TKR Implant loose soon after surgery.

[Celle]

Hi @psych96

You will see that I have moved your post and the responses to it from newfiemama's thread to your own thread.
Although the originator of the other thread has a similar problem to yours, it is her thread, not yours.

By putting the above posts in her recovery thread, you were disrupting her thread, which should be about her own recovery.
Forum etiquette: being polite when posting

Please post any updates or questions about your recovery in your own thread. We will see them there, as someone checks all the new posts every day.
If you need an urgent response to a question, just tag a member of staff.
How to tag another member; how to answer when someone tags you

You will know you're posting in your own thread because the background to the post will be light grey. If you post in someone else's thread, the background to the post will be white.

If you prefer a different thread title, just post what you want and we'll get it changed for you.

Just in case you couldn't find your thread, here are the instructions on finding your thread,
How can I find my threads and posts? . Many members bookmark their thread, so they can find it when they log on. Please will you do that, too?

 

[Celle]

Not sure how to tag Jamie but will look into it.

This article will help you:
How to tag another member; how to answer when someone tags you
It can be found in this area
https://bonesmart.org/forum/view/how-to-use-this-forum.74/
where there are lots of other articles about how to do things on BoneSmart.

 

[Jockette]

I had original surgery done at the Rothman Institute here in Philadelphia and the surgeon is the lead ortho for the Philadelphia Eagles and Phillie baseball team so thought I was in good hands.

Make sure the next surgeons you see do plenty of revisions. It sounds like a surgeon who takes care of national athletes would be good, but how many of those athletes have had TKRs? Probably none to few, if they are currently playing, so he may have been very good at orthopedic surgery but not done a lot of actual TKRs.

I learned the hard way to be sure your surgeon has plenty of experience with the procedure he is going to do on you. And if his office won’t tell you how many he’s done, move on to the next name on your list.

I hope you get some answers. I haven’t gotten help for my poor outcome. It’s a very hard position to be in. My xray looks great, end of story as far as the 3 surgeons I have seen are concerned. Those of us with poor outcomes don’t get the respect we deserve.

 

[Rockgirl4]

@psych96 I am so sorry for the frustrating experience you are going through. I have not had a loose implant or TKR revision, but my heart goes out to you.r

One thing I wanted to add though-----We make the best decisions we can and sometimes things just don't go our way. I had also lost faith in the medical community the last 8 yrs until I found my TKR surgeon and had things put in perspective. Now I know I'll never go to another surgeon if they're famous. My famous sports surgeon was supposedly the best in the Midwest, the team orthopedist for US Women's Track in 6 Olympics, and did 6 of my knee surgeries (4 of which were cartilage repair surgeries). I was literally "sports surgeon-ed to death."

He SHOULD have referred me to a TKR surgeon, knowing I was over 35 and had little to no chance those procedures would work. Instead, I was a guinea pig for his fancy procedures without realizing it.....and I didn't question him until it was too late because of his famous reputation.

So you have every right to be angry, but know you're not alone. I pray you get the answers you need sooner rather than later. Hugs!!!

 

[swmrgirl]

I did not have loose ligaments, but my left implant was loose, so I had a revision in April and it’s so much better! I know it’s not the same problem, but want to share with you how much I was dreading another surgery and how happy I am that I had it done. I went to a completely different practice and a revision specialist did my surgery. I have no more pain and feel like the healing is going very well.
All the best to you.

 

[psych96]

So sorry if I offended anyone by butting into their thread. I really don't know much about this forum so didn't realize the rules so my apologies. So to anyone who responded about having spacers replaced how did you find out that was the problem. Everyone says my xrays look good. Is there a way to image knee to check out loose ligaments. From what I have read you certainly don't want a revision unless you know exactly what you are doing and what the problem is. Thanks again.

 

[robert johnson]

So is the spacer issue a mistake in original surgery.

I don't think it's a "mistake" in the strict definition of the word. @Josephine or one of the other forum advisers could give you some insight into the thought process and methodology that goes into the spacer selection during the operation. I believe from discussions with them at the time that it's one of those possible outcomes that we hope never happens.

So to anyone who responded about having spacers replaced how did you find out that was the problem.

Well, I suspected I had a problem almost immediately upon waking up after the operation. But it must have been subtle enough that I went through 8 weeks of PT and nobody ever said to me, "hey your leg is unstable." I just felt it was too loose and it took me 2 months to convince the OS. He did eventually come around though.

When I went to have the surgery at 3 months post op, my operative instructions said: "(a) replace the poly liner with a thicker one, (b) remotely possible revision."

When I spoke to the OS the week before about whether or not he was going to do a revision, he told me he wasn't going to "go there" unless he really saw some reason after he opened it up. He instinctively knew he was just going to replace the spacer to fix my problem, but he wasn't making any promises ahead of time. They changed the spacer from 13mm to 16mm (3mm is not very much difference). When I was in recovery I asked the PA if they were sure they shouldn't have gone to the next size, she told me there was no way in Haides they could have gotten the next size in there.

So that's it. The short answer to your question is they found out it was the spacer after they changed the spacer.

 

[Josephine]

results indicated possible loosening of implant

Okay, that's one step forward

This Dr said bone scan useless as bone still healing, said a revision would make things worse

Why he said the scan is useless is a valid one because bone scans depend upon the 'flare' of healing to indicate something is wrong. If there is too much of this flare then it becomes confusing.

And a revision mightmake things worse but only in the wrong hands.

(he) also said seemed like too much movement. He thought it was possible that my ligaments were loose

That's an easy conclusion to make but often as not, the true reason is a loose implant.

then he said I would have 2 choices; wear a brace for life or have a revision.

Gosh, you can't possibly wear a brace for ever! And a revision is not a difficult option to take.

What made ligaments loose and why revision

The revision is necessary when implants are loose because generally, they are loose because the bone has died back from the implant (in uncemented) or the cement (in cemented) and this is not going to remedy itself so a revision is absolutely essential, the only remedy.

So is the spacer issue a mistake in original surgery.

It can be but often as not, it appears to be the problem because the ligaments have stretched since the op.

So to anyone who responded about having spacers replaced how did you find out that was the problem.

There is no way to prove absolutely that the problem requires a new spacer. It's all down to the skil and experience of the surgeon.

Is there a way to image knee to check out loose ligaments

Not really.

I really don't know much about this forum so didn't realize the rules so my apologies.

This article might give you some leaders Forum etiquette: being polite when posting

 

[Jamie]

@psych96.....what is it you wanted my help with? Please put a tag in your response like I did here and I'll see it much faster.

 

[psych96]

This has become a nightmare.
My sister in NC has a friend who is ortho and he is willing to look at all my records and see if he sees anything. So I had to call my surgeon's office and ask for them.

Got the records today and the 2nd specialist I saw, who was so rude and said I had CRPS (which I didn't), put in his record that I said my pain was 10/10 which is totally untrue;
I have said to the original surgeon's assistant that it's not so much the pain per se as the level of disability, i.e. not being able to walk much more than 8 blocks and only being able to do bicycle for 10 minutes at level 1, when had been doing 30 at level 8.

I have never said my pain was above a 5. I have a pretty high pain tolerance. It's more like a constant 2-3 until I walk several blocks or try to do bicycle at higher level that it goes up to, maybe 5 and so. I don't do those things.

Like you say here; if it hurts don't do it. Then he wrote that I had failed PT which is not true. They "graduated" me and told me to go to gym and continue on my own.

He also said I had intense pain on touch, which was not the case. I cannot believe it. Of course his record says I was referred by his "partner" (my original surgeon).

I think my original Dr and Rothman have just washed their hands of me, as they just say that everyone who has seen me there says there are no problems.
I was told if there were ligament/tendon problems they would have been seen on physical exam.

I will have to see what the new guy says, but so far the brace is not doing much and not sure why I need to wear it for 2 months, as it certainly can't fix loose ligaments.

Sounds like the longer you wait for revisions the more complex they become due to bone growing around implant. I did check the Surgeon Locator for Philadelphia but a lot of listed Drs. are at Rothman and I am done with them after this.

I really feel I need someone very experienced with revisions, but not sure how you locate one.
The Dr. I saw most recently at Penn, who gave me brace, does them but how do you know how experienced they truly are?

Another member, who had his spacer replaced at 3 months has been quite helpful here and sounds like he had a great surgeon.
But my original surgeon and the 2 specialists he referred me to have all said no problems and it just takes time.

I have looked all over internet and can't find much. I'm not even sure how much Medicare and my Plan G will keep covering, since this Dr who gave me the brace is now the 3rd specialist.
So if anyone knows a really good surgeon with lots of revision experience in the Philadelphia area please let me know.

Thanks again to all of you who have reached out.
I hope I am posting in the right place; I thought I was told the background should be gray if it's your own thread and this is white but looks like my thread so hope I am right.

 

[sistersinhim]

@Jamie, would you help @psych96 locate a revisionist?

 

[Jamie]

I have this surgeon on my list from Philadelphia:

Philadelphia, Pennsylvania

broken link removed: https://www.pennmedicine.org/providers/profile/gwo-chin-lee
University of Pennsylvania
Philadelphia, PA

And this one if you are willing to travel a bit:

Pittsburgh, Pennsylvania
broken link removed: https://www.upmc.com/services/orthopaedics/experts/pages/joint-replacement-experts.aspx
Dr. Lawrence S. Crosset

 

[Jolease]

@psych96 . I’m very sorry your going through all this. It’s very frustrating and I had nothing and still have nothing but issues. I have it band syndrome which gives me so much pain after walking for just a short time. What did you do to helps yours?

 

[marieltha]

When the pain from my torn meniscus (rightleg) was getting worse, I saw 3 doctors and did not like any of them. Folks in the waiting rooms looked tense. I kept limping and looking.
The 4th instantly inspired confidence—even the way he touched my knee was different! Waiting room was filled w happy patients, eager to praise him. He did the meniscus surgery a month later (2010). He gave me exercises and a schedule for walking, but didn’t believe in PT. (Much later, perhaps, but not right away.)Recovery was perfect.
My current OS (I live in a different state, but honestly, if I had not found one here, I would have traveled to the last one) also instantly inspired confidence and has the same touch as the other I trusted. Waiting room filled with happy patients eager to praise him. Also, no PT. He gives exercises and walking schedule. He has done my recent left PKR (March)and my even more recent Shoulder RCR &Biceps Release(May). Very happy with both. Keep looking. You will find someone who inspires confidence.
Good luck!

 

[psych96]

So sorry took me so long to get back to you I am out of town and my phone was acting up. IT band syndrome is pretty miserable. They recommend NSAIDS but I can't take them. Kind of a catch-22 as just having the TKR could not really rest. Just basically did stretching exercises iced and elevated and that was about it. My PT did massage it with a roller and I bought one and did some of that. Good luck. It does get better but takes a while.

 

[Celle]

IT band syndrome is pretty miserable. They recommend NSAIDS but I can't take them. Kind of a catch-22 as just having the TKR could not really rest. Just basically did stretching exercises iced and elevated and that was about it. My PT did massage it with a roller and I bought one and did some of that. Good luck. It does get better but takes a while.

We do have this article about IT band syndrome. It suggests some exercises that may help:
ITB (ilio-tibial band) issues and treatments

By the way, @psych96 - I edited your very long Post #30 and added paragraphs, to break it up. Such a large block of text is very hard to read and lots of people don't bother to try. So, please will you be a love, and use paragraphs? Thank you so much.

 

[psych96]

Thanks. Will use paragraphs. Wanted to ask if anyone else was told to wear knee brace for loose ligaments. I have worn for a week now and doesn't feel like it helps; not sure but may make knee a bit more more painful. It is the kind where knee is exposed so you can still bend but has metal on sides above and below knee. Am still exercising but limited in what can do. Very depressed about all of this.

I had also looked at Dr. Lee but one site said the revision rate for his TKRs was higher than should be expected. It is really difficult to find info about the doctors.

Thanks to all for your support.

 

[marieltha]

I am using a brace while my sprained medial knee ligament heals. See the OS tomorrow (6 weeks shoulder; 4 wks
Ligament; 14 weeks left partial knee). Will share what he says after. Ligament still hurts but does not feel as unstable as it first did.

 

[psych96]

I have been wearing the brace and it helps somewhat but now it is difficult to walk without it and still having some pain. Just the other day I noticed that my replaced knee is not smaller than my other knee so I am worried about that. Contacted original surgeon who now wants to see me (previously just kept saying I needed to wait as there was nothing wrong) but I no longer trust any of the drs where I had my surgery. I did get the name of a good dr and planned to contact him in a couple of months as was told no one would want to do a revision until a year had gone by but now am worried about this size discrepancy and continuing pain and discomfort. Anyone else had this experience. Thanks.

 

[Jockette]

I did get the name of a good dr and planned to contact him in a couple of months as was told no one would want to do a revision until a year had gone by but now am worried about this size discrepancy and continuing pain and discomfort.

I’m going to ask @Jamie to come talk with you.