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Revision TKR if at first you don't succeed....<

maybe, I just don't know why. She's usually so incredibly supportive, I couldn't understand what the problem was, but whatever it was, I'm just glad we've got over it.
 
Dr's have gag clauses in the US with insurance carriers, where the Dr agrees to not bring up certain (expensive treatments). Perhaps your Dr was prevented from volunteering a referral, but if you asked, she could proceed?
 
In the UK things are slightly different Pumpkin. We only have personal health insurance as a matter of choice - we don't pay to see our General Practitioners. I don't have health insurance - I'm going for an initial private consultation simply because it means I can see the surgeon of my choice much quicker (normally within a few days, but he's off sick at the moment) than I would going by going on to the National Health waiting list. I can then choose whether to continue to pay for private health care immediately or go onto the NHS waiting list to see the same surgeon free of charge but with a wait of possibly several months. Complicated, isn't it?!
 
Well, I've had an interesting consultation with the private OS this afternoon! He says he doesn't think there's anything wrong with the replacement joint in itself, but he's as positive as he can be without a few tests that it's the knee cap that's causing all the problems.

Apparently the kneecap is not routinely resurfaced/replaced during TKR in this country but he has found that in heavier patients (of which I am one, I'm afraid) a much better result is achieved if the knee cap is resurfaced or replaced at the time of original surgery and he now does it automatically.

He also said without me even mentioning it that there's absolutely no need for me to pay to see him privately and I'm now on his NHS list at my local hospital and he'll count today as the first consultation so he can get on with treatment. I'm a bit shell shocked as this is the first time in 18 months of pain that anybody has ever mentioned that the trouble might be coming from the kneecap but he says the symptoms and pain I'm getting are absolutely typical.

My GP gave me copies of the reports from the hospital that did the TKR to pass on to him and I was shocked to see that some of the information she'd been given was completely and utterly untrue, eg the pain was in my calf (I've never said that, it's always been at the front of my knee) and I could walk without difficulty. WHAT?!!! I haven't been able to walk for 3 years - if I could I wouldn't have been going back to try to get it sorted! Either the original OS has mixed me up with someone else or else he hasn't ruddy well listened to a word I've said! Feeling cautiously hopeful at the moment.
 
I'm glad your consultation with another OS went well. It sounds as if he is going to listen to your problems and try to help.
 
well, here we are again, two and a half years after my TKR and two weeks after my TKR revision - patellar resurfacing. It's early days yet, but I'm hoping that this time things will be different. Already I'm in a lot less pain than I was a full year and more after the original TKR. I had the op on a Wednesday morning and at 6am the next day I had walked outside the hospital for a wee smoke (I know, I know, but I was bored and wanted some fresh air!) and by lunchtime I was at home having a much needed decent cup of coffee. The scar has healed up incredibly well. I was on a Fentanyl pump in the hospital but never needed to use it and after 24 hours of maximum dose painkillers, I'm back to my usual morning only dose. The staff all seemed to be gobsmacked at how quickly I bounced back and was quite happily pottering about on my crutches just a few hours after surgery. There is some swelling and stiffness in the joint, I wouldn't expect anything else. The thing is, I can find plenty of advice regarding recovery after a TKR, but very little about after a revision. I understand that a revision is a much less major surgery, but can anyone tell me roughly how long it's likely to be before full recovery? I know everyone recovers at their own pace, but since I never had a normal recovery after the TKR I'd like some sort of ball park figure.The surgeon even used the scar from my TKR for the revision surgery to cut down on scars!
 
Hello again, @puppywalker
And welcome to recovery again.
Please will you tell us the date of your revision, so we can add that to your signature? Thank you. :flwrysmile:
puppywalker said:
The staff all seemed to be gobsmacked at how quickly I bounced back and was quite happily pottering about on my crutches just a few hours after surgery. There is some swelling and stiffness in the joint, I wouldn't expect anything else. The thing is, I can find plenty of advice regarding recovery after a TKR, but very little about after a revision. I understand that a revision is a much less major surgery, but can anyone tell me roughly how long it's likely to be before full recovery?
Click to expand...
It sounds as if you just had your patella resurfaced - is that correct? If so, yes, that is a less traumatic operation than a primary TKR.

However, if you have the entire knee replacement revised that entails removing all the original components and inserting new ones, and that is a major undertaking.

For now, follow the same advice as for a TKR, but use your common sense and judge your activity by your knee's progress. Be careful not to overdo during the early weeks, and go easy on the exercises.

Here is the recovery reading for you:
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: Would you like to think of a new title for your thread now? If you post what you'd like, we can change it for you.
 
Hi Celle, thanks for your reply. Yes, it was just patellar resurfacing. A new title? well now, how's about "if at first you don't succeed...." ?! I tried to get info about possible recovery times, but all I could find seemed to be regarding a full TKR and I was getting a bit confused, hence my question. I'm taking a leaf out of Josephine's book and not relying overmuch on set exercises, but just concentrating on things like making sure I bend the operated knee as normal when I walk. I can already bend the knee and place it on the next stair, but it's just a little too sore to take my full weight just yet. After the original TKR I still couldn't bend my knee enough after a full year to even get it onto the next stair up, so things are certainly looking more hopeful already. My new Guide Dog puppy is having his first free run tomorrow with my supervisor and for the first time in over 3 years I.m looking forward to doing at least part of it with him instead of sitting in the car watching my husband having all the fun. After all the strain and pain I feel like my life is about to restart and it's a great feeling!
 
Puppywalker,
Happy to hear you are doing well after your revision.
puppywalker said:
I'm taking a leaf out of Josephine's book and not relying overmuch on set exercises
Click to expand...
Glad you are taking it slow but sure, you will be out helping with the puppy guidedog training giving your knee a chance to heal.
 
Please will you tell us the date of your revision, so we can add that to your signature? Thank you. :flwrysmile:

I'm glad that just resurfacing your patella seems to have been the right thing to do.
 
it sounds like you picked a winner with this surgeon. But, remember, there still is a tissue healing stage and you cannot rush that stage. Take it easy a while longer and I am very happy for you as well!!
 
well, coming up for 6 months after the patellar resurfacing and I'm a new woman! No pain, walking as far and as much as I want. The recovery was amazingly quick. I was getting a checkup at the hospital a few weeks ago and the knee had 120 degree flexion without even a tiny bit of effort. I've lost nearly 4 stones because I'm back to being as active as I used to be. It just annoys me that I was totally ignored by the hospital who did the original TKR - I was telling them from 6 months after their op that something was wrong but they just didn't want to know. I'm so glad I insisted on a second opinion after 3 years of bring messed about. However, it's all in the past now and I'm just so grateful to have been given my life back. And my dogs appreciate it too!
 
Happy to hear how well you are doing after all you have been through.
:walking::dogwalk::doggie:
 
I'm really glad to hear you're dong so well.

It's great that you were persistent and you finally got the treatment and the result that you deserve. :yes!: :yay: :flwrysmile:
 
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