• RATE YOUR SURGEON ON OUR NEW JOINT SURGEON LOCATOR

    Your opinion matters so please click on this announcement to find out how to rate the surgeons you have worked with

    You could also go to the Surgeon Locator via the blue nav bar at the top - find the tab "Surgeon Locator"

Revision TKR Knee revision (patellar components)

bookread

junior member
Joined
Feb 9, 2019
Messages
57
Age
55
Gender
Female
Country
United States United States
I just had left knee revision surgery on September 26. I’m three weeks postop. The doctor did not have to remove the entire implant. He left the femoral and tibial component in place. The reason I had to get a knee revision surgery is because my initial knee replacement in December 2018 failed within six weeks. The plastic button underneath the kneecap became loose. It ook me nine months of excruciating pain to convince my doctor to do something about it. He would not, so I switched doctors, within the same orthopedic center. The plastic component underneath the kneecap was loose and it was the wrong size. I needed a larger size. The doctor also performed a lateral release. I had to stay in the hospital for four days because my incision would not stop bleeding. The doctor did not use outside sutures or staples. Which to me, was a mistake. Only inside sutures were used.
It is too soon to tell if the revision is working yet. I have already started physical therapy, but nothing I do in Physical Therapy is painful, so that’s good.
.
 

Jockette

FORUM ADVISOR
Forum Advisor
Joined
Aug 29, 2017
Messages
15,016
Age
63
Location
Delaware
Gender
Female
Country
United States United States
A loose patella button, that is very interesting. That probably doesn’t show on an X-ray.

I had a Patellofemoral partial 2.5 years ago that has never felt right. I have more limitations and discomfort now than before my surgery. I’ve had 2 second opinions in other states, and they say my X-ray looks fine, nothing to fix, we’re sorry you have discomfort. Period.

I’m not in a lot of actual pain and I do continue to see healing improvements even at this late date, but I would definitely not call my partial a success.

I have symptoms of a loose implant, but as I said, my main implant is supposedly right where it should be. But your case makes me wonder about the plastic button I know I have.

I also had a lateral release done and I continue to have most of my discomfort on the lower lateral side of my knee. I question how well mine was done.

I surely hope this revision is the answer for you, you’ve been through so much. Thanks for coming back with an update.
 

Jockette

FORUM ADVISOR
Forum Advisor
Joined
Aug 29, 2017
Messages
15,016
Age
63
Location
Delaware
Gender
Female
Country
United States United States
Did they diagnose your loose patella button before surgery?

Or is that what they found once they got inside your knee?

I would love more details, if you’d like to share them.
 

Cementless

senior
Joined
May 27, 2018
Messages
438
Age
72
Location
Texas
Gender
Female
Country
United States United States
@bookread, I too would like more information on how your loose patella button was diagnosed.
 
OP
OP
B

bookread

junior member
Joined
Feb 9, 2019
Messages
57
Age
55
Gender
Female
Country
United States United States
I had a CT scan prior to surgery which showed my implant loosened. My first orthopedic doctor refused to believe the CT scan and stated, “Radiologists do not know how to read a CT scan of a patient with an implant.” He totally brushed it off and said it was probably “a cyst.” I was in horrible pain and it was getting worse every week. It took me eight months to convince him something is very wrong. He then gave up and referred me to another physician in the same office. I also had not been able to go up or down stairs for two years now. I do not think the first replacement surgery was done correctly. Why else would the second surgeon have to put in a bigger plastic component and why did it become loose within six weeks of the initial surgery? My initial replacement was off 5° and now it’s supposedly 0°, which is much better. I have not had a follow-up with my physician yet. I read the post operative report that I requested from the hospital. It’s hard to understand some of the stuff on the report. I meet with my doctor in the middle of November and I will ask him exactly what was done and then I will make an update on this post.
I also had extensive lateral gutter scar tissue (whatever that means). The scar tissue was removed from the lateral gutter.
The actual post operative report states:
“There was gross instability from 5° of genu recurvatem to 140° of flexion. There was a space between the patellar implant and the bone. The patella was removed in its entirety and revised to accept a new 29 mm asymmetric button, followed by a partial lateral patellar facetectomy and lateral release optimizing patella centralization of the trochlear groove. Following this, the polyethylene component was upsized 4 mm to a TS component. This restored knee stability to 0° Full extension and 135° flexion.
I have no idea what a partial lateral patellar facetectomy means in the report.
Only time will tell if this revision helped.
 
OP
OP
B

bookread

junior member
Joined
Feb 9, 2019
Messages
57
Age
55
Gender
Female
Country
United States United States
Wow. The top area of my incision is burning really bad when I bend my knee to its maximum range. It’s like a fire. It is also extremely sensitive to touch! Is this normal after four weeks? No, I don’t have any signs of infection. Imagine you’re riding a recumbent bike and every time your knee comes up, it’s as if someone places a small fire on the upper half of your incision.
 

Celle

MODERATOR
Moderator
Joined
Nov 19, 2011
Messages
35,478
Age
78
Location
New Zealand
Gender
Female
Country
New Zealand New Zealand
I guess the top part of your incision is still healing after the revision. Perhaps you should cut back a little on doing the full flexion for a while, until it's less sensitive. There will still be sutures from the latest surgery beneath the surface that haven't yet dissolved.

You can also try de-sensitizing the area by touching it gently, and running different types of material over it, Start with really soft material and work up gradually to rougher material.
 
OP
OP
B

bookread

junior member
Joined
Feb 9, 2019
Messages
57
Age
55
Gender
Female
Country
United States United States
I see a dissolvable stitch, on the bottom of my incision. It looks like fishing line. It’s very weird. The pain from the top of my incision is pretty bad.
 

LindaO

FORUM ADVISOR
Forum Advisor
Joined
Feb 28, 2017
Messages
464
Age
63
Location
Texas
Gender
Female
Country
United States United States
I haven't experienced the severe burning sensation you have described but my upper and lower part of my incision is very tender. My incision is closed and my previous surgeon said to rub Vitamin E along my scar so I gently rub it along my scar and the sore area of my knee. I sort of massage it as I do it and it does seem to help a little.
I hope you find relief from the burning and pain. Keep us posted!
 
OP
OP
B

bookread

junior member
Joined
Feb 9, 2019
Messages
57
Age
55
Gender
Female
Country
United States United States
I don’t know why I am “cursed” and always have pain no one else seems to have. I’m sooo afraid of another loose implant. My guess as to my searing burning pain that takes my breath away: is it entrapped nerve? Nerve pain from my knee waking up? Dissolvable stitches that won’t dissolve and are pulling every time I bend my knee more that 90°? I have no clue.
The pain originates from the very top of my incision and shoots downward on both sides of my knee cap. Maybe a stitch is hitting a nerve? I’m at a loss as to what it can be.
 

sistersinhim

MODERATOR
Moderator
Joined
Dec 4, 2015
Messages
19,024
Location
Virginia
Gender
Female
Country
United States United States
Your infant knee is little over a month old and unfortunately, pain is normal. Have you called your OS and told him about your pain? You could also ask for a different pain med since it sounds like the one you have isn't working well for you.

I would stop bending your knee so much that it's painful. It needs to heal and bending like that isn't helping it to do that. All it needs is gentle movements and walking around frequently. Are you icing and elevating? That always helped to lower my pain and swelling.
 
OP
OP
B

bookread

junior member
Joined
Feb 9, 2019
Messages
57
Age
55
Gender
Female
Country
United States United States
Umm ... I’m not taking any pain meds. I teach and can’t be on any pain meds. No, I haven’t contacted my OS. I see him on November 17th. I figure I cannot get in earlier to see him anyway. I’ve kind of lost faith in doctors at this point in my life.
I ice my knee when I get home from work. I ice it more frequently on weekends. Okay, I’ll stop doing my heel slides and trying to bend it too much.
 

sistersinhim

MODERATOR
Moderator
Joined
Dec 4, 2015
Messages
19,024
Location
Virginia
Gender
Female
Country
United States United States
Is there a way you can elevate and ice while you teach, or maybe even at lunch? That should help some. I'm so sorry you are having all this discomfort.
 

Jamie

ADMINISTRATOR
Senior Administrator
Joined
Mar 24, 2008
Messages
57,337
Age
71
Location
Kansas
Gender
Female
Country
United States United States
I understand that you cannot take prescription pain medications while you are at work. But you can take Extra Strength Tylenol. I suggest you start yourself on a schedule where you take 1000mg every 6 hours through the day and night. Be sure you are not taking any other medications with acetaminophen in them (like cold or sinus medications), as the maximum amount of acetaminophen taken should not exceed 4,000mg in any 24 hour period.

Your revision surgery was just barely a month ago. It is probably a bit soon for you to be back at work and I imagine that is not doing your knee any favors. If you still find you have pain once you start the Tylenol regimen, you could supplement that with a Tramadol in the evenings when you're not at work.

Since you're back at work, you will get enough exercise going to and from and while you're there (probably more than you need, really). You don't need to do any additional exercises at home or go to therapy.
 
OP
OP
B

bookread

junior member
Joined
Feb 9, 2019
Messages
57
Age
55
Gender
Female
Country
United States United States
What is “Tramadol?” Is that a narcotic?
 

Jamie

ADMINISTRATOR
Senior Administrator
Joined
Mar 24, 2008
Messages
57,337
Age
71
Location
Kansas
Gender
Female
Country
United States United States
Tramadol is a synthetic opioid medication that is often used instead of stronger medications. It is available only by prescription, so you would need to speak to your GP or surgeon to get it. It should help you if you come home with pain after trying to work all day. Tramadol is not classed as a narcotic but it has many of the same benefits for pain relief. It is quite effective when taken with Tylenol.
 
OP
OP
B

bookread

junior member
Joined
Feb 9, 2019
Messages
57
Age
55
Gender
Female
Country
United States United States
Does Tramadol make one nauseous or tired? I will ask my doctor when I see him I November 17. I have such trouble with nausea and pain medicine.
 

Sara61

senior
Joined
Oct 1, 2019
Messages
330
Gender
Female
Country
Portugal Portugal
I have been taking Tramadol combined with dexcetoprofeno "Skudexa" 75mg & 25mg
I have had no side effects nor does make me tired. Originally in the 1st week post op I took it 8/8 hours now reduced to 12/12 hours ( now 3 weeks post op)
For me it's been a life saver as my pain was pretty intense in between doses I use paracetamol now with this combination I am pain free which in turn allows me to gentle exercise at home and move about easily.
Check with your doctor as this is only available on prescription.
Hope you find something that works xxx
 
OP
OP
B

bookread

junior member
Joined
Feb 9, 2019
Messages
57
Age
55
Gender
Female
Country
United States United States
Well, I took two Vicodin last night and it did NOTHING for the pain so I’m guessing (95% sure) that it’s nerve pain because of the burning pain. I just went to Sam’s pharmacy and bought Lidocaine patches. I have a patch on the left and right side of my incision. I’ll let you know if it helps. I sure hope so.
 

BoneSmart #1 Best Blog

Staff online

Forum statistics

Threads
48,977
Messages
1,339,102
BoneSmarties
30,895
Latest member
Julia1911
Recent bookmarks
0

Top Bottom