Fusion Long ride to a successful Fusion

[Josephine]

Was it a Küntscher nail? Surely not! Most modern nails are called by their design like Gamma or tibial/femoral nails.

But yes, for sure 0 degrees would be not only uncomfortable but almost unusable as your foot would never clear the ground as you walked.

TBH, I am relieve he has finally decided to see sense in this. Let's hope and pray that 2012 will finally be a relatively pain free year for you.

 

[wanttoride]

hhhmmm...that name of the "nail" sound familiar. Is that a bad thing? Bring on the information!!!!

 

[wanttoride]

The "rod" is an intramedulary (sp?) rod. The rod(s) go into the bone canal. He said that's "just the name of the rod". Have there been problems with this type of "rod"? He told me it was titanium.

 

[Pumpkin]

Hi Audrey,
I worked with a lady in her 80's, she had her knee fused at age 18, she said once she got used to it, she never had any problem. It had a slight bend to clear the floor.

 

[wanttoride]

Thanks, Chris! A POSITIVE knee fusion! wooopeeeeeeeee!!!! I know now that we've made the decision, I have LOTS of questions to ask him next month. I forgot to ask him how long the hospital stay would be. He DID say that I would most likely have to have a blood transfusion, as they can only use the turniquette for so long, and for some other reason that referred to the bone(s) itself.
So far, the permanent cast is working GREAT! I haven't had to take ANY pain pills today at all. The cold is bothering me, as I'm walking with stocking feet on the wood floors. Not to smart, eh!

 

[Pumpkin]

Thrilled to hear the cast is working so well. Bet, who passed well into her 90's would be pleased her story is helpful to others.

 

[Josephine]

Yes, I know what an intramedullary rod is! :wink1: But as I said, nowadays they aren't usually given the surgeons name like they used to. That's where the name Küntscher came from. But I'd doubt he'd be using that as, though the design was okay for its day, more modern ones have far superseded it.

And did you forget when you first came here, I told you how I trained with a girl who'd had her knee fused at a very young age. She was a bit older than the rest of us, about 25 I think, but she got through her nurse training and pursued her career very well. Nobody ever gave a thought to it and certainly never treated her as anything but totally normal. She was never in pain either. I did hear that about 20-25 years down the line she had it converted to a TKR but never knew how she got on.

 

[PhoenixS]

Audrey,
I am so sorry to hear of your loss. You just can't get a break!!!
I am very hopeful that the fusion gets rid of your pain, or at least takes care of most of it.
Sandy

 

[wanttoride]

Merry Christmas, everybody! :sleigh:

...Jo, I had forgotten about the girl you trained that had the fusion. I needed a lift today! I'm hoping that with the fusion, I could at least go back to work part-time. Being a home-body isn't my "cup of tea"! (hee hee)
I guess I'll have to ask Dr. K why he uses a Kutcher nail as his first choice. I think that's what he said the "name" of it was, as well as the talk of "intramedullary" (wow..that's a mouthful!) verbage. When I had my second opinion last summer with another Dr., he told me he would use plates and screws. I think I've got that discussion on her somewhere! I definetely know that I don't want the rod that goes in through the upper femur/hip area. Dr. K said he did not want to do that either. He had more successes with the (2) separate rods. In other news...............
John had to cut off the pink cast yesterday. Can you believe it! It became so loose, that I could slide it up and down a good 5 inches, and get my hand in from the top enough to touch the bottom of my kneecap. Because it was so loose, I could bend it a good 15-20 degrees inside the cast. NOT what this cast was supposed to do. It was supposed to be ROCK SOLID. hhhmmm....is it just me???? Why can't thinks go smoothly and correctly! Sooooo frustrated. Anyway...I'm using the cast I had this summer with the velcro straps to secure it tight. I can take it off at night, or anytime I want, but I'm going to keep it on just as if it was the pink one.
Jo...do you know the hospital time involved in a fusion? He also said I'd need a blood transfusion. Do you know the recovery time when they use the nails/rod? Would I be in a cast afterwards? .....my mind is mush....lots of information to remember and retain.

He doesn't think that the fusion will take away the pain, as it's RSD/CRPS and nerve, tissue and muscle related and not so much the knee implant itself. My PCP believes the same. So...the main reason for having the fusion is to stop the knee from moving and causing the pain, AND for stability to stand, "walk" and try to have a normal life without looking like a hunchback and grabbing at furniture just to go from one place to another. Bottom line: movement makes the RSD flare up and get worse. So...stop the movement and maybe the RSD will subside to a minimum instead of rearing it's ugly head each and every day to a pain scale of 6 or more. I can only hope!!!!!! I know I don't have many options left, and this is the one that I'm comfortable with and believe I can live with. Amputation is not an option. I just can't do that.

 

[Josephine]

I don't really know what the after care protocol would be nowadays. In 'my young day' they were certainly put in a plaster cast but for how long I have no idea.

If he's really planning to use a Küntscher nail I can imagine why as they are of a clover leaf design in cross cut and one can be slid into the other making quite a strong longer rod.

We used to use them for fractured shafts of femur and if we had a really tall chap and no nail long enough for him, we'd interlock two within the bone. Can't quite envisage how he's going to get the bend, though. You'll have to ask him that.

 

[wanttoride]

Should a knee fusion have even a slight bend in it? .....he told me that me leg would be 1/2 to maybe 3/4 of an inch shorter than the other because of the bone taken from the 2 TKR surgeries. He did tell me that it was going to be straight. Do you think he's saying "straight" because the leg will be shorter and won't need the "bend" in order to clear the ground when walking? He said he would do all he could to keep the leg as "long" as possible" and keep the difference as close to 1/2 inch as he could. Am I right in thinking that would be his reasoning for saying "straight"? Was your co-worker's from years back completely straight, or did it have a "bend" to it. I wonder if it did have a bend in it, how many degrees the bend was.
I forgot to mention that my quad muscle is still not working. He said it was still at 40% function. In your opinion, will the fusion help with the quad? I know it's not going to make it work better....I'm talking about stability.
It's a beautiful winter wonderland outside my window this morning!

 

[Josephine]

Audrey, there's no 'shoulds' or 'oughts' to this. One thing is certain that you would find it extremely difficult to cope with a straight leg that is the same length as the other one. It has to be adapted in either length or bend or maybe both. It really depends on the surgeon and what he thinks will work best. As for the quads, sorry, but I have no idea.

You know, I cannot remember whether my fellow trainee's leg was straight or what! It wasn't something I knew about in those days. I just knew she got about fine and no-one ever made any allowances for her 'disability' because as far as we were concerned, she didn't have one! There was also another student nurse who had a fused hip and it was just the same with her. We never gave it a thought. But then, there were a lot of them around in those days!

 

[wanttoride]

Thanks, Jo! Knowing if he plans to have the knee/leg "straight" or have a slight "bend" to it is tops on my list! We haven't really gotten into the "deep talk" about having a fusion, and my next appt. on January 26th will be that talk.
I can well imagine how difficult it would be if both legs were the same length, and one of them was fused straight. You'd have major hip action in order to clear that leg from the ground, that's for sure! ...and that wouldn't benefit me at all. I wish I could just wave that magic want and have it be just like it is in this cast....a slight bend (I think 8 degrees at max) and I can pretty much walk "heel-toe". Not perfectly, but at my best. He keeps talking about having to put a lift in my shoe, or having the sole of my left shoe modified to help out afterwards. He did have me stand on a board that was 1/2 and 3/4 high and then he removed the left side so that I could see just how much of a difference there would be. It wasn't any different than having my left knee bent to make the difference of 1/2 or 3/4 of a inch. That seems to be his BIG issue. I think he should spent a couple of days here and see just how much that doesn't bother me, and how I cope with having the leg in the cast.
I know it's hard for any Dr. They see you for 15 minutes and you try to explain everything, go over everything and gain information. Luckily, my January appt. is 45 minutes long. I'm getting my list of questions ready, so again...I'm asking all the BoneSmart people to think about any questions you think I should ask. THANKS!

 

[Josephine]

 

[awolfpaw]

Sorry I have been out of the scene soooo long. Moving, starting a new job, and adjusting to a new area has been trying, but an adventure.

I would like to commend you for being so strong and knowing how to stick up for what you needed/didnt need. Sometimes its hard to listen to your own body over the advice of an expert. But, you will be amazed after the surgery, even though it is hard surgery, how much better you feel. I know its hard to think positive, but Ive been there, and crying gets you no where. Trudging along, however, at least gets you a little farther than you were the previous day...especially if you have those who are willing to help And look at where that has gotten you! An answer, the help you derserve...and a following on a forum :P

If you have any questions,,,,concerns,,,,or just need to vent, let me know Good luck!

 

[wanttoride]

Hi "Wolfpaw"! I was hoping you would post something! I really, really need you!!!! :cry4:

 

[wanttoride]

"Wolfpaw", can you tell me how long you were in the hospital after the operation? Do you know how long the operation took? Did you have to have a blood transfusion? ....I know you had the external device. I'm being told mine will be the internal rods.
How long was it before you were able to bear weight on your leg after the operation? Did you have to use a walker for a while? (I'm trying to decide when the best time will be to have the fusion...I'm thinking in the spring, like march maybe? Do you have to wear a lift in your shoe to compensate for the difference in leg length?
Last I remember, you were hiking in NH at the Flume! You are my inspiration. I've gone on the hunt searching the internet the past few days, and mostly I find people who are very miserable with their fusion. It sounds like a lot of them didn't realize what life would be like with a straight leg.
It's not like I haven't had the chance to find out...I've been in the straight casts now since June or July. They have given me the opportunity to see what life will be like. I can get into my truck, go up and down stairs (one at a time) and sit in a chair (on the edge for a while, until my leg falls asleep!). I can stand for a while, but I do get tired standing for much longer than 10 minutes or so without leaning on something or putting all my weight on my good leg.
People see me with the cast on, and they say I'm a totally new person. When I don't wear the cast, I'm grasping for things to hold on to, and can't put much weight on the leg. (I had yet another surgery to put in a thicker spacer and to cut tendons in the back and side of my knee to give me more stability. I agreed to try this "last thing" before moving onto a fusion decision.
My leg is in far less pain when I have it in the cast. It seems it's more painful when it's trying to bend and straighten. I've just had it. I really need some positive feedback on having a fusion (Jo has given me some) by somebody who is as active a person as I am. I think the only difference is that I have the RSD/CRPS nerve pain that you don't have. My Dr. says the fusion probably won't end the pain, but it could lessen it a lot, since it won't be moving. I have high hopes....but am obviously nervous as well. This is permanent.

Looking forward to another post from you!

 

[Jamie]

Audrey, I'm so glad to hear that you are making plans for this positive step forward. I pray that the RSD will settle down and let you live your life again. You are one of the strongest people on the face of this earth....I admire you so. God bless you!!!

 

[cotton1958]

Catching up and reading your thread. Really, I think the blood transfusion is least of your worries. Guess why I say that, is my only surgeries, I had to have blood transfused. And I am fine.

I do wish you the best in this new surgery adventure. I am so sorry you have to go through it.

I do have a couple of old best friends, when we were young, had hip/leg surgeries. One was result of staph, the other genetic..I am not sure what the official name of the surgeries were. But they are very successful people and married and bore children.

Again, so sorry you have to go through this, and my prayer are for the best results.

 

[wanttoride]

Thank you for your wonderful posts and encouraging words. I'm moving forward!!!!