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Fusion Long ride to a successful Fusion

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Indeed it is. (says she who just told a friend that I don't celebrate birthdays! Sad git!)
 
Trainwreck said:
When we went oner the scan my L5S1 lit up like a Christmas tree.
This confirmed findings on an MRI suggesting severe degenerative disc disease at that level.
Sandy
Click to expand...

When I had my MRI in June, they discovered that I have degenerative disc disease as well. I have herniated discs at L4-L5 and L5-S1. It doesn't really bother me a whole lot as I just deal with it and move on. I do go to a chiropractor weekly and that has helped me with what pain I do get from that.
Stinks that in addition to our knees, we now have to worry about our backs too. :(
 
Coachie,
You have to look at the little suckers too, because as you can see from my case, pain from disks can radiate to the knee.

(The sciatic nerve has branches coming out of those areas)

I think mine was stable until I had my knee replaced, this straightened my leg which in turn shifted my pelvis. that's when the trouble started....
 
The herniated discs have nothing to do with my leg/knee pain. The reason I had the MRI was to check that and then after it was discovered that I had herniated discs, we thought that could be the reason for my pain. So I went down and had a cortisone shot in my back to see if that was the reason. They told me that if the pain went away initially while I had the numbing medicine in that it would be a good indicator that it was back related. Well, the pain didn't lessen at all, so the Physiatrist said that it was not back related.

I'm sure you fully understand the hope that I had that my leg/knee pain was back related. After my cortisone shot, I kept waking up each morning hoping and hoping that my pain would be gone or lessened. Each night I would go to bed disappointed...

Two weeks later I had a Ct Scan, and a week after that was told that my knee replacement was loose.

Also, Sandy- I think my back issue started with this last knee replacement. I have been limping for a long time now (post and pre-surgery, during recovery from my left tkr, etc.) so my hips got way out of position. My chiropractor has adjusted me pretty well so my hips are no longer that bad, but I still have issues. My orthopedic also has mentioned that he thinks the femoral component might be a little off by a little bit angle wise.
 
Back from the knee doc....surgery (again) in 2-3 weeks. He's going to release the tendons behind my knee, replace the 16mm spacer with a thicker one that also has a post (to stabilize my knee from side-to-side) remove some bone, remove scar tissue and force my knee straight during the procedure and immobilize it at 0 degrees post-op. 2 days in hospital, then home......he's also going to use the drug "Ketamine" to deaden the pain receptors so that the RSD "doesn't know that the leg/knee is in pain". He did this last year when he did the revision and it really helped keep the RSD calm. The only drawback was that I saw things in quadruple for a day or two. VERY powerful drug!
He's going to give this a try in hopes that a knee fusion won't have to be done, but because I'm such a "special case" (GAG!) we just don't know...we can only keep trying!
 
Hey Coachie! Do you remember me telling you that Dr. "M" thought my knee pain was from my back? He was SURE that it was, because I was thrown not once, but TWICE from a horse within a year's time...AND landed on my back both times! Man...that really hurt!!!! He had an MRI done, which showed the back did have some trauma, but there was nothing there to indicate a pinched nerve, or any other reason for the knee pain. He poo-pooed the entire test and was convinced it was my back. That sure turned out NOT to be the case, as we all know!
However...since I've had problems since his "botch job", my back has really taken the brunt of it. Walking with a "swagger" and limping, not to mention the "bent over like somebody with osteoporosis to the tenth degree" sure hasn't helped the back. I'm glad you are seeing a chiropractor for some relief. Hopefully, after the revision is done and you get back to "normal", you will be able to strengthen your back to carry you correctly and end the back pain.
I also have ankle pain as well, since I can't bend my knee. Our bodies sure do take a beating when we aren't balanced!
 
I believe that Ketamine is what they use on horses! :th_heehee:

How do you feel about this? Yet another 'let's try this and see'? Mind you, if it works, it'll be far better than an arthrodesis. :thumb:
 
NEIGH!!!! (and a whinny, too!) You are absolutely correct, Jo! My vet has used this drug on horses (mine included) to sedate them, but not "knock them out". :wacko: ...makes them look like "rolly polly eyes"!

I'm ok with it...I figured he was going to give it one last try. He told me that if this works, even somewhat....I may be able to get along with a brace when I want to me more mobile. I don't know how much recovery time is involved in a replacement of the spacer combined with a tendon/ligament release. He says he's going to "release the popliteal tendon" to hopefully stop the behind the knee pain. Honestly...I didn't even want to ask. I just figure it's gonna be what it's gonna be.
Tell me anything you know about "releasing the popliteal tendon"...I'm on overload, so I think I know this answer, but what does "release" mean? Does that mean he will make it looser and attach it someplace else? He didn't mention "removing" it. Also...the spacer he is going to use has a post in it that will help with side-to-side stability. Kinda looks like the one that is in there now, but with a 1" (?) post in the middle. He used a 16mm spacer last time. He says he may be able to use a 16mm again, but may have to go "thicker" in order to stabilize the "looseness".
 
The post is in place of the cruciates. If, perchance, your cruciates seemed okay and a cruciate sparing device was used which looks like this

[Bonesmart.org] Long ride to a successful Fusion


and then the cruciates failed, thus giving the side-to-side instability, then a cruciate sacrificing device can be used which, as you can see, has a triangular 'post' on the plastic insert that provides the stability

[Bonesmart.org] Long ride to a successful Fusion


As for the popliteal tendon, I think he may actually have said 'popliteus' which is this structure behind the knee
[Bonesmart.org] Long ride to a successful Fusion


By 'release' he means he is going to divide it - which is sometimes called a tenotomy.
 
Jo...you are sooooo good! That's EXACTLY what the spacer looks like that he wants to put in. GREAT picture! .....
By dividing the tendon, will that "loosen it"? What will he do....cut it in half, or slice it down the middle? OOOoooo...sound GRAPHIC,:sick: ,,,but that's what they do, huh!
 
Cut it as cutting a piece of string - snip! With the cruciate sacrificing insert, it will be a redundant structure anyway.
 
Audrey, I am so thankful that they are able to do something for you! May this be the start of a life that gets you back out with your horses and produces pain free times!:yahoo:
 
I really hopes this helps you and I hope you will be finished with surgery. As for Ketmine, I worked as a vet assistant for a number of years and we used it for dogs. It was used with other meds when we were doing surgery. It is a very powerful drug.
Hope you have a good weekend.
Greda
 
Wow! I hope when I wake up, I'm not "barking" or "neighing"! :loll:

...yup...haven't lost my sense of humor yet!
 
Actually, when it first came out, we did use it and for kids! Can't exactly remember which cases, only that they were short orthopaedic cases.
 
Jo, I have a question about the tendon "release." Do they slice it lengthwise and actually divide it into two pieces in the center? It's still attached on the ends, though...right? If so, what does that dividing do to make things better?

Sorry, Audrey, if this gets too graphic for you. :blush:
 
Lots of tendons and ligaments in our body have their functions doubled up with other structures. This particular one controls the rotation of the joint amongst other things. But since she's going to have a cruciate substituting post in her new knee, it will be a redundant structure. And if it is causing problems by catching on something or being too tight, then severing the tendon is the answer.

They do this frequently in children with spastic hips, knees and feet. Just snip it! In the old days, they even made special little scalpels to do it through a tiny nick in the skin
[Bonesmart.org] Long ride to a successful Fusion
 
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