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Hinged Joint Double PKR and MCL replacement a year later

I asked my GP who is a former surgeon what to do about the conflicting views of the physio (you'll need another knee replacement before long) and the surgeon whose strong feeling is that he is the one to be interpreting x-rays.
The GP suggested, as several have on this forum, that I get a second opinion. I was worried that the surgeon, who is Head of Orthopaedics, would take offence. My GP. poured scorn on that idea. I'm wondering what others here might think. The surgeon for my first two ops will surely hear about my seeking another opinion - they work in the same department.

In any case, a second opinion appointment is arranged for two weeks' time.
 
You have every right for a second (or even more) opinions. Doctors know this. They are big boys and can handle this idea that you are just seeking all the information possible before making a very important decision. Please don’t feel at all guilty. If for some reason your current surgeon was to mention this, then it speaks to his character and not yours. After all, it’s your body and you must be confident that you’ve done your best to obtain the best information for your decision. Surgeons frequently consult with each other. You are allowed to do the same with a second opinion.
 
Hi Rosadogrose,
It is good that you're feeling more confident in seeking a second opinion, even within the same practice as the surgeon that performed your first two surgeries. A good surgeon should support you in wanting to feel confident in your care. You're just making sure you have all of the information and options you need. Your confidence, level of trust and peace of mind with it all comes first. You need to feel comfortable with your plan moving forward.
Good luck in two weeks...please let us know how it goes.
@Rosadogrose
 
Two days ago I had my second opinion consultation. Not with the surgeon I'd hoped for - you have to take pot luck on the NHS. I may have to see another surgeon privately. Before that I'm seeing a very experienced physio privately, to ask him what he thinks is causing the pain: the new arthritis dating from the time after the first op when I was struggling to walk because the torn ligament had gone undiagnosed; muscle and tissue strain and stress from the knee being still too lax and values and thereby putting pressure on the middle and outside of the knee; or IT band damage. Or some combination of the three.

The consultant I did see says that before the first operation the area sore now was clear of arthritis. It seems to me that one of the errors made was not to x-ray the knee before deciding between the ligament replacement, which is what happened, and a TKR. How to keep surgeons onside when I feel really cross about the series of mistakes.

Meanwhile my neighbour had the good fortune to be referred by the NHS to a private clinic and is galloping around the neighbourhood six weeks after a TKR. Well, not galloping, but doing really well.

As ever, any thoughts are gratefully received.
 
It is sad when a medical professional you’ve trusted makes an error (like not having an x-ray prior to surgery) and you then have to deal with the fallout from resulting problems. But I think you are very wise to try and put that in the past and just focus on finding people who understand the current problem and can offer options to make things better.

If you can afford it, rather than just take whatever surgeon you are given with the NHS, I suggest you do see someone privately. It needs to be a surgeon who is well versed in complex revision cases. I certainly think that a discussion should be on the table about whether a TKR would help resolve your issues. That said, it is my understanding that you can request a specific surgeon with the NHS. Your GP must write the order to see that individual, but it can be done. Some GPs are not fond of doing this, though….so you may meet resistance there.
 
Thank you, Jamie. The surgeon I wanted to do the operation did do it - both ops. I went to some trouble to make sure I saw him and he agreed to do it himself. I saw him privately for half an hour beforehand to persuade him to order me titanium implants, which he did. I think where things started to go wrong was when, on the day of the surgery, he discovered that one of the implants was missing a part. He got the missing part sent by courier from Wales to Warwickshire, but it was by then late in the day for the surgery and I got the sense when I arrived in theatre that things were rushed, pressured. I think two surgeons worked on the two knees and while both implants I understand are well placed and strong, it may have been, from a comment my chosen surgeon made later, that the other surgeon may have been less experienced and that's when the ligament was loosened or went unchecked. I also understand now that my ligaments - arms, legs - are generally loose and I have always been pretty flexible. When my chosen surgeon replaced the ligament he discovered that my own ligament was pretty useless, just worn out.

My next steps are a) to see a very good physio in town for his prognosis about the current laxity; b) to see my naturopath for her view on whether my 80 year old body, prone to autoimmunity, can stand up to another operation; and c) to see my originally chosen doctor privately and talk about the prospects for a TKR, and, taking my courage in both hands, ask him to ensure that the surgery is done by both him and the other surgeon in the hospital who does revisions and has a very good reputation - the one I wanted to see for a second opinion. It was just the consultation when I didn't get to see the surgeon I wanted to see- the second experienced revisionist. I did ask for him, and my GP asked for him, but for whatever reason I didn't get him.

Thank you for your support. It means a lot. I'm widowed now and feel sometimes very alone, with lots of people rushing around and not paying quite enough attention to my knee issues which are severely damaging my life.
 
You’re never alone when you’re part of the BoneSmart community, so lean on us anytime you’re needed a boost. We’re here for you!!

It sounds like you have properly planned for the next steps. Good job. And it’s great that your GP is supportive and helpful. I did read that the NHS could substitute doctors at will if the one you request is “unavailable” … whatever that means. I would think that if a doctor was off for some reason or heavily booked, an appointment could still be made. It sounds like someone may have just decided to schedule you with someone else. If that happens to you again, I’d ask why you weren’t scheduled for the person you requested. It would be interesting to hear the answer to that question. I’ve found that many people in the UK don’t realize they have choices of who they see and it’s possible that the scheduling people take advantage of that. At least you’d know the reason for the change.

I think you’re doing a wonderful job of working through all this logically and methodically. Just keep being the squeaky wheel and ask lots of questions so that you understand everything that’s done or proposed. It sounds like you’re doing that, and that will give you the best chance for success.
 
Rosadogrose said:
Thank you for your support. It means a lot. I'm widowed now and feel sometimes very alone,
Click to expand...
You're never alone here, Rosa...stop by anytime for support or encouragement. We'll be here.
Wishing you the best as you seek opinions.
 
Hi Rosa,
Checking in to see how your doing. Wondering how the appointments went and if you've made any decisions based on those visits? As a bilateral, you're a brave one! Take good care and know that we're here for you and care about how you're doing. :loveshwr:Hope to hear from you soon.
@Rosadogrose
 
Thank you for asking Layla. I got back from the hospital two nights ago, after three days in for TKR revision with hinge. That was quite an experience. This is my third operation on the same knee: PKR followed by MCL replacement which didn't work and now this. I can understand why the surgeon tried to avoid putting me through it. I had the lumbar anaesthetic and from about midway through the op. I was awake. They had a tent over me so I couldn't see, but I could sure hear: drilling, sawing and finally serious hammering. My surgeon, only one of two qualified for this surgery in South Warwickshire, is big and strong and this was no tap,tap,tap hammering but full strength. I can see why orthopaedic surgeons need to be strong and fit and also very skilled. Towards the end I heard him say, 'Lovely jumbly,' indicating that he was pleased with what was going on, and a little later, 'That's much better.' When he came to see me on the ward he showed me how the knee no longer twists from side to side but is much more stable. He was also pleased with the range of movement: 110 at the end of the op and 0 for flatness.

I am holistically minded, having recovered from an autoimmune disease the doctors said they couldn't cure with natural methods, especially detoxification, and I avoid medicines if I can, so I'm just on paracetamol four times a day with lots of icing and elevation. I'm very tired and it really hurts, but a little less each day and the prescribed exercises for the first two weeks are not difficult. However, I used to be very good at leg lifts and now I can barely lift my operated leg at all (though this seems to be improving daily). They used a tourniquet which I understand can bruise muscles (along with the hammering).

Any input is so welcome, any stories of recovery from this kind of operation. Meantime, before the op. I heard of a 35 year old nurse who was hit by an e -bike and ended up having SEVEN operations before she could go back to work. These included the two for infection to do with the cement. So I guess I should be grateful.

I'm widowed now and live alone so feel pretty down sometimes. Just hoping this op works and I can walk again without too much pain.
 
Rosadogrose said:
However, I used to be very good at leg lifts and now I can barely lift my operated leg at all (though this seems to be improving daily).
Click to expand...
This is very common. Don’t worry, You will be able to lift your leg, but it may take a while, maybe an even couple of weeks.

Rosadogrose said:
I'm widowed now and live alone so feel pretty down sometimes.
Click to expand...
I’m sorry to read this. I am also widowed since my PKR, so I understand. As Jamie mentioned:

Jamie said:
You’re never alone when you’re part of the BoneSmart community, so lean on us anytime you’re needed a boost. We’re here for you!!
Click to expand...

Please tell us the date of this recent revision so we can update your signature. :flwrysmile:


I will leave you our Recovery Guidelines. Each article is short but very informative. Following these guidelines will help you have a less painful recovery.
(Administrative Note: For those reading this post, please be aware that these links are a premium service and only available to Insiders Club Members. To learn about membership, click here ).

Just keep in mind all people are different, as are the approaches to this recovery and rehab. The key is, “Find what works for you.“ Your doctors, PTs and BoneSmart are available to help, but you are the final judge as to the recovery approach you choose.

Knee Recovery: The Guidelines:

1. Don’t worry: Your body will heal all by itself. Relax, let it, don't try and hurry it, don’t worry about any symptoms now, they are almost certainly temporary.

2. Control discomfort:
rest
elevate
ice
take your pain meds by prescription schedule (not when pain starts!)
don't overwork your new knee.

3. Do what you want to do BUT
If it hurts, don't do it and don't allow anyone - especially a physical therapist - to do it to you.
If your leg swells more or gets stiffer in the 24 hours after doing it, don't do it again.

4. Good Nutrition is essential for successful recovery:
Dietary Tips for Recovery
Nutrition Basics

4. PT or exercise can be useful BUT take note of these
BoneSmart view on exercise
BoneSmart philosophy for sensible post op therapy
**and please also read the Recovery myths below.

5. At week 4 and after you should follow this:
Activity progression for TKRs

7. If you want to use something to assist with incision healing and scar management, BoneSmart recommends hypochlorous solution. Members in the US can purchase ACTIVE Antimicrobial Hydrogel through BoneSmart at a discount. Similar products should be available in the UK and other countries.

8. Still need recovery aids? The BoneSmart Recovery Shop offers BoneSmarties best-loved recovery products at great prices.

The Recovery articles:
The importance of managing pain after a TKR and the pain chart
Swollen and stiff knee: what causes it?
Energy drain for TKRs
Elevation is the key
Ice to control pain and swelling
Heel slides and how to do them properly
Chart representation of TKR recovery
Healing: how long does it take?

Post op blues is a reality - be prepared for it
Sleep deprivation is pretty much inevitable - but what causes it?

**Recovery myths:
Myth busting: no pain, no gain
Myth busting: the "window of opportunity" in TKR
Myth busting: on getting addicted to pain meds

We try to keep the forum a positive and safe place for our members to talk about their questions or concerns and to report successes with their joint replacement surgery.

While members may create as many threads as they like in the majority of BoneSmart’s forums, we ask that each member have only One Recovery Thread. This policy makes it easier to go back and review the member’s history before providing advice, so please post any updates or questions you have right here in this thread.
 
Welcome to recovery!
Wow Rosa! I can't even imagine being awake and hearing...drilling, sawing and hammering...oh my!

Your poor right knee has been through the wringer. Good to know that you're back home and the healing has begun. I'm impressed by how you approached holistically healing from an autoimmune disorder that physicians told you couldn't be cured. That's fantastic!

I'm sorry you're tired and hurting. I hope you find enough relief through the OTC meds, icing and elevation to allow for some restorative rest. It's no surprise you can't lift your leg after the controlled trauma of surgery and the resulting swelling and pain. View it as your body protecting itself. Keep up with the OTC meds, icing, elevation and throw in a big dose of patience. :wink: Each week should feel a bit better than the last.

I am sorry for your loss, Rosa:console2: I am sure it makes your recovery feel a bit heavier, just remember that you're never alone on the forum, lights never go out here, nor is support or encouragement in short supply, so please stop back often. I look forward to following your healing journey.
Hugs and best wishes!
@Rosadogrose
 
Thank you both for replying. So kind and supportive, it does me good.

Rosa
 
I have had 6 surgeries on each of my knees, so I know how frustrating it can be to go through this recovery. The best advice I can give you is to not overdo things. Since you have to take care of your needs, don't worry about doing PT or any exercises; you'll get plenty of exercise just doing your daily activities. Every time you get up and go to the bathroom or get a snack, etc., that is natural PT, using your knee the way God intended it to be used. As you are sitting or lying down, don't forget your heel pumps. These keep your blood moving nicely.

I iced and elevated the whole time I was sitting or lying down. I bought two Lounge Doctors, one for my bed and one for my recliner. That way I wouldn't have to worry about trying to carry it from one place to the other. I also had a seated rolling walker. I could set things on the seat to get them where I needed them to go. A reacher was quite handy too, since I found bending was painful on my knee.

You'll do fine on your own. Just plan things out before you actually get up to do them. And remember, don't overdo it, or you'll be sorry! Blessings and prayers for you!
 
Please give us the exact date of your TKR so we can add it to your signature for you. :)
 
Thank you, Sistersinhim. Goodness, you're experienced. And thank you for. the good advice. How are your knees now? Are you able to do what you need and want to?

My last surgery - the TKR revision with hinge - was on January 26th 2026.
 
Hi Rosa, Happy Sunday! I hope its a relaxing and pleasant day for you.
I am going to tag @sistersinhim to make sure she catches your questions to her above.
Wishing you a great week! :SUNsmile:
@Rosadogrose
 
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