TKR Diagnosing cause(s) of failed TKR

[Randi]

Joining in to this conversation late but just want to wish you well, @Regretful. I'm just 2½ weeks past a revision. It was hard to first admit something was wrong and then take the steps to finding the right person to deal with it . despite the challenges post revision surgery I'm glad I had it done and glad I now know what went wrong. I wish you well in getting the surgery you need and the answers you deserve and the peace of mind and body that are what will take you forward. Keep us posted, please

 

[wings]

@Regretful, glad you are getting additional information. Hope you've heard from your surgeon.

 

[Wanttobebiking]

I agree with @wings. Glad you now know what is going on with your TKR. Good luck in the next few weeks.

 

[iceguy]

Thanks for the offer. Earlier today I contacted my current surgeon's office and an assistant read me part of the metals/particles blood tests results that had just been received. It appears that I am highly reactive/allergic to at least two elements and mildly reactive to at least two others. My surgeon is calling tomorrow with the details, and I hope that she will be scheduling my revision surgery as a result. So I'd like to let the matter of an NYC meeting pend at this juncture. I appreciate your response.

Regretful,
I have been having similar problems. I had a revision on my left knee done about 10 weeks ago. Recovery has been stressful compared to the first two quad sparing operations. I have had continuous pain ever since the TKR two years ago. AT my one year checkup when told of the pain, the surgeon said "there's nothing wrong with what I did, go back to physical therapy." When I went to see my current OS I was told that the first surgeries were not balanced.
I have since found out that there was a recall on the Stryker Triathlon shape match cutting guide during the time when my surgeries were done. I had Stryker Triathlon #6 implants put in my knees and I am looking into legal action on this matter.
While members here have had positive comments on HSS, I have heard a number of negative results in the real world about this facility.
Hope that you can resolve this issue with the metals. I would be glad to compare notes anytime.

 

[Regretful]

I learned over a month ago that the reason for my my failure to recover from my TKR in January 2014 and the continuing pain, stiffness, inflammation, lack of mobility, and physically misaligned components was visible on an MRI that had been prepared by my original operating surgeon after the TKR, but was not interpreted appropriately by him. Hence, my original surgeon ordered and had in my file a test to definitely diagnose his error 8 months after the original surgery, but did not apparently interpret that test (the MRI) so as to pinpoint the error therein.

To explain, the rotation of both the tibial and femoral components must be within a certain degree of internal alignment with (I believe) the patella. Any rotation in excess of a few degrees causes all kinds of problems, like mine, and can lead to complete early failure of the prosthesis. My tibial component is 20 to 25 degrees out of alignment, whereas it ought to be only a few degrees out of alignment to be in a medically good and workable position.

I am therefore scheduled for revision surgery wherein my new surgeon will probably replace part or all of my tibial component, rotated far less internally, and may even have to replace part or all of my femoral component.

I am posting here because it took me 22 months to learn that this is the source of my continuing problems with my knee, not any other potential matter such as infection, allergic reaction to any prosthesis components, spontaneously recurring scar tissue, blood clots, or laziness regarding P.T., use of CPM, or other exercise. The medical personnel I consulted again and again subtly (and not so subtly) attempted to place the blame on me, whereas it is now abundantly clear that the original surgery was improperly performed (and most of them had access to this same MRI). When I finally learned the truth, I was in tears. My daughter was with me so I offered the surgeon (as a joke, of course, a la Helen Hunt in "As Good as It Gets") two female slaves. It's already been a long wait since I learned the truth and I must hold out another full month for the next surgery, but I am very hopeful and want to alert anyone else who cannot identify the cause of a continuing problem post-TKR to have a surgeon undertake or consult a post-surgical MRI or CT to determine if the internal rotation of the knee prosthesis is correct. This problem seems to affect a fair percentage of TKR patients, but gets little publicity.

 

[Josephine]

I'm so sorry to hear of all this though it's good you finally got someone with some common sense who is going to remedy it.

within a certain degree of internal alignment with (I believe) the patella

actually, with almost everything.

I am therefore scheduled for revision surgery wherein my new surgeon will probably replace part or all of my tibial component, rotated far less internally, and may even have to replace part or all of my femoral component.

Well just hope he does the entire thing. It's much the best in the long run.

This problem seems to affect a fair percentage of TKR patients, but gets little publicity.

Well it's certainly a known problem in terms of things that can go wrong and shouldn't but to say 'a fair percentage' have such problems is overstating it more than somewhat. When one considers the roughly one million TKRs that get done globally each year, the number affected is actually extremely small.

 

[newlybionic]

So sorry to hear about all the time it took before you were finally able to be your answer. I hope your revision goes well and you will finally be able to live a 'normal' life again. I'm off to my second OS tomorrow. I just hope I have the strength that you had to see it all the way through to finally get my answer.

 

[Jamie]

I'm so sorry to learn of all you've been through and certainly hope this revision gets it done for you. Your problem underscores the reason why we tell people not to settle when they have continuing pain that is out of the normal range. That is the time to seek opinion(s) from revision specialists who are used to seeing this type of mistake and can correct it. I'm so thankful that you've located a good surgeon who should be able to put you on the road to a real recovery. Hang in there!!!

 

[Steve4kids]

Im so sorry. Something in common , they seem to put it on me like it's my fault, I already feel bad so that really helps. They get paid well whether it's successful or not. When I work if I don't succeed I don't get paid, great profession , I picked the wrong line of work.
I hope you are on the path to less pain