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Looking for advice.

tarajenni

tarajenni

junior member
Joined
Sep 30, 2017
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81
Age
54
Location
Atlanta, Ga
Gender
Female
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United States United States
Hi everyone. Here’s my history.
45 year old female.
12 years ago had bilateral arthroscopic knee surgery with micro fractures for patello femoral disease.
Did fine until 2 years ago with increased pain. I’m very active with cycling and hiking so decided to go back. Started cortisone injections which worked until early this year. Did supartz injections which didn’t help any. Finally had MRI which showed high grade articulate cartilage loss of patella with mild changes in medial compartment.

Surgeon wants to do partial replacement. I know they don’t last as long as total and recovery is pretty much same for both. I’m talking to him tomorrow but wanted insight from the group before I do.

Thanks in advance.
Tara
 
More people will come along with their sage advice. My OS doesn’t do partial. Was told stil cutting bone, same recovery, and potentially need a revision by 5 years. I had a total. Very happy with my outcome!
 
Non-professional, anecdotal f/b that I got (actually at a barbecue last night :loll:) was, "if the doctor talks about a 'partial'...run in the other direction. I have no idea if that's valid or not, but mine recommended total x2 and that's what I'm going with...
 
Welcome to BoneSmart

There are some pretty experienced people on here who are of the view that partial inevitably, rapidly leads to total. I don't know; what I do know is that you must have complete confidence in your surgeon. If you are at all worried, seek a 2nd opinion.
 
On the whole, partial knee replacements (PKRs) don't seem to have a good, long-term result. Many even need to be replaced within a year.
One reason for that is that, once you have arthritis in one compartment of your knee, it tends to spread, sometimes quite fast, to the other compartments.
Another reason is that it demands certain skills to do a PKR and some surgeons don't have those skills.

I was fortunate. My surgeon was meticulous and my PKR lasted for 11 years. I was glad to have it. It gave me back the active life that I wanted. Eventually I wore out the plastic spacer between the metal components. I had to have a revision to a total knee replacement (TKR).

When I was offered a PKR for my other knee, I chose to go straight to a TKR. Both knees work well now.
 
Well you can't beat the voice of personal experience!

However, I have been keeping a log of members who have had to have their partial converted to a total within a fairly short period of time. That list is now 43.
 
Rhodyrhody said:
Non-professional, anecdotal f/b that I got (actually at a barbecue last night :loll:) was, "if the doctor talks about a 'partial'...run in the other direction.
Click to expand...
I love this! That is exactly what I should have done. Not happy with my partial at all.

I am probably on Josephine’s list, but as pending.
 
tarajenni said:
After reading through @surgchic17 thread I have a question. I’m having a patello femoral replacement next month and my problem stems from maltracking of patella too. My question, which I meant to ask my OS but forgot is...the surgery SHOULD fix the maltracking, right? How is this assured? Anything I need to be doing postop to aid this?
Click to expand...

It "should fix" the Mal tracking, there are no guarantees.
Recommend you call your surgeon and ask him, or leave a message with his nurse.
 
What did your surgeon say at your recent appointment?
 
Thanks!

He said that I have absolutely no cartilage on underside of my patella and I’m focally bone on bone. He said the medial and lateral compartments look great. He recommended the patello femoral replacement due to disease limited there. I brought up my concerns and questioned why not TKR. He said if I did TKR, I would get 30+ years out of it but most likely will outlive it, requiring a revision. He said the revision of a TKR is a big deal and after that, you run out of options. He refuses to do any other PKRs because they usually fail in 3-5 years. And he only does patello femoral on very select patients, usually between ages 42-52. Because of this he has a good success rate. But I have stressed if he finds anything in other compartments at surgery, to convert to TKR.
 
I trusted my surgeon to make the right choice for me. I didn’t have the information you do before surgery. I didn’t even know what questions to ask. I thought I was catching my arthritis early and the partial was all I’d ever need. (talk about how ignorant I was!)

When I told friends I was getting a partial, two of them thought it was wrong. One had had a total knee replacement and the other a hip replacement. I actually got annoyed with them thinking I’m sure my surgeon knows what he’s doing.

Unfortunately, mine has not gone well. It’s been 15 months and I don’t feel recovered yet. I was expecting a 2-3 month recovery from what I knew about it beforehand.

I am disappointed and frustrated that I have more discomfort now than I did before surgery. In my case, I traded arthritic pain that was only from “cause and effect” to an almost constant irritating discomfort. I’ve tried really hard to hang in there and give it more time and more time, but I’m losing hope in that theory.

If I could go back, in my case, I would wait until I had enough arthritis to qualify for a total and be one and done.

My age has never been a question, I was 61 when I had the surgery.

I recently had a second opinion and because my X-ray looks fine, neither my original surgeon nor the second opinion has an answer for my discomfort.

I hope yours works out better for you. Maybe your surgeon does more than mine does, so he’s more experienced with this procedure. At my one year check up I tried to find out from his office how many Patellofemorals he has done. They wouldn’t tell me. I got the run around with 3 different answers about totals and partials in general but no answer to my question. Surely there’s a record somewhere. It makes me very suspicious when an office will not answer my question. It makes me think they don’t want me to know.

I do hope things go well for you. In spite of my negative view of this procedure I will support you in your decision, and in your recovery, if you decide to stay with us here at Bonesmart. Bonesmart is an awesome and unique forum with lots of information and support. :flwrysmile:
 
Thanks for sharing your experience. I hope your pain subsides soon.

I’m reading as much as I can. I’m very appreciative of everyone’s input and support.
 
tarajenni said:
He said if I did TKR, I would get 30+ years out of it but most likely will outlive it, requiring a revision. He said the revision of a TKR is a big deal and after that, you run out of options. He refuses to do any other PKRs because they usually fail in 3-5 years. And he only does patello femoral on very select patients, usually between ages 42-52. Because of this he has a good success rate. But I have stressed if he finds anything in other compartments at surgery, to convert to TKR.
Click to expand...
The revision of a TKR is not such a big deal that it is a once-only surgery. There are people who have had two, or even three revisions.

At your age, a TKR is likely to outlast you, so the chances of you needing a revision at all are not high.
I just don't buy this "you're too young for a TKR, so I'll do a partial" argument at all.

My first knee replacement was a partial and it lasted me for 11 years, which is longer than most. The revision was no big deal at all. In fact, I think my recovery was easier than my recovery from the PKR.
When my other knee needed replacing, I was offered a PKR. but I chose to go straight to a TKR.
 
@tarajenni, I too am scheduled for a PKR on Aug, 8th! I am 57 and plan on requesting a TKR! After reading a lot on here and just not knowing how long until a revision! I’m really wanting to just be done with the pain and limitations on what I can and want to do!
I hope all goes well with your surgery and you have a quick recovery!


Sent from my iPhone using Tapatalk
 
I saw you in the August group and was going to reach out to you. You’re just a couple of days ahead of me so I’ll be following your recovery closely. I’m here for you for support.

Is your PKR patello femoral?
 
@tarajenni, Advanced Medial compartmental Osteoarthritis is my diagnosis! Been doing injection for a couple years and they just stopped working!


Sent from my iPhone using Tapatalk
 
@tarajenni, not really nervous yet! Just been busy with work and preparing for post surgery! I got some ideas on here on meal prepping, anticipating help for the first few days, taking care of insurance/work issues and trying to keep positive and excited for recovery! Also started the post op exercises!


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