Just diagnosed with a lower necrotic femur

[mike luttrell]

Hello I am happy to join and learn from this group. I was wondering what you thought about my situation. Last month my knee hurt so much out of the blue that i had an MRI done and the best Knee Surgeon in town (Santa Barbara California) indicates Necrosis although I do not drink much or have steroid use in the past. A few other orthapedists didn't see much but I have been non- weight bearing for 3 weeks and it is little better. Luckilly my work is having me sit down to see if the blood will reflow. So I was wondering where in Southern Cal is the best orthapedic surgery center(surgeon) for TKR? I do not want bone implants and am wary of bone decompression as well. Is there a model that I am suited for as I was active, kayaking, surfing, biking playing with my son etc.....
I am a 52 year old, healthy male. I also need to get it done by the end of the year. SO any necrosis model recomendations or any Los Angelos referral would be appreciated.

So Glad to join such a supportive group. I especially liked the " Keep a positive attitude" thread. Good Healing to all!

 

[Dixie]

Hi Mike,
I'm also 52 and going in for a TKR Nov 13. Mine's arthritic bone on bone resulting from a long ago injury. I'm in Atlanta so I cannot help with finding the best orthopaedist, but I've done alot of research on the "best knee" out there and have come to the conclusion that there are 3 or 4 top companies and they're all reliable and good products. They have differences, to be sure, but it certainly is most important to find yourself a good surgeon who is well trained and experienced with the product he/she uses. My sister is a drug rep and she asked physicians with whom she has contact and the it seems that 3 of the top ones are: 1)De Puy PFC Sigma...their newest is "rotating platform" with pivoting ability and deeper flexion. 2) Stryker Triathalon 3) Zimmer...they advertise their "gender" knee which comes in a variety of sizes many more suitable for a woman's anatomy. I don't know what else they have but I do know that any one of these knees seems to be a good choice ... Now you just need to find a surgeon! Sorry I can't help you with that!
Good Luck!

 

[Josephine]

An excellent reply there, Dixie! Yes, the rotating platform is a great idea and I would personally go for such a prosthesis. But they all have pretty good track records, FWIW.

I really must look into "how to find a surgeon in the US". It's an alien concept here in the UK! We get allocated, not given a choice.

I'm curious about their definition of necrosis, however, as it's not a disease per se but the result of a disease. So I would be asking what is the underlying disease process that has produced the necrosis? Osteoarthritis? Osteoporosis? I think the answer would be very germane to making a choice of treatment.

 

[mike luttrell]

Thank you both for the good INFO. I do want to get a better systemic reason for the lack of blood flow to the bone. One surgeon says we don't know how you got it. Websites do say that 20% of people that get avascular necrosis is from a trauma. SInce the two main groups of at risk people are alchoholics and steroid users I must be in the trauma subset.

As far as finding a surgeon my GM has given me sound confidence in one here in Santa Barbara. He also said something about smaller incissions and less muscle cuts so that leads me to a MIS device. Hopefully a Depuy or Striker, Zimmer type. I am 3 weeks off the knee, had some cortisone and it still feels bad. Hopefully it will get better to avoid a replacement. But if not I sure hope I can get 20 years from one that will hold up to my 200 lbs. I heard there are 400,000 replacements a year so hopefully I will work hard in my rehab, keep the negative thoughts away and be better by summer.

 

[Josephine]

LOL! Last year I looked after a lady had a TKR done and she weighed almost 400lbs!! And she did just fine!

 

[Dixie]

Mine is also from a trauma which occurred many years ago. My doc said that sometimes earlier injuries can later develop into arthritis. I know that when I used to run, and I'd have alot of pain in my knee, I'd keep thinking "just work through the pain...conquer it!" Stupid, huh? I had no idea of what was going on in there and had been for some time. I CANNOT WAIT to get a new knee! I am tired of not being able to walk up and down a football stadium where my daughter cheers and having to take cabs around when I visit some of the best walking cities in the world!

I was riding a little Taxi shuttle kind of golf cart back to my car from the Ga. Tech game the other night :( and I met a woman in her 70's who got the DePuy Rotating Platform knee last year and she's doing great! She said she's living without pain and her only regret is having waited so long! She said she's a new person! Love to hear stuff like that!

Good luck....it's 10 days for me. I am so ready!!!

 

[Josephine]

So do we, Mike! So do we!

 

[mike luttrell]

Thank you all for the kind consideration. Yes I can relate. Last night I had to miss a soccer game at UCSB against thier rivals SLO. My son (13YRS OLD) and I have been doing few things together-with me-my 4th week on crutches. This is in hopes of the lower femur bone will become replenished. I also identify with the old injuries that can be the source of necrosis. I read somewhere where 20% are from trauma.

I wish you a good operation and getting gone this painful knee. Are you getting the rotating platform? My Dr. has sent me to a MIS Zimmer surgeon. I will talk with him tomorrow and see the advantages of the DePuy and the Zimmer. I was wondering wether to have my replacement here in santa barbara or 2 hours away in LA where they do so many?

I also had to postpone a hip debridement with bone shaving procedure on the same leg. ANyone think of which to do first? The knee hurts more but the hip labrum tear has gotten worse and it is hard to situp at work.

Any thoughts on which knee is the best. And if my santa barbara surgeon doesn't offer the DePuy how I should pursue that?
I will be thinking of you in 8 days. Mine will probably be done this month as well. Pain be gone. Get on with life!

 

[Dixie]

Don't worry f you get the DePuy or the Zimmer. They're both good and one Doctor will swear by the De Puy and in the next matter of minutes you will hear someone else insist that the Zimmer or Stryker is the only way to go. Just make sure you're comfortable with your surgeon and that he/she is VERY comfortable and familiar with his or her product as well as with who you are. I lost alot of sleep worrying about which knee was the best and after alot of research and questioning others, I really believe that the success of the operation is largely based on the surgeon. As long as it's one of the reputable knees, it'll be fine. Concentrate on finding a good surgeon! Ask questions, look them up online, try to get word of mouth info! Good Luck!












I'm not sure but I think the knee replacement will be a longer rehab period than the hip.

 

[Dixie]

Oh! I forgot to tell you this...If you don't really know which surgeon to use, but feel you want the DePuy, or whatever, look up the knee you want online and you'll get links that will tell you which doctors in your area use your particulatr knee. I originally wanted the Zimmer Gender knee but my physcian only does the DePuy. After alot of angst, and , as I said, research, I decided that having HIM do my surgery with his product was more important than finding an unknown entity to do my preferred type of knee. If I had not already had a relationship with a surgeon I trust, I'd have sought out a Physician who does Zimmer. As it turns out I'm happy with my decision and now feel as good about DePuy as I would have with the Zimmer. Does that help you at all?

Don't know what to say about the hip!!!

 

[Josephine]

Don't worry f you get the DePuy or the Zimmer. They're both good and one Doctor will swear by the De Puy and in the next matter of minutes you will hear someone else insist that the Zimmer or Stryker is the only way to go. Just make sure you're comfortable with your surgeon and that he/she is VERY comfortable and familiar with his or her product as well as with who you are. I lost alot of sleep worrying about which knee was the best and after alot of research and questioning others, I really believe that the success of the operation is largely based on the surgeon. As long as it's one of the reputable knees, it'll be fine. Concentrate on finding a good surgeon! Ask questions, look them up online, try to get word of mouth info! Good Luck!

After a lot of angst, and , as I said, research, I decided that having HIM do my surgery with his product was more important than finding an unknown entity to do my preferred type of knee

Absolutely, Dixie, as I have said repeatedly in other threads. At a rough guess, around 70% of 'failures' are due directly to the lack of skill in the surgeon. Loosening, early wear/breakages (due to improper positioning of the prostheses), infection - all down to poor skill level. These are the real issues. Whether the artificial joint is a good match for the individual is somewhat academic if you suffer any of those issues. Personally, I chose a surgeon I know has a considerable amount of experience with good outcomes over choosing the implant.

I'm not sure but I think the knee replacement will be a longer rehab period than the hip.

Correct!! By about 3-6 months.

 

[mike luttrell]

Thanks Dixie and Josephine, I love to hear about the skill level I just got a good referal here in SB for a surgeon with 40 yrs of experiance. He is very nice and does the Zimmer MIS. We havent spoke about my candidacy for this type.

I love the earlier blog about jumping off cliffs at 17 years! Between the success stories and all the help here-in, I am feeling better about this neccesity.

I hope my same leg -hip labrum tear will not prevent a good recovery. Right now I am unable to situp straight and today I could not go to work because of it. I have been off my knee(crutches) for a month. We'll let you know about the sequence of events to mend this body of mine. Thanks!