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Revision TKR Here I go again!<<.

@Josephine sorry! That was a mistake on my part calling him a revisionist. He is an orthopedic surgeon specializing in revision surgery. The entire office specializes in revisions of hip and knees. I do believe that the comment is, in fact, preparing me for uncertainty.
 
I might help (or not help) by sharing one or two things about my knee stiffness. I had very aggressive arthrofibrosis rather soon after my TKA. I didn't realize it at the time, but looking back, I knew something was wrong very early on. I had MUA at 10 weeks, and within a couple of weeks my ROM was going backward again. My surgeon ended up removing most of the scar tissue arthroscopically. In particular, there was a 1/4" in wide band that looked like a ligament tethering my quad to bone. No amount of PT will get rid of such thing. Even after that procedure, it was a month before I passed 90 degrees flexion (through very gentle efforts not involving a PT). Ever since I have had an effusion and a rather fibrotic knee, but it bends well and I can actually kneel on it. It does have laxity (meaning the knee is loose and the lower leg moves unacceptably side to side, but the metal components were well done and still very stable), for which I wear a brace. I don't have a perfect knee, I have an acceptable knee. No pain, and I can do what I want. I think studies are beginning to show that there is some fibrosis with all TKAs, and if I ever I have another knee surgery, I certainly would be strategizing how to avoid the perils of arthrofibrosis. Key is the kind of approach recommended on Bonesmart. I wish you luck on your endeavor. These are tough decisions.
 
I agree with Jo....comments like that certainly don't inspire confidence. Search out another revision surgeon from somewhere not close at all to this group. If you must drive a bit to a larger city, do that to ensure there is no connection. While it's certainly true that you could have multiple revisions, you really do want someone who is going to do a good job for you the first time. The fact that the original implant loosened indicates a problem with the surgical technique and that would concern me if I was considering returning to the same surgeon.
 
I'm back.
I'm having revision surgery this coming Tuesday and although I have asked my surgeon many questions, I'd like to hear from some forum members.
1- can you live with a loose implant? My bone scan showed loosening. My new surgeon's specialty is knee revisions- Resurgens in Atlanta ( different from my original surgeon)
2-I've started some pre- surgery strengthening exercises and my knee feels stronger. My limp is slightly better. I'm now wondering if I truly need the revision or just needed some strength exercises? How certain are surgeons of loosening when bone scans are " lit up"

Also, could a forum advisor change my heading to - Headed for revision and move to revision thread?

Thanks
 
Last edited by a moderator:
Jordon6,
Thread title changed for you, revision banner added. Most just keep the same thread for revisions, did you want a new thread for your revision?
 
If your scans are lighting up, there is definitely a problem. IMO I would not want to live with a loose implant banging around in my knee, potentially causing more damage.
I will tag @Josephine to better answer your questions about the certainty of bone scans.
 
Jordon6,
I shortened up your thread title, if you want it changed post it here.
 
Jordon6 said:
can you live with a loose implant?
Click to expand...
Absolutely not! for one thing it just gets looser and looser until it's like walking on a bag of marbles - PAINFUL! For another, the moving implant will damage the bone, causing it to fracture and become damaged beyond repair. I know this is of a hip but it gives you an idea what I am talking about. It's fracture the cement as well as the bone (yellow arrows)

[Bonesmart.org] Here I go again!<<.


Jordon6 said:
I'm now wondering if I truly need the revision or just needed some strength exercises? How certain are surgeons of loosening when bone scans are " lit up"
Click to expand...
It's a definitive diagnostic tool. No two ways about it.


Jordon6 said:
Resurgens in Atlanta
Click to expand...
Don't know what this means ...
 
@Josephine thanks for your expertise! Resurgens is the name of my surgeons practice. Sorry for the misunderstanding!
 
Day 5 post revision- a bit more pain today. Up until today I was feeling very little pain. I'm getting around ok- with a walker of course. I even got out of the house. I rode with my husband on errands. I stayed in the car though! This morning; however I had a bit more pain. Maybe the block finally wore off and/or just over did it. I'm taking pain Meds on schedule but they seem to not work as well as days prior. Maybe I'm just expecting too much on day 5!
 
Ah yes, day 5 the day my doctor warned me about. It's when all the nerve blocks, pain pumps etc wear off. Stay on top of your oral meds and call and ask if you can take more or something different if yours aren't working for you.
 
I think you may be doing too much for this early after your revision. You need to be spending most of your time resting, icing, elevating and taking your pain medications on schedule. As a reminder, here is the recovery reading:
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.​
3. Do what you want to do BUT
a. If it hurts, don't do it and don't allow anyone - especially a physical therapist - to do it to you
b. If your leg swells more or gets stiffer in the 24 hours after doing it, don't do it again.​
4. PT or exercise can be useful BUT take note of these
5. Here is a week-by-week guide for Activity progression for TKRs


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?

There are also some cautionary articles here
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 a 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 history before providing advice.
 
PS: I've added your revision to your signature, but please will you confirm I have the date right? I put June 14th.
Thank you.
 
Thank you for telling me your revision date. I will correct your signature.
 
Be sure and follow the Bonesmart guidelines and that infant knee of yours will do well, with less pain!
 
Help! I need advice!

It's been 8 days since my revision surgery. I have had increase soreness over the last few days. I try to move around often. My surgeon ordered a CPM machine for me to help fight my scar tissue. He said that my scar tissue was extensive and before he could start the revision, he had to work on cutting away so much scar tissue.

Anyway, I have little knee pain just so much soreness. It feels like I ran 10 miles, had yoga, and then got run over by a truck. This soreness causes me to want to not move- I do because I know what's best for me in slowing scar tissue growth.

I stretch, use CPM but it's soooo painful!

Any suggestions!
 
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