Revision TKR ArthroFibrosis anyone?

MurrayB

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The new knee on my operated Leg (R) is larger than my good(?) knee. The difference in size is quite noticeable. Is this normal? I think it might be the reason I still have considerable pain, discomfort, reduced ROM, stiffness, pain when in bed, and more. It's been over 1 year since the operation. If anyone, including an Orthopedic Surgeon has a reply I would love to hear a reply.
 
Hi, Murray. I'm so glad you were able to post on the forum!

It would be helpful if you could provide your exact surgery date. We'll create a signature with that date in it so we can easily refer back to it when responding to your questions and concerns.

It is possible for your new knee to look different than your natural knee. But since you indicate you also have pain, swelling (which can reduce your ROM), and discomfort it is likely that you are still experiencing swelling.

We'll need some additional information from you to help determine what is going on.

First, tell us a bit about what led to your knee replacement and how your recovery went during this past year. Did you consistently have this swelling or is it something new in the last few months or so? Is your knee hot and/or discolored at all (posting a photo would help)? What kind of activity and exercise are you currently doing on a "normal" day? Have you been to see your surgeon about the swelling and pain? If so, what was the outcome of that visit?
 
This posting process should be a lot easier. Here goes. I had a TKR done July 30,2018 on my R. knee. The reason? I have arthritis (OA) in both knees, as well as hands, wrists, etc. My activities were becoming more and more difficult. I decided to go for the TKR. I am 75 now. Surgery was a success, results were a failure. Had Arthroscopic surgery then in Dec. 2018 to remove scar tissue, & drain a Baker's Cyst. It's now more than 12 months post-op. R knee still aches, still reduced ROM, pain exists doing simple movements, stairs, getting in and out of car, standing in a line, walking, even sitting as I write this. The knee feels 'wrong'. It feels as if it doesn't belong in me. I have constant soreness on the lateral aspect around the head of the Fibula and that extends above the knee and below the knee center. I also get pain down the front of the Tibia and on the Medial side right at the joint line. This is normal???? No it's not. I tracked my surgery results from Day 1-measured & compared with Left side-Temp., circumference, pain levels, for over 6 months. P.T. didn't help in fact made it worse. What else can I say. My Left knee is bad but I refuse to take the risk of having more surgery with poor results.
 
This posting process should be a lot easier.
Murray, all you have to do is bookmark your thread, so you can find it every time.

Then, to post, you just go down to the bottom of the page, and start writing in the box where it says "Write your reply". Keep all your updates and questions about your knee in this one thread, so we have a complete story.

This area may help you to use BoneSmart:
How To Use This Forum
 
Thanks for providing some additional details about your situation.

What does your surgeon have to say about the pain you describe? I note that you had a problem with adhesions that the surgeon attempted to address with additional surgery. This particular procedure can be very tricky and it is possible for the scar tissue to return, especially if the knee becomes irritated and inflamed after surgery. This can sometimes occur because of over-zealous therapists who don't understand the importance of keeping inflammation at a minimum. Is it possible that you might have had a therapy program that started early after your surgeries and was a bit intense?

At any rate, the past is just that and we need to deal with what you are feeling now. Tell me a bit about your activity level. What does a typical day look like for you? Are you participating in any sports or other programs for exercise or pleasure? If so, how often and for how long at a time? I'd also like to know how long you can stand and what distance you can walk with out pain.

Would you be willing to seek out a second opinion from another surgeon? I don't have a lot of surgeon names in Canada, but I do have a few. They are in Toronto and Ontario.
 
Just a thought, but have you talked to your surgeon about nerve irritation/pain in the peroneal nerve below your knee? I'd feel bad for not mentioning it because a lot of what you described sounds just like the peroneal nerve problem I ended up with following my first knee arthrotomy in 2015. It has occurred again this summer after my TKR in May, just not as severe.

The first occurrence followed a major knee surgery with a 6 inch incision, loads of PT, scar tissue removal surgery then MUA. I finally had to get 2 injections into the nerve sheath in 2017, but I went a lonnnnggggg time thinking it was muscle or bone pain---and I just suffered in silence. The injections worked magic and proved it was a nerve issue in my case. It has flared a bit after this TKR, but I'm doing no strength training yet, which has helped keep the nerve calm. I was able to figure out what activities set if off more so than not in 2017.

The only explanation I was given is there was likely scar tissue wrapped around the head of the fibula bone, and that's the area where that nerve runs through. I swell a lot and retain fluid in that area too, so maybe that played a role. Who knows the truth to it, but it made sense. My TKR surgeon spent over half an hour removing scar tissue before actually doing my TKR,so we know there was loads of it in there.

I hope you get some answers and best of luck to you.
 
I think I'm at the right place. Here goes. My activity level is at a rather boring minimum. I can't walk for exercise other than short distances. I have trouble getting in and out of a car, using stairs, turning around, lifting my leg, dressing, etc. etc. I get pain in bed sometimes without moving a muscle, or just simply turning on my side. It doesn't last but lets me know the problem still exists. I too have numbness, swelling over the head of the Fibula & sometimes the pain extends down the lateral aspect of my leg and/or it extends down the anterior aspect from the location of the Patella Tendon, and sometimes I get short jabs of pain on the lateral aspect right at the joint line. My surgeon said on Friday to keep my appointment with the Pain Clinic. Also one extreme alternative would be to "rip out" the existing TKR and put in a new one. Yikes! No guarantees there either. There is 'ALWAYS' a feeling of discomfort, of the knee not being mine, a feeling that there is something wrong, that it's not the right size yet test after test shows nothing medically wrong. I've quit golf (again), cancelled a trip, can't do my gardening, etc. This was the worst decision I have ever made-to have the TKR. My other (Left) knee is in need of help but I fear I would end up a total cripple if I had the surgery. Even my Dr. agreed that I should not consider another TKR.

Someone mentioned Toronto & Ontario. Toronto(City) is in Ontario(Province). So whoever you know of please send it along to me.

I'm still not sure how to use this forum. It took me 10 minutes to be able to post this.
 
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@MurrayB, I'll post the names of surgeons that I have here in your thread. That way they are also available to anyone else who might be following your story and need that information as well. I have removed your email address as it's not really a good idea to post that on a public forum.

I'm sorry you're having difficulty using BoneSmart. Posting a reply is fairly easy. The REPLY block will always be found at the bottom of your thread. You just scroll down and start posting. When you're finish you click on the POST REPLY button and that does it.

If you are using a desktop or laptop computer, there are a lot of "how to" articles in our How To Use This Forum area. You can find a link to it by clicking on the HELP AND INFORMATION tab at the top of the page.
 
Here are the two names I have in Canada. Thanks for letting me know that I needed to get the actual city for Dr. McCalden at Western University. I hope this is helpful to you.

Dr. Jeffrey Gollish
Sunnybrook Health Sciences Centre - Holland Orthopaedic & Arthritic Centre
43 Wellesley St. E., Suite 315. Toronto, ON M4Y 1H1
(416) 967-8730

Recommended by Randi who had a knee revision.


Ontario, Canada
Dr. Richard W. McCalden
London Health Sciences Centre
Western University
London, Ontario, Canada
 
I know Dr. Gollish. He did a revision Hip Replacement on my wife 2 +years ago. The 1st surgery ended in a disaster for her. The other, Dr.McCalden, I don't know but when the time is right I will be seeking 'another' opinion for my problem(s). I want to go to Cuba in November and I don't want anything to interfere with my plans. Maybe when I return if things are still not improved I will be seeking others' advice. Thank you for the quick response.
 
I can't walk for exercise other than short distances
There is 'ALWAYS' a feeling of discomfort, of the knee not being mine, a feeling that there is something wrong.
I had a Patellofemoral partial, and I have these same issues. My X-rays are “fine” and the 3 surgeons I’ve seen won’t even do any further testing.

I don’t necessarily feel my implant is too big, it feels more like someone twisted my knee and left it twisted. It’s an awful feeling at times.

I am still able to bowl, so I’m thankful for that. I have had to modify my approach to the throw line, though. Now I just carry the ball to the line and throw it, basically just bending at the waist. My ball speed is slower as a result and my average is down, but has started coming back up this summer.

I agree, my partial replacement has been the worst decision I ever made. Do I want to try for a revision? I don’t know, but I haven’t been offered that anyway. I guess something will have to “snap” to make me do it. My other knee is not great, and getting worse, but I’ll put it off as long as I can. And it won’t be the same surgeon.

Sometimes I wonder if I have a metal allergy, or at least a sensitivity. Sometimes it feels like it’s itching inside. I used to think that was a sign of healing, but it’s been 2+ years, so I have my doubts.

I honestly think I have a loose implant, but they say no because my X-ray looks fine.

It is not fun. But I know it could be worse, so I manage as best I can, for now.
 
Oh my gosh, you sound just like me. I can't bend down to do anything without fear of losing my balance, pain or both. In my case the surgeon did a 're-alignment' of my knee because he said it 'needed' it. Well I was walking OK before that, and now I have difficulty. My surgeon said last Friday that he thinks my body is 'allergic' to this new knee, that my body just doesn't want to accept it. I'm in the 15%-20% category where the surgery was a success but the results were a failure.
 
I don’t understand what he means the surgery was a success but the results are a failure. To me, the results define the success of the procedure.

I can’t lean down and put weight on the replaced knee. That causes a lot of limitations that I didn’t have before. I need a cane and/or a handrail to do stairs.

My knee feels worst when I am doing things in the kitchen. I’m constantly leaning and bending from the waist to get things in and out of the lower cabinets and turning from one counter to the other. By the time I’m done cleaning up after dinner, my knee feels really bad.

Like you, I am so disappointed with my results. I wish I could go back in time and not have this surgery. I didn’t know how good I had it, with the arthritis. I realized I rushed into it too soon. I was not bone on bone. All I knew was I had a fair amount of pain, but only at certain times, not all the time, and they said they could fix it. But things are much worse now. But my X-ray looks great! :doh:
 
I don't need a cane but sometimes I feel I should. What I meant about the surgery was a success etc. is that everything looks good, X-Ray, Ultra Sound, Bone Scans,Etc. BUT I am more limited now than before the surgery thus I didn't get the results I was hoping for. I was bone on bone on the R. side where I had the surgery. I also have bone on bone on my Left side but I will not put myself through the pain and reduced ROM, etc. to be in pain again. With no intelligent explanation why my R. knee is problematic I refuse to put myself into that situation again.
 
My surgeon said last Friday that he thinks my body is 'allergic' to this new knee, that my body just doesn't want to accept it.
This is a rather odd thing for your surgeon to suggest as your body does not reject a joint implant. It's pretty dismissive of your complaints. Frankly it just sounds to me like he's out of his element when trying to diagnose your problems and it supports the idea that you need someone new to work with.
 
I couldn't agree more. He's a good surgeon but not good at problem-solving. I need a Sherlock Holmes. Any suggestions?
 
Well now I am 18+ months post-op and my knee is nowhere near comfortable, reliable, or fully functional. And now I have a very suspicious 'Rash' all around the knee (operated). I still have trouble with stairs, walking a long distance, sleeping (esp. turning in bed), and the 'feeling' that my leg is stiff which it is. I still have noticeable swelling from the knee down to the ankle. Now I'd like to say to one and all, Total Knee Replacements are a snare in Delusion, especially from the many comments, posts, I read about and see herein this Blog. Mine is successful but a failure to me. Last word:I believe I have an allergy or sensitivity to the metal but have been told that no one will replace it because there is nothing wrong with my knee! (RIGHT!!!!) They(Dr.'s) make me feel that I am to blame for their incompetencies, their lack of knowledge of problems, etc. 'Nuf said for now.
 
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MurrayB,
If you have an allergy there are two labs that will test for metal allergies.
You will have to send a blood sample to the labs. Regardless of were you live, you will have to pay for the testing. If you are allergic, see a surgeon specializing in complex joint replacement or revisions.

This lab is Colorado Springs does tests for many allergens and allergic reactions.
http://www.ccrlab.com/contact.html

This lab in Chicago has more of a metal allergy focus.
https://www.orthopedicanalysis.com/metal-sensitivity
 
I had a TKR in 2018, followed by 2 Arhroscopic interventions + MUA's within 18 months. Then in 2021 I had a revision of the original TKR primarily to overcome the pain and lost ROM +++ I experienced. Now after the revision I still have same pains: over the patella, over the head of the Fibula, on the medial aspect of the knee, and down the lateral aspect of theTibia from just below the Patella to the top of the ankle area. My knee has been swollen for 4 years, is warmer than the other knee by 4-5 degrees. I've had every test, scope, probe, culture, etc. etc. to no avail. I live in Canada and I am now waiting to hear from the Mayo Clinic in Florida for either a video conference or a consult. I'm 77, male living alone now and in my own home. Does anyone know of a good investigative Orthopaedic Surgeon? I'll go anywhere (even considered Germany).
 
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I’m so sorry to read that you are still having these problems with your knee. I will ask @Jamie for information about surgeons for you. I hope you find someone who can help you.

I had a TKR in 2018, followed by 2 Arhroscopic interventions + MUA's within 18 months. Then in 2021 I had a revision of the original TKR
Your signature has the date of your original TKR and the first arthroscopic procedure. Could you give us the dates of the additional one and the MUAs so we can update your history. It helps us to see that in a signature so we can better advise you.
 

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