Is this the "Computer Surgery" my wife told me about?

[JRogers]

Hi....haven't been on the forum in over a year.

My wife had total knee replacement done in April, 2008 and the results were not good. She is now considering revision surgery at a large medical complex in a major city and She's heard about this new "computer surgery" from a couple of people who have heard good things about it. Is this type of procedure used in revisions? From what I've been able to gather from her new doctor, my wife is probably facing a fairly involved procedure - "more radical than the first TKR" acc'd to the new doctor - which will entail complete removal of all the original metal parts and adhesives/bonding compounds and possibly ligament(s) transplants from a cadaver. There has been talk of some loss of range of motion resulting from this revision...Have any of you had this sort of revision surgery and, if so, what extent of loss of motion did you wind up with?

Thanks

 

[Texas]

Welcome wow I am so sorry. Can I ask what happened? That is terrible. I know there are others on here that have had revisions. Not sure if its the same procedure as hers . Im sure they will post soon. Both of you be strong. Hopefuly this will be the last...That is to much for one person. Sounds like you are being a great care taker...Good luck to you all.....

 

[loggon]

Oh my. have not heard of a computer type revision, but Jo and or Jamie will be on and post.

I did have my TKR with a computer to make sure it was aligned correct and some other things where done using the computer but that was so I could have a perfect aligned knee. I left the hospital with the extension at 0. My ROM is ok I am still working on it.
Would like to get to 130, but if I don't it is OK. I can do all I need for a normal like at the ROM it is now.

I do hope your wife does great and does not lose any ROM or extension.

 

[Dawnie]

I have heard someone mention this this, I believe it is called 'mosiac', I dont know much about it but it may help if you want to research on the internet.
I hope all goes well for your wife.
Dawnie.:thmb:

 

[Jamie]

Dawnie, everything I saw on the internet regarding "mosiac" surgery related to cartilage repair. Cartilage repair processes would not apply in JRogers's wife's case where she needs the joint replaced.

JRogers, I believe you may be referring to the computer assisted joint replacement process that Loggon mentioned. A computer assists and guides the surgeon in making the proper bone cuts to ensure good alignment of the knee. Our forum nurse, Josephine, would have to say for sure, but I don't believe this technique is used in a knee revision.

One thing that IS important in a revision, is that the surgeon is very skilled and a revision specialist. Since she is seeing a new doctor, I hope that means her first surgeon referred her to a revision specialist. These doctors typically handle the more difficult cases and have the knowledge and skills necessary to handle non-routine issues with the removal of the old hardware and placement of the new joint.

Do you know what caused the joint failure? That could give a hint as to what difficulties the new surgeon may be facing. I know this is devastating news for both of you - to have to go through the surgery all over again. But sometimes this happens. We have several folks on the forum who have had revisions and they are doing well. Having a revision does not automatically mean reduction in the range of motion, so at this point I wouldn't worry about that.

Here is a web site that explains the revision process:

https://www.orthoworks.co.uk/revision-TKR.htm

Josephine should be checking in here shortly. She will likely have more to say. You and your wife will be in my prayers and I hope for a good outcome for this surgery. Please let us know how things go....we care about both of you!

 

[Josephine]

Hi....haven't been on the forum in over a year.

My wife had total knee replacement done in April, 2008 and the results were not good. She is now considering revision surgery at a large medical complex in a major city and She's heard about this new "computer surgery" from a couple of people who have heard good things about it. Is this type of procedure used in revisions?

Hi there, JR - good to see you again tho wish the circumstances would have been different. I'm sorry for your wife. That's a shame.

The computer guided navigation system is a bit of an off-shoot from the computer guided missiles the military uses! Good work if you can get it! And it's used in all joint replacements procedures, not just revision.

From what I've been able to gather from her new doctor, my wife is probably facing a fairly involved procedure - "more radical than the first TKR" acc'd to the new doctor - which will entail complete removal of all the original metal parts

That's usual in the majority of revisions. Only exceptions are the few instances were the plastic insert has had too much wear.

and adhesives/bonding compounds

Use of bone cement which is also commonly used.

and possibly ligament(s) transplants from a cadaver.

That's less usual. I reckon her collateral ligaments - those responsible for securing the femur to the tibia - must have become shot.

There has been talk of some loss of range of motion resulting from this revision ... Have any of you had this sort of revision surgery and, if so, what extent of loss of motion did you wind up with?

Also not uncommon after a revision but given the ligament reconstruction, I would imagine it to be so.

I don't think there is anyone on here at the moment who has undergone a revision like this. Sounds like your wife is in good hands.

 

[JRogers]

Welcome wow I am so sorry. Can I ask what happened?...

Sure. Let me start by thanking you all for your responses.

My wife had standard TKR done in April 2008 and within days we knew that something was terribly amiss. She had nerve function impairment to the degree that she could not kick her leg outward at all and could not raise her lower leg backward from the knee ("adduction/abduction" are the right terms here??) but just a tiny bit. This persisted for the better part of 90 days post surgery despite vigorous and supervised attempts at physical rehab. She spent a long time post-op getting around with a walker with great difficulty and, thankfully, recovered to the point where she was able to be fitted with a brace. She'd pretty much decided that, all things considered, she would thereafter accept what had been dealt her and had not been considering more surgery until very lately as her knee has begun to swell and render wearing the brace iffy at best. Shortly after the 2008 TKR, her lower leg began to "drift outward" (I could draw a picture better than I can explain with words.) at a pronounced angle. Early on, post-op", we secured our documentation from the original orthopedic surgeon and no longer have any ties to this individual.

I will not go in to the issue of doctors refusing to "fix a (real or even potential) golfing buddy's mistake" that we endured except to say that the practice is at ground zero of what is commonly referred to as "Man's inhumanity to Man".

We were eventually able to find a reputable orthopedic surgeon in a large city some fair distance from where the original TKR was done. The setting is a large medical center complex and he has sought out much advice from his associates prior to recommending that my wife have the revision surgery. If all goes as planned, she will probably be having the procedure done before the end of summer.

 

[Josephine]

Well, she surely got the sh***y end of the stick there, JR. Please give her my sympathies and, if it's any consolation, I would give good odds on you having chosen an ace pilot to operate the computer guided navigation system! I look forwward to hearing the further reports on this. Tell her God bless and we will all be praying for her.

 

[loggon]

Wow so sorry to hear of how much she has been through.

I do hope Once she has this surgery done it will be smooth sailing and that she will have good ROM.

Jo I have a question on the type of knee replacement
I had. It is a Swedish product

Medacta Evolis system TKR

Have you heard of it? It was used because of the
computer type surgery I had.
I tried to look up some info but did not find much.

 

[skigirl]

One thing that I would still question---is the surgeon a "revision specialist" or a surgeon who has asked his collegues for information. Given the scope of what he has described, I would for sure get a second opinion and I would make sure it was a revision specialist. I hope you are considering a law suit with the first doc.

 

[Jamie]

JRogers, my heart goes out to you both and I will be praying for your wife to improve following this surgery. Things like this don't happen very often, but when it does happen to YOU, all the small percentages and statements about low risk are meaningless!!! And that stupid doctor and his buddies should be flogged. I'm so happy you found someone that is more competent...even if you did have to drive a ways....hopefully, all this bad stuff will become a distant memory one of these days. (((HUGS))) to you both!

 

[calling_all_angels]

JRogers,
I have no words of comfort to offer that could ever come close to what your wife has been through!! But please know that I will be praying for her!!! She is a very brave Lady!!

 

[JRogers]

We just found out that the computer surgery thing is more than likely not what my wife will be having for this revision. Still not sure of when she's having the revision but will stop in and update on the regular knee replacement forum as things progress. Thanks for all the kind words.

JR

 

[Jamie]

JR, please do keep us updated. And also please give your wife a big hug and let her know she is in our thoughts and prayers. She has a wonderful caregiver in you!