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

[speccybecky]

Have you tried phoning mr picard s secretary

 

[puppywalker]

i tried that first, since it was him who ordered the tests etc, but was told it all had to go through Mr Roberts as he was the operating surgeon.

 

[puppywalker]

another week on and still no reply from the hospital. I spoke to his secretary yet again and got the same answer that I've been getting for a month now - she put a note on his desk but he's very busy. Well, I'd like somebody to do something about the fact that 6 months after surgery I still can't walk and then maybe I could be busy as well instead of sitting in the house stuffing painkillers! Sorry for the rant, but I'm so angry about the way I'm being treated. I'm seriously considering an official complaint to the hospital. If there is infection in the joint, which I was told was possible, this last month has given it a lovely chance to settle well in.

 

[speccybecky]

Can you try asking for an appointment with him? He maybe doesn't know what's going on? What about your GP?

 

[Josephine]

If there is infection in the joint, which I was told was possible, this last month has given it a lovely chance to settle well in.

Well please don't worry about that. Unlike most other infections, a peri-prosthetic infection is generally better for being left to 'mature'. It changes the genetic nature of the bacteria so it is more susceptible to antibiotics.

Which hospital are you going to? I could look out another one and a surgeon who you could go to for a second opinion. I'll tell you what to do when you've made a choice.

 

[wberry]

I hate getting the cold shoulder, did they have electronic medical records so you could log on and see the results?


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[Josephine]

Well they do but as its restricted under the data protection act, only those with a 'need to know' like doctors and appropriate hospital staff have access.

 

[puppywalker]

@Josephine - sorry I haven't answered your post before but to be honest I've been so fed up that I haven't felt much like talking to anybody at all. However, after 7 weeks of nothing being done today was the day I was told that I would get to see the OS himself for a review of my knee. When I got called in it was the nice Frenchman again, who was very angry that no therapy had been arranged and was most surprised that I still hadn't seen the OS since surgery. He actually went and got the OS then and there. The upshot of it all was that I was told I had excessive scar tissue and heterotopic ossification. The new joint itself is very stable and all the pain when walking is coming from the misplaced bone growth and scar tissue. I was given a steroid injection into the knee to try to ease things off a bit and told to massage the sore area to try to break up the scar tissue. He wants to see me again just after Christmas to see if the scar tissue is improving and will discuss the ossification then. I must admit today has been lovely because of the local anaesthetic in the steroid injection - haven't been able to feel a thing since I got it! It's starting to wear off now and the next few days may be a different story but I'm enjoying it while I can! I did a little research online as I'd never heard of this ossification thing and I can't actually see what treatment there might be for it but hopefully things will be made a little clearer at the end of December. I just wish I hadn't had to go through all the palaver before someone took me seriously.

#heterotopicossification

 

[Josephine]

I'm so pleased for you. We all deserve our carers to take what we say seriously, don't we?

As for the HO, you should have looked in our Library - we have articles on almost everything!
Heterotopic ossification
I must say though, it's most unusual to get it in the knee.

 

[puppywalker]

I did take a look at the Library but couldn't seem to find very much on the knee - it seemed very largely to be a hip problem, but that makes sense if it's not usual to find it in the knee, I suppose. I've seen an electric hand massager online which is supposed to help do deep tissue massage - do you know if it's likely to help and how I should use it? It says you should use it across the grain of the scar tissue, but I don't know what direction it's growing in!

 

[Josephine]

That's why they're a bit of nonsense! And no, it won't help with this. No massage will help as it's a bone growth issue and nothing to do with the soft tissues.

 

[puppywalker]

I think the OS meant the massage to try to break up the scar tissue? His communication skills seem to be a bit limited. I have to admit to losing faith in him to a certain degree - I had considered asking my GP for a referral for a second opinion but I don't know if I can do that while I'm still under his treatment. A girlfriend of mine broke her leg in several places at the beginning of this year and also developed the HO ( I only found this out tonight) and they told her that in time the body would decide that the bone was unnecessary and would reabsorb it. I've had so many different opinions and diagnoses on this knee over the last 3 years that I'm not sure if I trust any doctor any more. Yesterday nothing was said about any form of treatment or prognosis for the HO.

 

[Josephine]

the massage to try to break up the scar tissue?

Yes, but it's a myth!

I had considered asking my GP for a referral for a second opinion but I don't know if I can do that while I'm still under his treatment.

Of course you can! I wish I could offer to help but Scotland doesn't use the UK National Joint Registry so there's not a lot I can find out for you.

 

[puppywalker]

at last - good news! The steroid injection has worked miracles! I can walk without limping at all and with only a little discomfort - hardly noticeable after what I've been having, I can trot around the supermarket for an hour without having to lean on a trolley, I can walk my dogs (greatest joy of all!) and can go up and down several flights of stairs so easily, no more backache - I can't believe it. I had started to try to lose some weight to try to help but it was hard going because I couldn't exercise. However in the last 6 weeks I have lost a stone and a half. Nobody can predict how long the steroid injection will be effective, but I see the OS again on 30th December for further discussion about treating the ossification and possible further steroid jabs. Thank you all for your support - it's been rough, but I made it! And the icing on the cake is that my new Canine partners puppy is arriving this afternoon to start training - I seriously doubted if I'd ever be able to do this again and am sooo excited at the thought of starting again.

 

[Slainte]

So happy for you. Wonderful when something works! Enjoy your new puppy.

 

[Lovestoread]

Here's hoping that steroid injection helps for a very long time!


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[puppywalker]

well, here we are, almost a full year after surgery and things are worse than before I had the TKR. I can't walk for more than a couple of minutes without being in agony, I'm walking so badly (even in the house) that I'm getting excruciating back pain, I've had to give up my puppy training because I can't give the pup enough exercise and I'm so fed up I don't know what to do with myself. In the last 6 months I've been back to the hospital 3 times, had 4 different diagnoses of what's wrong, one steroid injection that worked wonders and another that had no effect whatsoever. I just don't know where to go or what to do. I just finished a course of PT but the PT said that the muscles of the operated leg are just as strong now as the good leg and there's nothing else she can do to help. I wish I'd never had this done.

 

[Tabbycat]

@puppywalker
I've just read your thread and I do so feel for you, you have been through so many ups and downs. I am facing this surgery on the first anniversary of yours and I must admit it's a scary time, not knowing how things will eventually turn out. I hope some experienced people on here can advise you, but in the meantime please try not to give up hope. Please know that somebody cares
Love, Tabbycat

 

[skigirl]

I am going to tag @Josephine, our forum nurse. Additionally, she lives in the UK. Why don't you post what hospital and doctor you used for the the TKR---Jo knows the health care system quite well and I think she will be able to advise you as to your next step.

 

[Josephine]

Before we go down that road, @puppywalker, I need some more information.

Can you tell me the exact site of your pain using this chart?
You'll need to give me references from both charts so please state which chart you're referring to as they a pretty much identical. Just say 'knee' and then 'hip', okay?

Please note the instructions in the smaller image

I'd like to ask you some questions if you don't mind, and it would be very helpful if you would answer each one individually - numbered as I have done - in as much detail as you can then I'll come back as see where you are ....

1. what are your pain levels right now? (remember the 1-10 scale: 1 = no pain and 10 = the worst you can imagine)

2. what pain medications have you using, how much are you taking (in mg please) and how often?

3. are you icing your knee? If so how often and for how long?

4. are you elevating your leg. If so how often and for how long?

5. What is your ROM - that's flexion (bend) and extension (straightness)

6. is your leg swollen?

7. what is your normal activity level? What do you do in the way of housework, cooking, cleaning, shopping, etc., and

8. what kind of physio exercises and exercises at home are you doing most recently? How much and how often?
This is the most crucial question so please help me by using the format I have left as an example

Exercises done at home: (enter number) of sessions each day
(enter exercise) x (enter number of reps and sets)
(enter exercise) x (enter number of reps and sets)
(enter exercise) x (enter number of reps and sets)

At PT
(enter exercise) x (enter number of reps and sets)
(enter exercise) x (enter number of reps and sets)
(enter exercise) x (enter number of reps and sets)