr.
I have another revision Dr. examining the knee in another 2 weeks, but he's the partner of my original Dr. He's a very well respected Dr. in this area and I wonder what he'll say?
I was stunned and shocked after getting this opinion. I've had a few people comment over the last year on how the appearance of my knee and particularly a bone area looked "not right". All the time, blood, sweat and tears I've spent trying to improve extension and in 5 minutes someone tells me it was impossible to ever get the leg straight because the parts don't fit properly. 5 surgeries on both knees and I've had 2 total surgical failures. Batting average of .600 in baseball would be pretty good. In knee surgery business it sucks!
I'm open to all advice and comments.
PS: My heading never got changed to "Revision". I'd do it myself but couldn't figure it out Thanks!
 
We'll change your heading (prefix) when it's confirmed that you are actually going to have a revision. Let's wait and see what the next second opinion surgeon says.

It's often the case that a second opinion differs from the original surgeon's opinion. The surgeons who specialise in problem knees can often spot something that has eluded the original surgeon.

PS: I had to have a revision and, although I was apprehensive, it turned out not to be as bad as I was fearing it would be.
 
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