Revised PKR to TKR Agilitymom's revision recovery<<

[agilitymom]

@Jamie no problem with unoperated knee. My major concern is that in the 2 previous revisions, X-rays of my right knee showed absolutely nothing wrong either. Both surgeons were reluctant to go in. However after both surgeons went in both came back with exactly the same first reply that the implants were very loose.

 

[Jamie]

I can understand why that would concern you. It's true that problems are not always evident on imagining and most surgeons don't like to go into a knee unless they can clearly see a problem. This is all well and good until someone has unexplained pain or mobility issues that need to be addressed. Everyone has their own feelings about pursuing multiple opinions when this occurs. Sometimes it does take a lot of doctor visits to find the person who diagnoses properly and is able to fix a problem. It can take a lot of patience and determination.

 

[agilitymom]

@Jamie or anyone else: Do you think a D.O. that has many TKR and Revision qualifications and certifications would be a good option for a surgeon that might look further than X-rays on a second opinion? I have called 4 surgeons that specialize in revisions and none will see me unless I have verified infection or problem with implant. As in my last post, i am still having tremendous pain, swelling, nerve pain and heat. My knee surgeon, whom I will never see again, will not see me as last December he saw me, took fluid out, amazed at large amount, and no infection found. He says it is my back causing the problems. Saw back Dr again and he had nuclear CT done and MRI of spine. CT showed no problem anywhere except my knee. MRI showed no back problems to cause my issues. I am so frustrated and am tired of constant pain. Sorry to vent.

 

[Jamie]

I can understand your frustration and you are very much entitled to feel that way after basically being blown off by the surgeons you’ve seen. I would have no reservations about seeing a DO who has a good history with joint replacements. Go for it!

 

[EalingGran]

As in my last post, i am still having tremendous pain, swelling, nerve pain and heat.

Don't worry about venting. It must be so frustrating and I can totally understand your worries. It seems there must be something wrong to have so much pain swelling and heat. I hope you find someone knowledgeable who can get to the bottom of things for you.

 

[agilitymom]

Well turns out the DO is in the same large practice as my 3rd surgeon, the one who wont see me. So still looking for someone to look for answers.

 

[Jamie]

Dang.....too bad. You may have to travel a ways or see someone virtually.

 

[agilitymom]

Finally saw a doctor for a second opinion. I have decided to try for another opinion as the first thing this new doc said was my previous doctor does great work so he did not think there was a problem with the surgery. This doc did listen to me and agree that I have swelling and warmth on my knee. He did not think the nuclear CT scan showing my knee was the only lit up place meant much of anything.

I asked if it was possible to pull up X-rays from before last revision and he did. I asked if there was any lucency showing and he said no. I explained that that revision was not planned but was supposed to be an open lysis of adhesions only and that once the knee was opened up the replacement parts were very loose and an immediate revision was done. So I asked if it was possible these were loose also and do not show in X-ray and he said no not possible as he knows this doctors work.

He wants me to see a pain specialist to have injections to hopefully help the constant pain. If they work then an ablation would be recommended. It might help the pain but what is causing the pain? 2nd opinion doc also suggested another test for infection in a couple of months.

Can deep infections come and go? I am confused on that one.

 

[sistersinhim]

So I asked if it was possible these were loose also and do not show in X-ray and he said no not possible as he knows this doctors work.

It sounds like your second opinion has a 'hero worship' of your previous surgeon. It is much better to go to a doctor that is out of your area and that would not know your revision surgeon. Something sounds like it is not right, you should not be in this much pain.

So I asked if it was possible these were loose also and do not show in X-ray

Many times loose implants don't show up in an x-ray, usually an MRI will show it.

 

[Jamie]

I agree with sistersinhim. This latest doctor does not sound like the right person for you to get an independent opinion on your knee. You may have to drive a bit, but please do seek out someone else to consult with. Ask these same questions…..they are good ones that deserve answers. If you need assistance finding a surgeon, let me know and I’ll do my best to help you.

 

[agilitymom]

Does anyone in Bonesmart Land have any familiarity with Orthopedic Speciality Institute Medical Group of Orange County, CA? I am trying to find a surgeon that specializes in revisions and that will look deeper than the latest X-rays. I am considering trying for an appointment with either Dr. Steven Barnett or Dr. Jay Patel, both with that group.
Since I am having a hard time finding someone here in San Diego that is not associated with a scrips or knows my current Dr, I am looking further up the coast or elsewhere.
My knee is getting more painful and the inflammation and heat are constant.
Any suggestions will be appreciated.

 

[Jamie]

I have Dr. Barnett on my recommendation list, so I would suggest him as a good option for a consultation.

 

[agilitymom]

Thanks @Jamie . Going to give his office a call today.

 

[agilitymom]

I could not get in with Dr. Barnett but have an appointment with Dr. scudday in the same office and specialty group end of June. In the meantime, I had a follow up with the pain doctor I have been seeing for a couple of years. He is suggesting a genicular nerve block to see if that might help with the ever increasing pain. If it does he suggests a genicular nerve ablation. Dr says it will not treat the problem but hopefully will give me some pain relief so I can strengthen my quads. Then that might help the problem.
I had the nerve blocks done about 9 months ago and had about 2 hours of pain lessening. Maybe 60% improvement in pain. Dr thought that was a good enough outcome to go ahead with the ablation, but I did not. With the pain getting worse, I am going to try the block again to see if my outcome is any better.
Any thoughts? Knee doctors I have seen seem to think I will have to live with this pain and the lessening of my range of motion.

Am I wrong to keep trying to find someone who will look deeper than an X-ray for the cause of my pain, inflammation and warmth in my knee?
Sorry for venting. I am having a tough time with my body right now.

 

[sistersinhim]

I am so sorry you have to deal with this awful, debilitating pain. If I were you, I'd keep striving to find some relief. It should not be something you have to live with. There is something wrong. I pray that you are led to the correct solution.

 

[Jockette]

I find it shocking when we have pain that the doctors refuse to look past an X-ray that looks fine. Been there, done that! If they did a bunch of other tests and still couldn't help us then at least we’d know they tried.

I hope you find an answer.

 

[Jamie]

I don’t believe it’s wrong to keep looking for help with this pain. New eyes, new processes and techniques, new medications happen all the time and sometimes you just have to find the right things that click for you. Hang in there….we’re behind you!

 

[Ghostpipe]

I’m no expert, just going on personal experience. I would keep going, there must be a reason for this. Even if there is no remedy, you will not regret not having tried everything. After over two years of pain, I am on surgeon no.4, who has found a cause when the first 3 said that there is nothing wrong with my implants, and he is still looking into why this has happened. Hope springs eternal.

 

[agilitymom]

Thanks Jamie , Jockette and sistersinhim I am in a continuous quest. Kinda like a video game. I just keep repeating until I reach a new level, in this case a doctor who will actually dig into my problem.

 

[Layla]

Please don't apologize for venting here. That's part of what we're all here for, we were looking for support through the good and the bad. I am sorry you're struggling with pain. Sending a warm hug, wishing you lots of comfort and a resolution to the pain. Please keep us posted.
@agilitymom