Revision TKR June 17

[patient 99]

cruciate sparing device

Hi limpy7 quite understand that you still feel a bit groggy. What is it 6 days out. If they had asked me my name
at that stage I would have hesitated. In an earlier post you said you thought the cruciate sparing device was the problem. I was just curious to find out how they became aware of this problem eg, was it by taking Xrays? Also why it had gone wrong.

Personally I think you are doing the right thing - LOOKING FORWARD. My questions are to do with my upcoming second opinion. I've got it into my head that the better informed I am, the better I will be at getting it right for myself. But I know that a little knowledge can also be a dangerous thing.

Keep posting when you feel up to it. My very best wishes. Carol

We would hate to ruin our upholstery or carpeting,

absolutely. got to get our priorities right <chuckle>

 

[limpy7]

@patient 99 I do know that what the doctor found out during surgery didn't show up on x-rays. Initially (in December) he didn't like the looks of the cement on the tibial part of the prosthesis. When he got in there though, he said it was fine. I'm just thinking that maybe sometimes what they see with their own two eyes paints a clearer picture. When is your appt.?

Drat. I wish someone with a medical degree had read my description of what I thought the doctor told me. It might have cleared some of this up. Keep us posted.

 

[Celle]

I'm trying to recall what the surgeon said the problem was with my knee. I believe he said that the prosthetic device that I had was a cruciate sparing one and that it wouldn't have been what he would have chosen for me. So I no longer have a cruciate ligament. He replaced everything except the tibial part because it looked fine. He did replace the part attached to the femur because it had a small amount of nickel in it, but he didn't think that was ever an issue. He also said that I would never have been able to bend it more the way it was. Does this sound correct to any of our medical people?

@limpy7

I remember that @Josephine posted some pictures of cruciate-sparing replacements and of those with a peg that stabilizes the knee when the ligaments have been removed. Perhaps those pictures would help?

 

[patient 99]

I'm just thinking that maybe sometimes what they see with their own two eyes paints a clearer picture.

I'm sure that's right, but it really does put pressure on the patient. Nobody wants extra surgery if non invasive diagnostic tests can provide the answer.

My second opinion is on 8 July. I feel I should know what I want from that appointment, but as yet I don't. Sorry, that came out wrong. I want the OS to find out what is wrong with my knee in the easiest way possible ie, without surgery/keyhole surgery if possible. But if I feel I am being fobbed off I need to be sufficiently informed about my options, so that I can make a constructive response. Carol

 

[Josephine]

I believe he said that the prosthetic device that I had was a cruciate sparing one and that it wouldn't have been what he would have chosen for me. So I no longer have a cruciate ligament.

You have that the wrong way round. If your knee was cruciate sparing then you still have cruciates. No surgeon would use a cruciate sparing knee and the absence of functional cruciates. It just ain't done!

He also said that I would never have been able to bend it more the way it was. Does this sound correct to any of our medical people?

Really can't comment on that as I didn't see how it was when he found it! Sorry.

 

[limpy7]

Well, there you go. People on medication shouldn't sign legal documents, make important decisions, etc. My recollection is a perfect example of what drugs can do to your cognitive abilities. Thank you Josephine!

 

[limpy7]

I know I'm not being real active, but I haven't been pigging out either and I've gained 5 1/2 pounds. Where did this come from? Generally I lose weight because of nausea, but I don't have any nausea this time around.

 

[limpy7]

I know I've done this replacement thing before, but please refresh my memory. My knee has less bend now than it did in the hospital a week ago. I'm not doing much of anything with it except gentle stretches. PT comes tomorrow, and I feel confident that I can stand up for myself with them. If they say that my ability to bend now is much less than it was in the hospital, what do I say? My knee is very swollen from the knee up but not from the knee down. I just want to be calmly prepared to defend my knee. Any information/ideas are welcome.

 

[Pumpkin]

Limpy,
You have more swelling that is why. I had a revision in April, and my swelling is above the knee too. Maybe all the surgeries cause this?
I know for me this recovery is taking longer, they did tons of work, and scar tissue removal.

Tell them you want to them to address the swelling before you even look at ROM, that will keep them busy.

Let us know what happens,

 

[1ELISEA]

Hi @limpy7
Maybe say something like this:
Your knee is injured; if you had a broken arm they wouldn't try to bend it and yes, it would be swollen. When you have surgery the knee needs time to recover.

If they force the knee it will swell more, which will make it harder to bend and a vicious cycle of forcing and more swelling.
Right now the word is gentle gentle gentle and lots of ice......

 

[limpy7]

Thank you @pumpkin and @1ELISEA. I think I'm set for being strong where PT is concerned. It's a hard concept for me to understand that as gentle as I have been, the knee has gotten more swollen. I guess that's the path it will take. Nobody's going to push me this time.

I do remember now, that the PA visited me in the hospital, and I had gone from 97 degrees to 95 degrees. He said not to worry and that it was because of swelling. Thank you for the info and for jogging my muddled memory. I'm thankful for the pain medication, and I would be miserable without it, but I'm missing my mental alertness a little bit. I think I'll stick with the pain medication.

 

[limpy7]

I had a very nice time with the physical therapist. She was kind, gentle, and she doesn't believe in doing lots of measuring. She taught me tricks for working with swelling ( @pumpkin ), and working towards a normal gait. It want way better than I expected.

 

[Pumpkin]

Glad to hear you have a gentle PT, getting the swelling down will help your healing

 

[patient 99]

Hi Limpy7 11 days post op. How you feeling? Is the recovery anything like the first time round? Carol

 

[limpy7]

@patient 99 If I were to compare my TKR with this revision, I would say that for the most part there haven't been too many surprises. I can only speak from my experience, and I would have to say that this hurts every bit as much as the first time around. When I had my first TKR I couldn't sleep in our bed as we were remodeling. This time I can sleep in our bed and it is much more restful. I can't sleep the whole night through, but I couldn't do that in the recliner. In our bed I can sleep in different positions. I slept on my side a few times in the hospital. They would put pillows between my knees and tuck pillows in behind me.

This time I don't have much nausea. I'm thankful for that. My husband leaves on Sunday. He works out of state. He'll be back Wednesday night. I also have my two week checkup with my OS on Wednesday. The home nurse and PT each come twice a week. PT says she was approved for four weeks, but I thought it was only 2 weeks when I had my first TKR. My memory isn't spot on right now. I'll probably check that out with my insurance on Monday.

 

[patient 99]

this hurts every bit as much as the first time around.

Hi Limpy7 But not more. From what I've read on BS a revision is a bigger deal than a TKR, so for it not to hurt more has to be good. Oh I know pain is pain and if you are at level 8 you aren't thinking `well I should be pleased that this isn't a 9'. But it bodes well. Carol

 

[limpy7]

@patient 99 I don't think I would say it's more painful, at least not at this point. Also, the bottom part that goes in your tibia wasn't replaced, so possibly I don't have more pain because of that.

 

[H2OPoloMom]

@limpy7 I too gained 5lbs the first time I got on the scale after surgery. I think it comes from the IV, swelling, and retaining water because I certainly wasn't eating much! It was gone by the end of the first week without me changing the way I eat, so it had to be fluids. I hope your revision continues to heal well and you can keep the pain under control. It sounds like you are having a better experience this time around and I'm happy for you in that regard!

 

[limpy7]

@H2OPoloMom, I think you are right about gaining weight. The weight I had gained is gone. Now I have hives on my legs. Otherwise, things are moving right along, and I have the best PT. She is a wealth of knowledge and gentle. Tomorrow I have my 2 week check up.

 

[H2OPoloMom]

Good luck on your 2 week checkup! They removed my staples at mine and only a few of them pinched; I couldn't even feel the rest even though I was watching. My OS was in surgery, so his PA checked my incision, answered my questions and didn't even check my ROM for which I was very grateful! I haven't had any issues with hives, but I did/do have a very large blister from swelling and the inside of my thigh is red like it is sunburned. They said it was normal and now comes and goes. Not quite sure why, but it's not from the ice because it extends further than where my ice is. Anyway, I hope all goes well for you at your checkup!