PKR Clunky Knee

[EalingGran]

One positive, my company have added me to their BUPA scheme which includes any and all pre-existing conditions. I have decided to continue on my current journey and then seek a second opining in the new year.

I see you are in the UK. If you are near London I would really recommend my surgeon ( Alex Liddle- private at King Edward's and NHS at Charing X). He is excellent and has done a lot of research on PKRs and TKRs. He is also really good at explaining things. I would trust his opinion on whether further surgery is a good idea.

 

[Ginger1210]

HI all good people at BoneSmart. Its been well over a year since may last post. Tried to get on with life and manage with my troublesome right knee. I hope all of you are well.
Last April marked my 4 year anniversary of my right PKR. No great changes still have good and bad days with little or no clue as why.
I am active and continue to swim regular , I have tried some gym sessions all low to non impact which I do enjoy but this does not come without a cost ( swelling and pain the following days) I have been considering getting another opinion on my knee for a good while now, my company have given me private medical health care ( BUPA) I have had a teams call with a physio and from that they have recommended three Knee orthopedic specialist in my area ( West Yorkshire England ) Mr. Neil Hunt, Mr. James Parker and Mr. Simon Jones. All look to have a good record. May I ask you fantastic members if anyone has heard of any of the three gentlemen or in fact could recommend any of the above.

 

[Layla]

Hi Ginger, I am sorry you're still troubled by your PKR results four years post op.
As you wait for responses from other members, you can use the SEARCH at the top right of the page, typing in the names of the orthopedic specialists you shared to see if any of them were mentioned on the forum.
I do wish you luck in finding a reputable specialist for a second opinion and some direction back to pain free.
Take good care!
@Ginger1210

 

[Ginger1210]

HI Layla.

Thanks for the information that's great I will do..

 

[Legseleven]

@Ginger1210 I have sent a DM. You can also look them upon the joint registry.

 

[EalingGran]

Agree with @Legseleven that the UK joint registry is a good place to check on a surgeon's operating record.
I would also consider looking for links to a teaching hospital like Leeds.

 

[Ginger1210]

HI All I hope all you good people on this forum are doing well.
Quick update. I took the decision to utilize my companies BUPA Private health care. I had a appointment with a Mr. Neil Hunt last Saturday. MR Hunt specializes in only Knees ( So I figured if this is all he does he must be good at it ) and I reviewed his profile on the NJR register he had a good revision percentage as well.
The appointment went well. We discussed my history and just where I am now with in regards to pain and stiffness. Mr. Hunt agreed that my current outcome wasn't the best ( He said i should be walking a minimum of 5 miles without experiencing discomfort or pain) I did laugh at this. He examined my knee and looked at My X-rays from 2021-2022. He thinks my pain is mechanical and has seen this type of problem before. He has booked me in for further MRI and X rays plus he is going to supply a hinged brace for me to try out purely to see if the the brace does reduce my pain while walking it would support the idea that maybe my implant spacer is to small which may be causing the clunking and pain. He did stress that there may not be a easy answer but he will investigate further. He also said he had a patient who had two full knee replacements, one was fine but the other just wasn't right, he replaced the spacer with a larger one and all is now good. This does give me hope.
I will await further appointments and see where it goes.

 

[Legseleven]

Good luck with it all @Ginger1210 and please keep us posted. I’m glad you have seen someone.

 

[benne68]

Thanks for the update, @Ginger1210. I hope you find a solution to your pain with this new specialist.

 

[sistersinhim]

I'm so glad you have found an OS that sounds like he's on the right path to help with your discomfort. Please keep us updated.

We recently implemented a new membership program and there are new Guidelines for Posting. You are currently a Basic Member, which enables you to search the forums, and read about other recoveries.

If you want a more involved experience, I hope you will choose one of our subscription options so you can start a recovery thread, officially join the June Sunbeams, and receive one-on-one personal support to quickly answer any questions or concerns you may have. We are a non-profit organization and the small subscription cost goes toward keeping BoneSmart available for everyone.

Basic BoneSmart membership enables you to post “on-topic” comments in existing threads on the forum. But only members of the Insiders Club are able to address new questions or provide updates on their own situation for discussion with other members and staff. Your concerns are important to us, and we will retain your post for up to 30 days until we receive notification that you have added this service to your account. Should you not wish to join the Insiders Club, you are still able to search the entire forum for information, read threads, and post supportive comments to other BoneSmarties.

Link to Membership Page

To join the Insiders Club, please use this link: https://bonesmart.org/forum/pages/membership/

Once you have joined, a special Insiders Club icon will appear in your profile box. It will remain there until you cancel your subscription to our premium services. As you use the forum, be sure to check other members’ profile boxes for the same icon. That way, you’ll know who you can freely communicate with on all our available forums and social areas.

 

[gobears31]

Hi All, first post here. I will be at 12 weeks this Friday of TKR of my left knee.

Thank you! this site looks like a great support system

 

[Layla]

Thank you! this site looks like a great support system

Hello and Welcome gobears31! We're happy you joined us. Congrats on your new knee.

You're right, BoneSmart is a great support system and many of us find it hard to imagine our recovery without the comfort, support and encouragement found here.

Unfortunately, you won't be able to receive that encouragement on this thread, nor have questions answered as it's reserved for Ginger1210's recovery.

I will leave our membership information along with best wishes and hope you will thoughtfully consider becoming an Insider. Please join us! We'd love to support you through your healing journey.

Link to membership info -

Become an Insider

bonesmart.org

 

[Ginger1210]

HI All good people i hope all are well and getting ready for Christmas. Following on from my last post in July. I was supplied a hinged knee brace to try and see of this helped my pain. The brace worked really well ( I couldn't wear it at work due to its size ) But at home while doing chores it does help. I have also had a follow up meeting with Mr. Hunt after further X-rays and MRI scans took place.

The meeting was positive in places. Basically Mr. Hunt confirmed the rest of my Knee was in good health and didn't recommend a full conversation to complete knee replacement. My Partial implant is in good order and well placed. He did however confirm after he asked about how the brace performed believes my spacer maybe to small and the lateral movement in my knee is the cause of my pain and discomfort. He suggested a larger spacer ( This would mean a similar procedures to the PKR but with out replacing any metal work and hence a quicker recovery. ) 6-8 weeks was suggested. As we all know this is just conjecture as everyone recovers at different rates.

He did stress that there was no guarantee this would cure my pain but he had performed cases like this before and seen real improvements. He suggested I go home and consider my options. He has sent me a formal letter on his prognosis which I can supply to my employer. I have decided to not do anything and make no decision until 2026.

At Present I am prepared to go through with this but I am not looking forward to the procedure or the recovery as I know now what it involves. And my real fear is that my outcome will not improve.

Thank you all again for your continued advice and support and please may I offer you all a Merry Christmas and happy new year.

 

[EalingGran]

It sounds as though he understands your issues and isn't making unrealistic promises.
You could put spacer into the BoneSmart search facility and see what other members have experienced with spacer exchanges.

 

[Layla]

Hi Ginger,
Thanks for the update. Wishing you clarity as you contemplate next steps, peace of mind with your decision and comfort as you move forward. I hope you have a lovely holiday season!
@Ginger1210

 

[sistersinhim]

Hi Ginger. Thanks for the update. We have had members who have had spacer replacements and have done well afterward. I think giving yourself time to think it over will be a good thing.

 

[Layla]

Hi Ginger,
Here is a link to threads where spacer replacement was mentioned if you care to look through them.
I hope you have a nice weekend!
Spacer replacement
@Ginger1210

 

[Ginger1210]

Hi All good people at BoneSmart. I hope all are well.

Its been a good 3 months since my last post. After really thinking about my options in regard to my right knee i have decided to go for it and have the surgery to replace the spacer. This is booked for the 21st of May. I have considered all my options and discussed with family and friends. I am managing well at the moment but still taking pain medication which i would ideally like to give up. I am still very nervous about this upcoming procedure as i know what is coming but its been nearly 5 years since my initial PKR and there are still days where i really struggle.

My real fear is coming out of this second surgery worse than before.

 

[benne68]

Hi @Ginger1210. Thanks for checking in. Sorry to read that you are still struggling with that knee.

I've added your new surgery date to your signature. Keep us posted.

 

[Myrica]

Hi @Ginger1210

Just came across your thread and am wondering how you are doing? Did you proceed with the surgery to replace the spacer?

I'm from the York area, and had a left medial partial knee replacement done in December 2025, which is very problematic and I'm now on the route to having it revised to a TKR. I recognise the names of your different surgeons you've seen over the last few years, and see you went with Mr Hunt for this latest. He was my choice for the potential revision, but my doctor's surgery managed to get that wrong and I'm being seen by his colleague, Mr Gibbon, who also only does knees, and like Mr Hunt has done many revisions. Both are extremely experienced. My friend (a retired GP) had bilateral PKR done by Mr Hunt a year ago, and her knees are great. Her husband had a TKR done by Mr Gibbon and that was successful too.

The surgeon who did my PKR was also very experienced, has done thousands of PKRs, and the woman whose knee was done hours before mine by him, hers was successful. The way the dice rolls I guess.

The description of your knee pain below the patella sounds very similar to mine. I've additional deep 'bone' pain in the medial area, plus all sorts of rubbing, catching etc. I need to use 2 sticks - the other knee has been bone on bone for 6 years also, and desperately needs doing. But not until we know why my left one has failed!

Are you aware of the Get It Right First Time (GIRFT) protocol for knee revisions, which is being rolled out by the NHS? You are in the Leeds area, and Leeds was one of the hospitals selected to be a specialised major revision unit, so that protocol should be in full operation in your area. Tees is the other hospital chosen as a major revision unit in our area and they are on the protocol. Here in York we don't seem to be! I used my NHS patient's choice right to demand a hospital and surgeon that met the volume requirements as detailed in the protocol.

Are you also aware of the recent Orthotype test for metal allergy, developed by NHS Newcastle and Tees? The test uses next-generation DNA sequencing (via blood or saliva) to identify specific HLA gene variations linked to delayed-type metal hypersensitivity (ALVAL) or adverse reactions to metal debris (ARMD). I've requested that is done for me. At the moment I'm waiting to hear if our local NHS Trust will fund it, otherwise I'll pay for it myself. They say up to 44% of problematic knee replacement patients show an adverse immune reaction to the metal of the knee replacement part.

Would love to hear how you are doing.