Revision TKR Multiple Knee Replacements

at the two year mark, I began to have a lot of pain in my knee at the patella. It turned out that I had extensive adhesions holding the patella down so that it could not move. I did have an open lysis of adhesions to free up the patella.

I really doubt that that is the problem you are facing. I wonder if you have been tested for metal allergy? I think that is something that could be done easily at HSS.
 
I live in an area where there are no experienced knee revision surgeons.
The one who “might” be capable is booking out 4-5 months just for the initial appt. I booked it but I can’t imagine waiting that long just for the initial visit? I asked the receptionist if he would review my MRI and operative notes just to see if he even felt comfortable seeing me and the secretary said no, he doesn’t do that. (?)
Other experienced surgeons are a plane ride or full days car drive away.

Can anyone suggest a revision surgeon near Upstate NY area? Or close?

It’s crazy how this takes such a toll on you in every way.. financially, emotionally, relationally, etc...
 
It’s crazy how this takes such a toll on you in every way.. financially, emotionally, relationally, etc...
It definitely does!

I SO hope you can find the help you need. I wish I had a suggestion for you.
:console2:
 
I have never heard of a metal allergy. I just looked it up and it says if you have an allergic reaction to "cheaper" jewelry, it could be possible. That is true for me. I had my ears pierced between the ages of 18-20 yo (2 holes each side) and to this day, (30 years later!!) I STILL cannot wear earrings in them for more than a day, as they get infected.

?? Maybe I am grasping at straws but seems like something I should ask my OS about?
 
Can inflammation inside the joint cause the patella to maltrack/snap/get stuck in flexion?
That's one of those questions no-one ever has an answer to!
Can a TKR help in resolving this issue?
And that's another!
My surgeon has suggested that if the Euflexxa doesn't help, she can go in arthroscopically and remove some inflamed tissue. I am NOT feeling confident about that.
I agree with Celle - don't let her do that. The very last thing that should be done is to cut into inflamed tissue. It would be a very good way to get your CRPS to flair up again.
MRI indicates a subchondral cyst behind the graft... don't know what that means exactly). MRI also indicated chondryl "thinning" on medial side.
Neither of those are of any significance.
I am sure she is thinking about the fact that my quad is struggling to get stronger
I really don't see what one thing has to do with the other.
I have never heard of a metal allergy. I had my ears pierced between the ages of 18-20 yo (2 holes each side) and to this day, (30 years later!!) I STILL cannot wear earrings in them for more than a day, as they get infected. Maybe I am grasping at straws but seems like something I should ask my OS about?
Are you telling me that you've never told her about this?
 
Josephine,
No, I have never told her about being sensitive to any metals or jewelry. It never occurred to me and my OS has never mentioned it. It's just not something I had ever heard of before until someone mentioned it here.
 
If you decide to do the metal allergy test, do the blood test. The patch test is not reliable. I think everyone should have a metal allergy test before getting any implant. But, of course, insurance doesn't cover it at this time. I believe in the long run that it would save insurance companies money. If someone has a metal allergy, the only thing that can be done is a revision to a non-metal implant.
 
I think that you should insist on a metal allergy blood test, even if you have to pay for it yourself. It will answer so many questions and I think it is imperative at this stage.
 
Please join us for Joint Replacement Awareness day on April 14---there is a link to the site on my signature. I think you will find some important information about your knee there.
 
Hello All
I just wanted to update.
I found a surgeon within 2 hrs from me who is going to see me next week for a second opinion.

My pain specialist wants to do a genicular nerve block. That is scheduled for 2 weeks out.

I have a call in to an allergist who has the metal patch test and so I am just waiting for a call from their scheduler to get in. Hopefully, I can get in within the next few weeks for that.

So at this point... I am just waiting to figure out what the plan is going to be. I am curious to see what the new OS has to say about everything.
 
I have a call in to an allergist who has the metal patch test
We suggest that you get a blood allergy test. The patch test isn't conclusive.

Great that you have an OS for a second opinion. Be sure and let us know what he says.
 
Hi all
I saw another surgeon for a second opinion. He spent approx 60 sec with me. Never asked about my pain, history, what’s going on, what brought me to see him... literally nothing. He walked in and barely looked at me. He twisted my knee around (very roughly I might add). Was completely dismissive. He said I have 2 options.
1. Live with the pain and disability
OR...
2. He can remove the partial and start over.
Then he stated I would have approx a 25% chance at best that it will even improve and that I would “hate it” (a TKR).

I told him that I cannot live like this... I can’t even walk! And he just repeated himself... that if I “wanted him” to change out my partial he can but it wasn’t going to help.
I said, “great, then I’ll just have it amputated then”
Then he shrugged his shoulders and left the room.
I am literally dumbfounded. Drove 2 hours and wasted my time and energy on that stupid jerk!!
Ugh
Well... next week I go for the diagnostic genicular nerve block.
My other knee is killing me I can barely move.
Wish I had something better to update.
 
I'm sorry this happened to you too! There is no excuse for you having been treated this way by that surgeon. I'm not sure where you got the recommendation, but obviously it was not the right one! If you'd be willing to see someone else, I'll be happy to help you find another doctor.

Can you tell me what surgeons you've seen, as I do have a couple of names at University Hospital in Rochester and another in Syracuse. Please tag me with your response.
 
I prayed about it beforehand, that God would make it clear to me what to do.
Well... after that appt, I DEF was clear!! He is NOT the right one!

@Jamie my doc at HSS is Beth Shubin-Stein and honestly, I think she is extremely competent. She is being very cautious about another surgery because of the CRPS-like symptoms I have had in the past, and she is the one who recommended the "scope" if the genicular nerve block doesn't help. According to the MRI everything looks "great" so that's why she is trying other types of therapies first. It is hard to get a hold of her though, and I live 6 plus hours away so when there are issues, it makes it very difficult to see her.

My first arthroscopic surgery was done by Michael Maloney in Rochester. (epic fail). I saw Christopher Drinkwater and he said I was "too young" for a knee replacement. I saw Dr. Grimm in Canandaigua who told me my case was "too complicated" and he didn't feel qualified to take it on. (I appreciated the honestly). I just saw Robert Sherman at Upstate Joint in Syracuse yesterday who was the rudest of them all.

I made an appt with Michael Klotz in Rochester but they said he can't even see me for an initial CONSULTATION until the end of September!?

I'm having my 5th Synvisc injection in my NON operative knee next week. It's not doing well at all. But I am terrified of having another surgery as this one has not gone well, and I only have arthritis under the knee cap so not an indication for a TKR... just another partial.

IDK... its just all so crazy
 
I will never agree to another partial. I am not impressed with the one I have. I’m sorry I had it done.
 
@Jockette
When I was discussing options with my OS, I asked about Partials, due to I had bone on bone on the medial side only. My OS told me it is cutting into the bone, same recovery, and will need to be replaced within a few years. In other words, he doesn’t do them. I feel for you, I wish you would of gotten the same medical advice
 
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My surgeon only recommended the Patellofemoral. He didn’t discuss a total that I remember. I knew nothing so I trusted him as he has a good reputation in my area.
 
Here are the surgeons I am aware of that are fairly near to you. Since you haven't seen any of them, it might be worth a try.

Syracuse, New York

Dr. Michael Clarke - hip and knee, primary and revision


Rochester, New York (University Medical Center)

Rishi Balkissoon - Knee and hip, primary and revision

John G. Ginnetti - Knee and hip, primary and revision

But, I think you should seriously consider staying with the person you're seeing at HHS primarily because of your CRPS-like complications. Not all surgeons are equipped to deal with this potential problem. I know it's a pain to get to New York City, but.....it's really important to have the right surgeon who can do the job for you this time.
 
Thanks everyone. I SO appreciate you all and am very thankful for this forum
 

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