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Revision TKR Knee revision fail

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napper

napper

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@napper Sorry you are dealing with this problem knee. Sounds like you are on the right track getting an appointment with a specialist. Can you see your family doctor for some advice/medication to help get you to that appointment in January?
Thank you for your reply. I am seeing my original surgeon on Wed. But, we know that is long and drawn out. Xrays, bone scan, bloodwork. All come elsewhere. That is why I was thinking the ER would be the best thing. They could get all the testing done. ???
 
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I came in today because I'm having horrendous pain 13 months after my knee replacement revision. Three knee surgeries in four years. I'm at my wits end. Unfortunately, I have other physical issues as well. 40+ surgeries since I was 18. I'm 54 now. I'm waiting to see a knee replacement failure specialist. I can't get in to see him until Mid Jan. In the meantime, im headed back to my original surgeon because the pain has become so severe. So, two failed replacements. My one big issue is pain control. After my MANY surgeries, my tolerance to pain meds has become very high. I need so much more to relieve the pain. Actually, I get no relief at all. So, the revision a year ago was HELL. The surgeon wouldn't prescribe strong enough meds. So, I basically ended up being tortured.

I started going to a pain clinic because I have all over body pain, plus two knuckle replacement and will never be pain free again. I'm in the process of preparing to have a pain pump surgically implanted. It goes directly into the epidural space, so uses a tiny amount of med compared to what you would take orally. They said Im reaching a dangerous, no go zone. Pretty soon, pain meds won't help. So, I can't get another revision until I get the pump situated. Once that is done, which can take months, I can consider getting the knee redone.

It scares me thinking I have to go through this again. I know others have had it much worse. But, why do these things fail? I'm not that old. You'd think a TKR would work.
 

Helizabug

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Have you been to the ER for this before? If not, maybe go with the plan to learn whether or not this is the right choice. Sometimes knowing that your knee’s condition is not an emergent issue allows you to push harder for treatment of the chronic issue. That much pain and swelling could be an infection, which needs immediate care, or it could be a symptom to be managed until a better solution can be found. If you don’t know which, maybe the ER is the right call.

Not sure this makes sense, as I’m recovering from my own surgery right now; but maybe it helps?
 

Helizabug

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Just read your next post. I’m probably too naive to give any advice.

Sounds awful and terrifying.

I hope there’s a turn for the better soon.
 

Celle

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@napper - I'm really sorry you're still having problems with this knee.

You'll notice that I have merged your two threads together as we prefer that members in recovery only have one thread.

This is for three reasons:
1. if you keep starting new threads, you miss the posts others have left you in the old threads
2. it often ends up that information is unnecessarily repeated
3. it's best if we can keep all your recovery story in one place so it's easily accessed if we need to advise you. In your case, your previous thread gives a lot of history that is relevant now.

Please keep all your questions and updates on this thread. If you would like a new thread title just post what you would like it to be and we'll change it for you.
 
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Just read your next post. I’m probably too naive to give any advice.

Sounds awful and terrifying.

I hope there’s a turn for the better soon.
It's ok. I appreciate you taking the time to answer. I'm still debating the ER. I have been doing small amounts of housework and am now suffering. Truthfully, I don't want to go on. I scare myself because I have no will to live.
 
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@napper - I'm really sorry you're still having problems with this knee.

You'll notice that I have merged your two threads together as we prefer that members in recovery only have one thread.

This is for three reasons:
1. if you keep starting new threads, you miss the posts others have left you in the old threads
2. it often ends up that information is unnecessarily repeated
3. it's best if we can keep all your recovery story in one place so it's easily accessed if we need to advise you. In your case, your previous thread gives a lot of history that is relevant now.

Please keep all your questions and updates on this thread. If you would like a new thread title just post what you would like it to be and we'll change it for you.
I'm sorry, I didn't even notice. I apologize.
 

Celle

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I'm still debating the ER. I have been doing small amounts of housework and am now suffering. Truthfully, I don't want to go on. I scare myself because I have no will to live.
In that case, go to the ER. tell them not only about you knee pain, but also about your feeling as if you can't go on. It sounds as if you're depressed and help could be available for you.

As far as your knee goes, I'm going to repeat what I advised before. You do need to see a surgeon who specialises in problem knees and in knee revisions. I know you have an appointment to see someone in January, but it would be a good idea to get more than one independent assessment.

If you tell her the name of your original surgeon and the surgeon you will be seeing in January, as well as where you live (zip code) and how far you are prepared to travel, @Jamie may be able to suggest some surgeons.

Above all, don't let your original surgeon operate on your knee again. He's had two chances and he hasn't got it right yet.
 
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I'm still debating the ER. I have been doing small amounts of housework and am now suffering. Truthfully, I don't want to go on. I scare myself because I have no will to live.
In that case, go to the ER. tell them not only about you knee pain, but also about your feeling as if you can't go on. It sounds as if you're depressed and help could be available for you.

As far as your knee goes, I'm going to repeat what I advised before. You do need to see a surgeon who specialises in problem knees and in knee revisions. I know you have an appointment to see someone in January, but it would be a good idea to get more than one independent assessment.

If you tell her the name of your original surgeon and the surgeon you will be seeing in January, as well as where you live (zip code) and how far you are prepared to travel, @Jamie may be able to suggest some surgeons.

Above all, don't let your original surgeon operate on your knee again. He's had two chances and he hasn't got it right yet.

Thank you for your advice. I'm confused because I have more than one problem going on and there's only so many days in a week. I see a psychiatrist for my depression and am on an antidepressant. I also see a phychologist. Right now I'm feeling this way because nobody takes my pain serious. I walk ok, so I must not have any pain. I smile, so I'm not hurting. It's just so irritating.

Don't worry, I have no intention of letting the Dr work on me again. I don't even want to go back to see him, but because I'm his patient, I can get in on Wed.
Should I NOT even bother going?

I have an appt with an Orthopedic Surgeon next Tues for a consultation for a pain pump. He specializes in back surgery, but also does knee replacements. I"m not considering him for my knee, because that's not his speciality, but I wonder if I can tell him about my knee while I'm there and see what he says? Also, this is where I'm confused. I was told to get the pump first, then get my knee redone. But, I wasn't having such bad pain at the time.

The Surgeon I'm seeing for my knee is Dr Brad Boyd in Fairfax, Virginia. He uses the robot, which I like. I had a hysterectomy using that. I think that would line up the knee better.

My old surgeon is Dr Michael Kavenaugh with Leesburg Orthopedics.

As for other methods of pain relief, is it up to me to ask the surgeon about them?
 
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Celle

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Don't worry, I have no intention of letting the Dr work on me again. I don't even want to go back to see him, but because I'm his patient, I can get in on Wed.
Should I NOT even bother going?
You may as well go and see him, and tell him how much worse the pain has got. Be open with him and tell him you are seeking different opinions as well. But it's best not to see a surgeon he recommends, because you need to see someone who will look at your knee with new eyes, without being influenced by your current surgeon's opinion.

As for other methods of pain relief, is it up to me to ask the surgeon about them?
Yes, I think that is a good idea. If you don't, you could only be offered the standard pain relief protocol that surgeon uses.

I have an appt with an Orthopedic Surgeon next Tues for a consultation for a pain pump. He specializes in back surgery, but also does knee replacements. I"m not considering him for my knee, because that's not his speciality, but I wonder if I can tell him about my knee while I'm there and see what he says? Also, this is where I'm confused. I was told to get the pump first, then get my knee redone. But, I wasn't having such bad pain at the time.
Certainly discuss it with him.. Things have changed, since your knee pain got worse. Don't consider him as someone to do your knee, though. You'll need someone who specialises in knee revisions.

The Surgeon I'm seeing for my knee is Dr Brad Boyd in Fairfax, Virginia. He uses the robot, which I like. I had a hysterectomy using that. I think that would line up the knee better.

My old surgeon is Dr Michael Kavenaugh with Leesburg Orthopedics.
Thank you for the names of these surgeons. That could help @Jamie with her recommendations.

I'm pretty sure that the knee replacement instrumentation has ways to help with lining up the knee accurately, especially if the surgeon does computer-assisted knee replacements.
 
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Jamie

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Let me know how your consultation goes and whether or not you want some help in locating a doctor. Please tag me with your response so I see it quickly. To tag, you type the "at" sign (@) followed by my username with no space....like this.... @Jamie
 

Cjackso21

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Waiting for the revision specialists is so frustrating but unfortunately necessary. I too have loosening for the 3rd time. I have 2 different surgeons right now. The first was available right away which was a bit worrisome but it ends up he’s fairly new at these and it was his “slow” season. Bonesmart was able to find a fantastic specialist for a second opinion and was able to see his PA right away. You might consider seeing if your doctors PA is available. Often they are and they can usually discuss your case with the doctor and order appropriate tests. So this second doctor that Bonesmart referred me to was for a second opinion but he was so good that I scheduled surgery with him but he was not available until February and I scheduled it in September. Fortunately both surgeons agreed on approaches for my revision. I scheduled with both hoping to be able to wait until February but in case it became emergent I have surgery with the less experienced one on Dec. 10. Many days I don’t think I can make it until Feb. but I’ve been able to find ways to deal with the pain, mainly icing with elevation 2x a day, using a huge cumbersome but effective brace, swimming, jacuzzi and doing exercises to keep my knee muscles strong. I am fortunate in that I have a high tolerance to pain. Good luck and I hope you are able to get help.
 
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Let me know how your consultation goes and whether or not you want some help in locating a doctor. Please tag me with your response so I see it quickly. To tag, you type the "at" sign (@) followed by my username with no space....like this.... @Jamie
Thank you very much. I'm actually heading to the ER today. At least I can get the testing done and not have to make several appts to do so. I have too much else going on right now.
 
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Let me know how your consultation goes and whether or not you want some help in locating a doctor. Please tag me with your response so I see it quickly. To tag, you type the "at" sign (@) followed by my username with no space....like this.... @Jamie
Thanks for offering to help. I went to the ER and they did xrays. The ER Dr said to follow up with an orthopedic surgeon. There are two areas of concern. He's pretty sure it's loosening. Wants me to wear a brace. So, now that I'm pretty sure I'll need another revision, the question is do that first or the pain pump first? I'm seeing the pain pump surgeon next Tuesday, so I could always ask him his thoughts. I know I'll need a bone scan to prove the loosening.

The one surgeon I'm seeing is Dr Brad Boyd. https://www.drbradboyd.com/
That's a bit away from me, but doable. That's about as far add I'm willing to go. Driving in this area is a mess. Rush hours are a big concern, so it would be hard to make appts around them. I live in Bluemont, VA. I could go the other direction, towards Winchester. The Orthopedic surgeon I'm seeing for the pain pump is Dr Zoller. https://www.woaltd.com/provider/john-h-zoller-iii-md
Would you happen to know anything about him?

@Jamie
 
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Waiting for the revision specialists is so frustrating but unfortunately necessary. I too have loosening for the 3rd time. I have 2 different surgeons right now. The first was available right away which was a bit worrisome but it ends up he’s fairly new at these and it was his “slow” season. Bonesmart was able to find a fantastic specialist for a second opinion and was able to see his PA right away. You might consider seeing if your doctors PA is available. Often they are and they can usually discuss your case with the doctor and order appropriate tests. So this second doctor that Bonesmart referred me to was for a second opinion but he was so good that I scheduled surgery with him but he was not available until February and I scheduled it in September. Fortunately both surgeons agreed on approaches for my revision. I scheduled with both hoping to be able to wait until February but in case it became emergent I have surgery with the less experienced one on Dec. 10. Many days I don’t think I can make it until Feb. but I’ve been able to find ways to deal with the pain, mainly icing with elevation 2x a day, using a huge cumbersome but effective brace, swimming, jacuzzi and doing exercises to keep my knee muscles strong. I am fortunate in that I have a high tolerance to pain. Good luck and I hope you are able to get help.
You've certainly had your share of problems. Do you think you're going to do the earlier surgery? I wouldn't want to do it before Christmas. Partly because I want my husband to be able to relax. He's been through a lot with me, too.

Good luck in whatever you decide to do.
 

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No, I don't happen to know of Dr. Zoller. But including the spine with hips and knees in his specialties is an interesting combination. I'll be interested to know what you think once you've met with him.

You may not need a bone scan. A good surgeon should be able to detect loosening from a regular x-ray unless it is very, very minor. But maybe yours does the scan just to be sure he sees everything.....
 
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No, I don't happen to know of Dr. Zoller. But including the spine with hips and knees in his specialties is an interesting combination. I'll be interested to know what you think once you've met with him.

You may not need a bone scan. A good surgeon should be able to detect loosening from a regular x-ray unless it is very, very minor. But maybe yours does the scan just to be sure he sees everything.....
I hope I don't need a bone scan. They are a pain. An all day event. My loosening definately isn't minor. The one I'd really like to know about is Brad Boyd, https://www.drbradboyd.com/. He's the one I'm seeing Jan 16 as a second opinion .

I'll let you know how the meeting goes with Dr Zoller.
 

Jamie

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I don't know of him either unfortunately. But same deal.....I'll be glad to hear how your appointment goes. The link does indicate he does knee revisions, but you'll want to determine exactly how many he does in a year and how many cases like yours he has dealt with successfully.

I only have a couple of surgeons in the Virginia/WashingtonDC area and am certainly on the lookout for more good ones who work with more challenging cases.
 
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I don't know of him either unfortunately. But same deal.....I'll be glad to hear how your appointment goes. The link does indicate he does knee revisions, but you'll want to determine exactly how many he does in a year and how many cases like yours he has dealt with successfully.

I only have a couple of surgeons in the Virginia/WashingtonDC area and am certainly on the lookout for more good ones who work with more challenging cases.

Who are the ones you know about? And based on your knowledge would you consider getting the knee first or the pain pump? I'm so confused.
 

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