Help me think through a revision

[Celle]

I haven't heard of a cupped spacer disc, so let's ask @Josephine .

 

[Blinddog]

Yes, I had my spacer replaced. There was a lot of scar tissue so the recovery was as bad as the first time but I was lucky the surgeon did not have to replace the titanium posts. The knee is great now.

My spacer was increased from 10 mm to 12 mm. A friend of mine had a very unstable and painful knee for 3 years after her first surgery which sounds more like yours. She had surgery 7 weeks ago and is doing well. Her spacer went from a 10 mm to a 15 mm. I would say we are both happy, finally.

I never got an explanation from the manufacturer why my post broke off. I think it is always a very difficult surgical decision during the operation. There are a lot of factors that influence the size of the spacer. Go for it.


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[Josephine]

Never heard of them either but I imagine it would just be one with deeper 'saucers' for the femoral condyles

 

[Josephine]

my NEW surgeon today wants to replace the disc/spacer only with one that is shaped like a cup to stabilize the knee

Well, the plastic spacer are sort of cup shaped to accommodate the metal femoral part. Similar to this.

But changing the spacers is not an uncommon procedure so you should be just fine

 

[jacksv153]

I am looking to talk to someone who has had the spacer replaced. Any folks like that out there?


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[skigirl]

I moved your post to its own thread, so that you can get the answers you need without 'derailling' another person's thread!!


I had what is called an "Open Lysis of Adhesions and a Spacer Exchange" . Basically my knee was opened along the old scar line. The doctor removed extensive scar tissue and put in a slightly larger spacer. I had pain for three or four days and then just the boredom of yet another recovery!!

My doctor stressed that if I exercises a hot, inflamed knee I would cause more scar tissue to form---especially since I had already had a large amount of scar tissue. So, for the first two weeks, I just stayed home on the couch with my knee elevated and iced. I did a few heel slides and some leg lifts, but that was about it. He told me if I do any activity that increases the swelling, I was to put ice on it immediately until the swelling went down.

At three weeks, I began formal PT, but my PT agreed with my doctor. His advice, we will go very slowly until 8 or 10 weeks. If the scar tissue reforms, at least we will know that we did everything we could to prevent it.

If I had limited insurance coverage for PT, I might have waited another week or two to even start it.

We did only table exercises---leg lifts, clam shells, heel slides for another two weeks--no weight bearing exercise at all. I did ride the bike for 15 min prior to PT. If we did anything that made the knee warm, we stopped and iced it.

I was so impatient!!! I hated the forced inactivity, but I was determined to give the knee the best chance I could give it. We started light exercise at 8 weeks. step ups---very small lift. bike for 20 min. no squats or serious weight on any machine.

I am now three years out from that surgery. I have some scar tissue there, but it does not impair my movement like it did prior to surgery. I have pretty good rom---138. Most of all, my knee is much more stable with the bigger spacer. My doctor told me that since the knee was moving a little too much with the first spacer, that alone might have caused some of the scar tissue. Am I glad I did it? Yes.

The biggest hassle was the slow recovery. The pain was really nothing compared to a TKR.

 

[Jamie]

@jacksv153 .... I have merged your latest thread with one you posted last Friday on the same subject. Please don't start new threads unless you have a different subject you want to discuss. Having multiple threads like this confuses people who want to respond and they may end up writing to you multiple times. Between this thread and the one you have in post-op, you have received a lot of comments from people with spacer replacements. This is actually not all that common a surgery, so it may take a while to get a large number of responses.

If you have specific questions related to the replacement process that weren't answered by Josephine's post above, please don't hesitate to ask them. We do want to help you.

 

[jacksv153]

What is the normal outcome after total knee supposed to be like? No pain? Eventually, no stiffness? To be able to go up and down stairs one foot at a time?

What is a good expectation?

 

[Catanne]

I have just had a second knee put in, and I wouldn't have done it if I had not been delighted with the first one, over three years ago.
I expected my new leg to be straighter as I had become bowlegged, it is now totally straight. I could, until the second one gave out, go up and down stairs normally again. This did take me six months to achieve, but I did it. I could walk, dance, swim, ride a bike, and ride a horse. I still couldn't get on my horse from the ground, but no problem with a mounting block.
I could kneel, but it was uncomfortable, and I could not do the splits, nor sit right back on my haunches. But really the new knee functions pretty much like a normal knee. Maybe 80% normal.
It does occasionally still feel a little stiff after a lot of exercise, but not very much, and when I have banged it it does hurt a bit more than a normal knee would. It still twinges a bit from time to time-but it's nothing like the pain and lack of mobility I had before.
I would say, expect it to take time, but it's great, eventually.

 

[KarriB]

It seems you're trying to decide if this is the right direction for you, so I'll leave you some info that may help. Most drs recommend no running or playing singles tennis, but beside that you can go about your life.


Welcome to BoneSmart, glad you found us!

Here is some pre op reading for you.

New BoneSmart members like you are in various stages of their journey to joint replacement. Making the decision whether or not to have surgery and preparing for surgery can be easier once you have done your research and know what lies ahead. Here are some tools that can help you decide what is best for you.

If you are at the stage where you have joint pain but don't know for sure if you are ready to have surgery, these links may help:

Score Chart: How bad is my arthritic knee?
Choosing a surgeon and a prosthesis
BMI Calculator - What to do if your surgeon says you're too heavy for joint replacement surgery
Longevity of implants and revisions: How long will my new joint last?


If you are at the stage where you are planning to have surgery but are looking for information so you can be better prepared for what is to come, take a look at these links:

Recovery Aids: A comprehensive list for hospital and home
Recliner Chairs: Things you need to know if buying one for your recovery
Pre-Op Interviews: What's involved?


Regardless of where you are in the process, the website and app My Knee Guide can help you stay organized and informed. The free service keeps all the information pertaining to your surgery and recovery in one place on your smartphone. It is intended to be a personal support tool for the entire process.

And if you want to picture what your life might be like with a replaced knee, take a look at the posts and threads from other BoneSmarties provided in this link:

Stories of amazing knee recoveries

 

[Pumpkin]

Looks like you are a little over a year since your TKR, you should be painfree, maybe a little stiffness here and there, and twinges if you over do. But for the most part you should have your life back.

 

[Josephine]

@jacksv153 I have merged your three existing threads together as they all seem part of the same topic.

 

[jacksv153]

And I am no where near pain free :(
So I will have to do something as I cannot go on like this for the next 20 years.

 

[Celle]

I'm sorry you have to go through this.

Go ahead and get the replacement that your revision surgeon recommends.

 

[jacksv153]

I am headed in the same direction. Repeat knee surgery. Mine has always stayed hot and swollen. I have an unstable joint. Wrong implant was put in. My PCL was cut during the surgery and I guess OS did not know that he did that. I am scared to death after going through a terrible time the first time. I was still on a walker and cane 4 1/2 months after my surgery because I could not walk due to the unstable knee. My OS never picked up on that. Just said that healing takes one year. Well I moved. I'm in a new State and I went to see other surgeons to see what can be done. I still cannot step up stairs one leg at a time. I can't swim, dance or exercise. But I can walk without a cane or walker. I am trying to stay positive when all I want to do is cry. I need the support of this group as well.

 

[newlybionic]

@jacksv153 Do you have a thread of your own? I found out I needed a revision 5 months post op and had the surgery 8 months after my original TKR. I found the recovery went so much better because my knee kept getting better and better. I followed everything I learned here and did better than the OS predicted for me. A revision is not the worse thing that can happen to you. It's far less than having to live with a non-functioning knee. I was very worried going into it but my new OS and the members here helped me get through the waiting for my revision.

 

[jacksv153]

I do have a thread. Thanks for responding to me! What caused you to have to have the revision? What did they discover? I am fearful of the revision because the first time was awful. I fear it will be awful again. I have shared that I was still using a walker and a cane at 4½ months post op because I could not walk - now I know why- due to unstable knee and wrong implant. What caused your revision?