Revised PKR to TKR Agilitymom's revision recovery<<

[agilitymom]

Saw my revision knee surgeon yesterday. Xrays showed everything is still in place, as they did in all my previous knee replacement X-rays. Dr said there was absolutely nothing he could do for me except to check on it every 6 months. Dr said my weird body made lots of scar tissue after 3 months, when it had looked pretty good. He feels the inflammation and heat and pain will just be something I have to deal with but that I can’t hurt my knee doing anything I want to do. However it will hurt me and I will have to ice and take Tylenol. My best friend is a PHD in Physiology and she is going to help me with a very easy stretching and band exercise once my back is a bit more healed.
I have to admit the hour long drive home was good so I could feel sorry for myself a little and then get my mind on the right track again.

 

[Jamie]

I think it's good to hear that your knee is still looking good. Sometimes we have to take the small victories while we deal with larger issues. The idea that you can use your knee at whatever level is comfortable for you is promising. I also like the idea of you working with your friend on stretches and other exercises to help you.

You will be in my prayers with the hope that all this will settle out to a manageable level for you. Please continue to let us know how you're doing. We're your cheering squad when you need a little boost!

 

[Jockette]

Sending hugs and prayers that you will be able to cope with the knee you have, it’s been through a lot.

 

[agilitymom]

Here’s my latest update. I am 9 months post spine fusion surgery. My spine doc is concerned that I have had so little improvement in nerve pain going down my leg. He suggested having a Pain Mgt Dr do injections in my SI joint to see if maybe the SI joint is impinging the nerve. I had one injection 3 weeks ago that gave me about 60% relief for about 5 hours. We both agreed that it was not enough to say it is the SI joint causing the problem. So I agreed to another diagnostic injection next week. If this one does better we may discuss a cooled radio frequency ablation. I had several of them around my cervical spine 10 years ago.
Anyone have any similar issues?
I also see my knee surgeon in early September. I plan to ask if there are any tests besides X-ray to see if there is a problem in my knee. I am more than 2 years post revision number 2 and still having way too much knee pain on the inside and upper right parts of my knee.

 

[Jockette]

I’m sorry you haven’t had more improvement from the spinal fusion. One doctor offered my husbsnd that, but 2 other doctors didn’t agree, so we didn’t do it. My husband had a degenerative disease and looking back, I really think, in his case, that was more the cause of his spinal pain, as it wreaked havoc with his posture. No pain medications were prescribed for him, so he just took over the counter ibuprofen. It helped a little. He did have injections, and radio frequency ablation, but they did nothing for him. All in all, very little was done to help him, and what was offered, didn’t work.

 

[Jamie]

So sorry things haven't worked out as planned with your fusion and the diagnostics you've had so far. But I do think it's a good idea to keep trying to get to the bottom of what is causing your pain. It's possible that whatever is going on with your spinal area is affecting your knee, so it may be that your orthopedic surgeon won't find anything there. But the only way to know for sure is to have it checked out. Sometimes finding the source of pain and being able to properly treat it is a huge exercise in trial and error as well as the process of elimination. Hang in there and let us know how things go.

 

[agilitymom]

Saw the Pain Mgt Dr on Monday. Based on getting some leg nerve pain relief, about 60%, from the 2nd SI joint injection, we are going to try a cool rfa. Hope it will give me a bit of relief from the nerve pain and hopefully from the lingering back pain after the back surgery 9 months ago.
I see my knee Dr tomorrow to do my every 6 month visit to do X-rays and see if any improvements. I have actually lost some ROM and still have terrible pain especially standing and sleeping.we will see how it goes.

 

[Jamie]

@agilitymom It's good to hear you may be able to get some relief from the back pain. Please let us know how it works.

It will also be good to hear what your surgeon has to say about the knee pain you're experiencing. You have definitely had more than your share of challenges. Bravo for you for continuing to search for answers. Sometimes that's difficult thing to do when you hurt and all you want is just for the pain to stop. But it's the only way to have hope for finding that person who can get to the bottom of what's going one. Hang in there and you'll be in my prayers.

 

[agilitymom]

Thanks @Jamie

 

[agilitymom]

Saw my knee surgeon and after new xrays he was still adamant that everything is fine and the swelling behind my knee is just fluid. He is not concerned about the pain I have in my knee nor the fact that standing is super painful. ROM was about 110 which is livable but hope for more over time. I hope the RFA will help the knee a bit besides the back. Time will tell.

 

[Jockette]

Can you go to someone else for another opinion? This much pain is not “fine” and neither is the fact that he is not concerned.

@eaglemom had the cool RFA.

 

[Jamie]

I have to agree with Jockette. Something is causing the “fluid” (swelling) he says you have. That‘s not normal and I think it’s really sad he’s basically blowing you off. You’ll no doubt have to travel to see someone else, but it could be worth it for you. I’ll help in any way I can to assist you in getting additional opinions.

 

[agilitymom]

@Jamie I am sorry to get back to you so late. I have had to go to my MIL’s house to help her out for a week or so. Hoping to go home tomorrow. No internet and my cell coverage stinks out here. Had to go to town so stopped at Starbucks for a break and check my emai.
I would love to know how I can locate surgeons that specialize in weird or special cases. I thought I was going to one, but if he is he gave up on me. Do I do an internet search or word of mouth or whatever. I live in San Diego, CA but am able to travel wherever I need to go.
If you have any suggestions please let me know.

 

[Jamie]

You will be looking for a good revision surgeon. Here are some suggestions for you to try:

Los Angeles, California

Surgeons near Los Angeles:

Ran Schwarzkopf, M.D. - hip and knee primary and revision

Dr. Steven Barnett - hip and knee primary and revision (Orange County)

Thomas P. Schmalzried, M.D. - primary and revision hip and knee surgery

Jay R. Lieberman
Keck School of Medicine
University of Southern California
Speaker at 2018 ICJR workshop on problem hips and knees



San Diego
Dr. Joseph Jankiewicz
2929 Health Center Dr
San Diego, CA 92123
(858) 939-6502


Santa Monica, California
Bert J. Thomas M.D. - does primary and revision knees and hips. Does a lot of complex revisions.

Burbank, California
Shahan V. Yacoubian, M.D. - hip and knee primary and revision surgery

 

[agilitymom]

@Jamie i have been doing some research on the names you provided. Thank you. In the mean time I had a 5 day period where my whole leg, the one with the knee replaced 3 times, swelled up quite a lot. I am a really small person, 5’1 and under 100 pounds so swelling shows up rather prominently. My knee was also much warmer than usual.Took a picture and sent it to my same knee surgeon and he saw me right after Thanksgiving weekend. When I saw him he did X-rays that of course showed nothing out of place, just like on all previous surgeries when they turned out to be loose. I also had blood work done which showed my C Reactive Protein is elevated at 29 so some inflammation. He is going to do a knee aspiration sometime this week. I really need to get moving on a second opinion.

 

[Jamie]

I agree. This is definitely a reason to find another surgeon to consult for a second (or even a third) opinion. The fact that your knee is very swollen, it's hot, and your C Reactive Protein is elevated moves the situation to a more serious one rather than just experiencing post-op pain. If you have this surgeon do an aspiration, be sure to get a copy of the results to provide to your new doctor.

 

[agilitymom]

Thanks so much @Jamie .

 

[agilitymom]

@Jamie , so the nurse called and said the fluid they took out of my knee was fine. I got the results over the weekend and it said it was cloudy and not clear. Kinda weird that my Dr thinks it is just fine when it comes back as cloudy. No elevated WBC which is good. Also Fluid Nucleated Cell Count was very high at 993 with normal range of 0 to 200. Dr. cracked me up when he took out 31ML and said he was shocked he could get so much fluid out of my knee. Then he asked if I felt a lot better and to stand up. When I did my knee nearly gave way. Crazy. I called a local Dr today about a second opinion and was told it would be May before I could be seen if the Dr would decide to take my case. Looking again tomorrow. Starting to order all my X-rays and records for a second opinion. I do not have copies of X-rays but here is a picture of my latest. Also a picture of my entire leg swollen. As you will see I am kind of a tiny person. I am still not sure an adult size knee is the right size for me.

 

[Jamie]

Although your surgery leg appears to be swollen and larger, your knee prosthesis looks good and covers exactly what it's supposed to in the x-ray. You just don't have a lot of "meat" on your legs normally, it seems, and that makes it seem that your bones should be smaller than normal. But they look completely normal to me. Your unoperated knee looks pretty good. You're not having any problems with it, are you?

 

[Jockette]

Then he asked if I felt a lot better and to stand up. When I did my knee nearly gave way. Crazy.

Maybe not so crazy, you just had a needle inside your knee and it was upset.

Before I had my partial, we tried a gel shot to see if it would help. It hurt really bad when they inserted the needle, and even worse as they inserted what felt like a thick liquid, which obviously a gel is. I could barely bend my knee for a few minutes after, and it took me 2 days to walk regularly again. I should have taken that as a sing of things to come, like how bad the early recovery would be after a joint replacement!