Revision TKR Instability Question

[rah2435]

 

[Josephine]

The first two were sort of better but to me, they still don't show any issues. Best I can do, I'm afraid.

 

[rah2435]

Right - all the docs say this as well. The xrays look good. I guess there is only so much you can tell from looking at an xray. Leg length discrepancies can't be seen. Looseness - if the spacer is not thick enough. etc.

Maybe I'm just crazy! This leg has never felt right. I mean, with two knee replacements now, I was thinking I could walk and stand pretty much like a normal person. Even do work on me feet! But I have so much trouble just standing and walking. And my back is an issue now. Apparently I have chronic sciatica.

Maybe I should go for the nerve ablation thing in the back. I was putting this off thinking that 1) the LLD and instability in my left knee is what's causing my back issues. So this isn't treating the cause, just the symptoms and 2) I've read the this radio frequency ablation doesn't have the best track record.

Ugh @Josephine I'm really having troubles here..... :-/
plus - today I have a cold!

rah

 

[Jockette]

You are not crazy. There are others of us who have issues with our knee replacement that no doctor can diagnose. I am rather discouraged myself.

Colds are miserable and just add insult to injury. I hope yours clears up quickly.

 

[Josephine]

I guess there is only so much you can tell from looking at an xray.

Well it doesn't show soft tissue issues, that's for sure!

Looseness - if the spacer is not thick enough. etc

Well I've seen them where doctors haven't. Though to be honest, they are easier to see in hips than in knees.

Maybe I should go for the nerve ablation thing in the back.

I would recommend to see a chiropractor first.

I was putting this off thinking that 1) the LLD and instability in my left knee is what's causing my back issues.

Indubitably! LLD very often causes back problems.

I've read the this radio frequency ablation doesn't have the best track record.

Me too. Not a treatment I'd readily go for.

plus - today I have a cold!

 

[Momma-me]

You're not crazy!! I wish I had some practical advise for you (and everyone else) that is struggling for answers. I guess the best I can do, is let you know that you are not alone!

 

[rah2435]

One of the hardest things for me is trying to tell the surgeon, or anyone for that matter, how the knee feels.

How to put it in words. It also seems like somedays it feels differently than others. I have an appointment with the revisionist coming up on the 30th. I want to tell him how it feels. I want him to listen. These guys always seem to have so little time. He also didn't believe me about my leg length discrepancy and wouldn't look at the x-rays (proof). I've had many second opinions and they ALL felt this was not possible. The last guy was convinced after he sent me to get x-rays that proved my LLD.

Today when I walked a bit on it - it felt loose at first, then as I walked and put my weight on it, it feels like the spacer is made out of rubber...like a rubber ball. Then it feels tight- although I can still move it. Then pain - mostly in front. This is what makes me feel like maybe it's too thick (after all it came out 2.7 cm longer). But you would think that this would give me little ROM.

MY ROM is fantastic - I haven't measured it but it has always been 0-140+.

When I stand on it (one of the hardest things for me to do) it feels like I'm balancing on a rubber ball. I can move my leg around in a circular motion from my knee... most normal humans can't do this! BUT I can also stand on it in a yoga tree pose - go figure.

SO - is it too loose or too tight? The soft tissue around it feels tight! Always! Also - I DID have femoral nerve damage following the surgery that lasted a while but my last nerve conduction test shows that as healed. An earlier test showed the femoral nerve damage and reported it was "stretch damage".

It's all so confusing. This new OS is thinking about yet another, thicker spacer to give me more stability. But - maybe it's already too thick.

AHHH!!!!!!!!!!

What do I tell him? How do I fix this (I WILL NOT GIVE UP!!)
I really think the right diagnosis and a good OS can save me. I just don't know what to say or do.

rambling again!
rah

PS - right knee feels good!

 

[Jockette]

I struggle with the same thing, how to describe what my knee feels like.

I just made a list of how it felt in different situations. Mine pinches at time. Sometimes it feels like there is a golf ball in there, not center front, but on the lower outside section of my knee. The discomfort/pain is always in that same spot. Sometimes it feels like a baseball is in there. Sometime I feel a burning and itchy feeling.

Recently it felt like someone had tied my leg in a knot, at the knee. Unless the doctors can feel these things in their own knee they may not understand.

One of our members described her knee as feeling “full.” I wasn’t sure what she meant, but over time I realized that it was a good description of what I feel, and now I understand. I think it’s inner swelling.

I so hope you get a resolution.

 

[rah2435]

oh - and another thing My right knee (and this has been happening ever since my spacer swap) likes to buckle forward a bit when I put weight on it. It did this from the very first step off of the bed after the swap!
Doc told me to do strengthening exercises but... 3 years since, lots of exercises and it's still doing it.

thought I'd add that.

rah

 

[rah2435]

6 weeks ago and the calf of her leg is swollen and so is the top of her foot.

six weeks out - still a baby. I had some swelling in my foot early on with my right leg. Just had to remember to keep it elevated and iced.

 

[Josephine]

These guys always seem to have so little time.

That's their problem, not yours

One of the hardest things for me is trying to tell the surgeon, or anyone for that matter, how the knee feels.

I struggle with the same thing, how to describe what my knee feels like.

To both of you, you really should only need to tell him you are in PAIN. It's then up to him to find our how and where by hands on examination to start with.

 

[rah2435]

So my appointment with Dr. Lee (the revisionist OS) at University of Penn orthopedics was today (not the 30th). Again I told him of the PAIN (lol! ... for you @Josephine) and instability in my knee. Again he pulled on my knee and - yeah - lots of movement. Loose. Not the implant though. He said it's the ligaments on either side of the front of my knee (I hope I'm getting this right). They aren't "doing their job".

So my choices are either bracing with an ACL type brace for the rest of my life (I tried this many times - helps a very little and I hated it! ) or a revision surgery with a special type of poly that will, I guess, help out these poor tired ligaments. Unless they just cut out these ligaments...should have asked.

On a REALLY scary note, he told me sometimes they just have to put a hinge in - hinging your femur and tibia together. OMG!!! that's unthinkable!

There was also the number 85% thrown at me... I guess that's success rate? or maybe the satisfaction rate?

But he left saying very confidently that he could fix me. SO - I signed up. He can do this as early as next month! YIKES!!!!! what am I getting myself into.

Well - I know it's not working now. I was in so much pain on Saturday when I went out food shopping with my wife ... it was horrible. pure torture.
But the right knee is .... really good!

So - this guy is supposed to be the best, the go to guy.

AHHHH!!!!!
lol!

rah

 

[Josephine]

On a REALLY scary note, he told me sometimes they just have to put a hinge in - hinging your femur and tibia together. OMG!!! that's unthinkable! There was also the number 85% thrown at me... I guess that's success rate? or maybe the satisfaction rate?

Oh goodness me! You are making a mountain out of a molehill about this! It's a very commonly used device and the numbers "thrown at you" are both the success AND the satisfaction rate - since satisfaction is a major part of what's considered a success!

Here's what such a knee looks like. And they are generally very successful!

 

[Jockette]

@Pumpkln has a hinged knee and she likes it.

 

[Josephine]

Well, there y'go then!

 

[Pumpkin]

My hinged knee works very well, my knee is stable. It is not like a door hinge, it allows stability with mobility. You should be much better off than you are now.

 

[rah2435]

Wow! That's quite a large piece of hardware. Is the recovery time longer? I was hoping to travel 6 weeks after.... Thanks for calming me down guys. When I hear "hinge" I think I won't have much mobility in my leg at all.... just up and down. Legs need to do more than just this.

rah

 

[Pumpkin]

I was hoping to travel 6 weeks after....

That pushing it even after a primary TKR. If you are flying here is some information.
Flying soon after surgery

Recovery should be about the same as after a primary TKR. That said, all recoveries are different, even on the same person, and even the same knee.

 

[rah2435]

thanks @Pumpkln. Wow! that thing looks more like a LEG replacement than a KNEE replacement!!

 

[Pumpkin]

It does, fortunately you cannot see all that hardware. Your leg will look just the same, only now it will work properly.