Oh, no! You can certainly plainly see that. The third time has to be a charm.
Amputation Left Above-Knee Amputation, 22 April 2025
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JusticeRider
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Oh wow. I’m speechless. The image of your x-ray made me want to say a bad word! It’s so obviously wrong and I can see why you’ve been hurting. Do they think this has been the cause of your pain all this time, since your last revision? When were your last x-rays?
WFD
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Yes,the surgeon thinks this is the root case of my recent problems. My last X-rays were August 3rd, 2021, a month after my revision, and looked normal. The damage occurred between then and now.
I’m just amazed it has not already snapped. I’m on crutches full time now, and visualizing that X-ray with every step I take.
I’m just amazed it has not already snapped. I’m on crutches full time now, and visualizing that X-ray with every step I take.
JusticeRider
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I bet you are…! I hope you get full relief from this surgery and it is your LAST on this knee 
Please keep us updated. Wishing you the best of luck and speedy healing.
Please keep us updated. Wishing you the best of luck and speedy healing.
WFD
graduate
Thanks, everyone.
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I am so so sorry for your troubles. I wonder how long it has been loose but I guess that is impossible to say.
Really hope you get success with the next surgery.
Really hope you get success with the next surgery.
So sorry that all this is happening to you. It seems that the component has been loose for a long while, you have had shin pain ever since the revision. Perhaps your moment of relief from this was when it made it through the bone and the friction temporarily stopped.
You have done everything possible to enable a good outcome from the start, and shared your experiences on the forum. I wish you final success with the next revision, you deserve it.
You have done everything possible to enable a good outcome from the start, and shared your experiences on the forum. I wish you final success with the next revision, you deserve it.
WFD
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...oh and thanks to whoever updated my signature block for me.
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WFD
graduate
WFD
graduate
Day 7 - One Week since second TKR revision, left knee.
Mods - would someone be kind enough to change the title of my thread to 'August 1st 2023 Second TKR Revision Left Knee'?
I had my revision surgery on Tuesday August 1st. Everything went fairly smoothly, and the doctor was able to do a replacement and not a hinged knee, which he had in reserve depending on the condition of the bone.
One concern was that before the surgery my blood inflammatory markers were elevated, and during the surgery they found a little bit of murky fluid in one part of the knee. Samples were sent out for culture but have so far not shown anything. My surgeon said that half or more of bacteria found in infected knees will not grow in a culture, and so you hope for a postive result from a culture so you know exactly what antibiotic to use.
Unfortunately we don't know so during the four days / three nights I spent in the hospital I was receiving several different IV antibiotics. I had a PICC line fitted before I came home and now have to infuse myself everyday with antibiotic solution, as well as having to take oral antibiotics. The PICC line is supposed to be in place 4-6 weeks, and the oral antibiotics may go one for several months.
It's been two years plus one month since my last revision, and I'd forgotten how much the recovery hurts. Man this stinks. I'm just now beginning to see a lessening of the pain level. Right now most of the pain is in the front of my ankle and it makes any weightbearing very difficult. After that, the biggest pain is in the middle and upper thigh, presumably from the tourniquet (I'm still not able to do a leg lift unaided). The knee itself is not that painful, relatively speaking.
One small blessing is that I can sleep most of the night, at least 60 or 70% of the time. I stay in bed 10-12 hours and usually take a one or two hour nap during one of my icing sessions, so I'm good on the sleep front.
I had my first visit with the home PT assigned to me. I explained the approach I wanted to take and she agreed, given my history, and is going to structure her reports so that my surgeon does not get alarmed (he is a believer in aggressive PT), so I'm lucky on the home PT front. I'll arrange outpatient PT to start maybe a month from now. I'll use the guy that I used for amy last two surgeries, as he 'gets it' and I trust him.
Here are x-rays of the new prosthetic parts:
Today I was also allowed to remove the drain pump. While I was at it, I took off the ace bandage for a first look and it doesn't seem too bad for the one week point:
That's all for now. I'll update again in a week.
Mods - would someone be kind enough to change the title of my thread to 'August 1st 2023 Second TKR Revision Left Knee'?
I had my revision surgery on Tuesday August 1st. Everything went fairly smoothly, and the doctor was able to do a replacement and not a hinged knee, which he had in reserve depending on the condition of the bone.
One concern was that before the surgery my blood inflammatory markers were elevated, and during the surgery they found a little bit of murky fluid in one part of the knee. Samples were sent out for culture but have so far not shown anything. My surgeon said that half or more of bacteria found in infected knees will not grow in a culture, and so you hope for a postive result from a culture so you know exactly what antibiotic to use.
Unfortunately we don't know so during the four days / three nights I spent in the hospital I was receiving several different IV antibiotics. I had a PICC line fitted before I came home and now have to infuse myself everyday with antibiotic solution, as well as having to take oral antibiotics. The PICC line is supposed to be in place 4-6 weeks, and the oral antibiotics may go one for several months.
It's been two years plus one month since my last revision, and I'd forgotten how much the recovery hurts. Man this stinks. I'm just now beginning to see a lessening of the pain level. Right now most of the pain is in the front of my ankle and it makes any weightbearing very difficult. After that, the biggest pain is in the middle and upper thigh, presumably from the tourniquet (I'm still not able to do a leg lift unaided). The knee itself is not that painful, relatively speaking.
One small blessing is that I can sleep most of the night, at least 60 or 70% of the time. I stay in bed 10-12 hours and usually take a one or two hour nap during one of my icing sessions, so I'm good on the sleep front.
I had my first visit with the home PT assigned to me. I explained the approach I wanted to take and she agreed, given my history, and is going to structure her reports so that my surgeon does not get alarmed (he is a believer in aggressive PT), so I'm lucky on the home PT front. I'll arrange outpatient PT to start maybe a month from now. I'll use the guy that I used for amy last two surgeries, as he 'gets it' and I trust him.
Here are x-rays of the new prosthetic parts:
Today I was also allowed to remove the drain pump. While I was at it, I took off the ace bandage for a first look and it doesn't seem too bad for the one week point:
That's all for now. I'll update again in a week.
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Nice to hear from you, WFD. Thanks for the update!
You certainly are lucky in the ability to obtain the sleep you need for healing. You may have a few jealous of all of that restorative rest you’re getting.
Sounds like you met a good match on the visiting PT front. You have an understanding.
Stay in touch and have a peaceful evening!
@WFD
You certainly are lucky in the ability to obtain the sleep you need for healing. You may have a few jealous of all of that restorative rest you’re getting.
Sounds like you met a good match on the visiting PT front. You have an understanding.
Stay in touch and have a peaceful evening!
@WFD
WFD
graduate
Day 15 - Two weeks since second TKR revision, left knee
I'm gradually making progress - the pain is slowly decreasing and my range of motion has increased a little to about 55°.
The reason my RoM is not better than that is that I think I have developed a large hematoma above my knee joint. This exact same thing happened after my first revision. These are supposed to be uncommon after TKR or revision (~1% and ~2% respectively) but I've had it twice in a row. I suspect that it happened because both times my surgeon prescribed both Eliquis (blood thinner) and Celebrex (powerful NSAID). The Eliquis website says not to prescribe it with Celebrex due to the risk of bleeding, so I think this may be the cause.
I'm going in tomorrow to have the bandage removed so I will see if they can drain it (last time they drained 240cc of blood from that hematoma) and whether they will agree to let me discontinue the Eliquis.
When I had my original TKR and then the open LOA, the surgeon that performed those did not prescribe either drug and I didn't develop any hematomas.
On a slightly different topic - for anyone who, like me, gets a PICC line for antibiotics, Amazon sells these plastic sleeves with neoprene seals on each end that keeps the PICC port and dressing perfectly dry, so you can shower. Works great, much better than plastic wrap and tape.
I'm gradually making progress - the pain is slowly decreasing and my range of motion has increased a little to about 55°.
The reason my RoM is not better than that is that I think I have developed a large hematoma above my knee joint. This exact same thing happened after my first revision. These are supposed to be uncommon after TKR or revision (~1% and ~2% respectively) but I've had it twice in a row. I suspect that it happened because both times my surgeon prescribed both Eliquis (blood thinner) and Celebrex (powerful NSAID). The Eliquis website says not to prescribe it with Celebrex due to the risk of bleeding, so I think this may be the cause.
I'm going in tomorrow to have the bandage removed so I will see if they can drain it (last time they drained 240cc of blood from that hematoma) and whether they will agree to let me discontinue the Eliquis.
When I had my original TKR and then the open LOA, the surgeon that performed those did not prescribe either drug and I didn't develop any hematomas.
On a slightly different topic - for anyone who, like me, gets a PICC line for antibiotics, Amazon sells these plastic sleeves with neoprene seals on each end that keeps the PICC port and dressing perfectly dry, so you can shower. Works great, much better than plastic wrap and tape.
JusticeRider
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Hi @WFD , I hope you are continuing to rest and heal. I’m glad you’re able to sleep well and it sounds like the pain is improving. I’m very sorry about the possible infection and resulting treatment. That doesn’t sound like much fun. But you have a great attitude and, it seems to me, a formidable will. Being married to a man with a formidable will, I’ve seen first hand how far it can take you! You will get through this. You know what to do, so just keep resting, icing, elevating, etc and keep your eye on the prize each day. And do keep us updated on how everything is going. Rooting for you!
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WFD
graduate
Hi @Layla . Everything was fine. The incision looked good, and I received a fresh bandage that I have to wear for four more weeks, which will feel like a long time. The skin under the bandage really itches, and the bandage restricts my range of motion (perhaps for the best though so I don't open the incision.)
X-rays showed everything to be normal.
The surgeon agreed to let me discontinue the Eliquis, since as he said, I was moving around a lot. I expressed surprise at this, and he said most patients my age with as many surgeries as I've had are recovering in a rehab facility, not at home, which made me feel better, since I'm frustrated at sitting around so much.
Home PT today measured me at 72° flexion, up from 55° a week ago. The improvement is probably mainly due to the new bandage which is not as restrictive.
He also had the news that the culture taken from my knee had yielded up results finally - it is a non-MRSA staph infection. That is good because it is susceptible to all the usual antibiotics. The infection is probably the reason my tibial prosthetic component became loose, and was probably present since either my arthroscopic LOA (17 months ago) or the revision (25 months ago) and was the cause of all the pain and difficulties I had.
Tomorrow I see the infectious disease specialist and we'll see if he is going to change my antibiotics as a result, and also maybe determine how long I have to keep the PICC line in.
X-rays showed everything to be normal.
The surgeon agreed to let me discontinue the Eliquis, since as he said, I was moving around a lot. I expressed surprise at this, and he said most patients my age with as many surgeries as I've had are recovering in a rehab facility, not at home, which made me feel better, since I'm frustrated at sitting around so much.
Home PT today measured me at 72° flexion, up from 55° a week ago. The improvement is probably mainly due to the new bandage which is not as restrictive.
He also had the news that the culture taken from my knee had yielded up results finally - it is a non-MRSA staph infection. That is good because it is susceptible to all the usual antibiotics. The infection is probably the reason my tibial prosthetic component became loose, and was probably present since either my arthroscopic LOA (17 months ago) or the revision (25 months ago) and was the cause of all the pain and difficulties I had.
Tomorrow I see the infectious disease specialist and we'll see if he is going to change my antibiotics as a result, and also maybe determine how long I have to keep the PICC line in.
