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Revision TKR Loosening, RA ?Second Revision

Shortie said:
I am someone who likes to know what is what
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Hi Shortie, Me too. But Please ignore me if all my questions are tiresome. Its just I have a second opinion on 8 July and the more I can learn the better prepared I will be.

You had the biopsy to check for infection. Which showed no infection. Presumably you had an Xray to check on the bones and prosthesis fit. Did you have an MRI scan too to check on the soft tissue? If so, did the Xray and/or MRI scan reveal what was causing your pain?

Increasing the drugs will make the next couple of months a little easier, so its a no brainer. My thoughts are with you. Carol
 
Hi @patient 99 do not worry about questions that is what BS is all about.

I have not had an MRI since TKR I have had X-rays, a bone scan and arthroscopy with biopsies.

I have also had extensive physio which made no difference.

My OS said about my x-rays that if I didn't have pain or reduced ROM would be acceptable however as there is pain +++++ and a reduced ROM (was 70 but during arthroscopy he did have a bit of a bend and got it to 90 but now it is 80 at best) there are very small nit picky things like femoral component may be a tiny but too big (but if I was asymptomatic would be fine) and also there is a tiny line somewhere (can't remember exactly) which has been there since op which he said if he had done op it is something he would have kept an eye on but again in an asymptomatic knee he wouldn't worry.

Hope that helps x

GP agreed to increasing OxyContin so on new strength tonight - tomorrow will be test if I can function on the new dose - mind you if they help me sleep I will have to weigh up extreem exhaustion functioning and drug side effects functioning!

Spoken to OH so should hear next week if they can find me something desk based until revision.

As I am going to have the revision would it be OK for one of the moderators to chNge my blue TKR thingy to a yellow revision one please x

Night night.

Shortie x
 
Hope you find pain relief, and can get some sleep, and continue to work.
Before my Revision I was up every night with knee pain. At least now that is gone.
 
Thank you - I'm just (as always) impatient to get it all done and get on with living.

I think the increase in OxyContin helped last night as although it took until 1ish to get to sleep I then didn't wake up until six - longest I've slept in one chunk in a long time! I will keep my fingers crossed that it is the OxyContin and not that I was just soooooo exhausted but have hope to sleep better on a more regular basis. Just got to see how I function during the day on the increased dose.

The sun is shining here today, I've got some hope that this will be my last summer of not joining in with the kids and next year there will be no stopping me! @RestAssured and others you have inspired me so much - Thank you x

Have a good day everyone.

Shortie x
 
Shortie said:
My OS said about my x-rays that if I didn't have pain or reduced ROM would be acceptable
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Hi Shortie, thank you so much for answering my questions. No matter what else is the same, managing to get a decent sleep must help enormously. I struggled in the early days just trying to look after myself with help from my husband. It must be extra hard if you have children and a job you are trying your best to keep.

From what you have said they are going to do a revision because of the pain and reduced flexion. But they haven't said what is causing the pain and reduced flexion. As another bonesmartie said, having a TKR prematurely meant you went through a lot when perhaps you didn't need to, but I can't see how that would give you your current issues.

Perhaps the surgeons simply don't know why some TKR don't work (all the more reason you would think they would use everything that is available to them to find out - including MRI scanning). When they don't know I would prefer they just came clean and said it. We patients know they are not god. We just want a bit of honesty. I've seen my surgeon on 3 occasions. I am no shrinking violet, yet each time I've felt outmaneuvered.

Anyways, we are at different stages so my banging on about the diagnostic stage is not where you are at now. You know which way you are going, and I can tell for that at least, you are grateful. Hopefully I will get some answers/clarity on 8 July when I go for my second opinion.

Take care and thanks again. Carol
 
@patient 99 I know for being a nurse that every one of us is different. Medicine is not an exact science. There is a lot of whys in medicine for example why does my daughters best friend have type 1 diabetes, why does another friend of hers have coeliac disease, why did a 30 year old colleague of mine have a small orange sized lump of cancer in her breast, why is my TKR so painful?? What caused all of these things? There is speculation and opinion on them all and tests to try To find out but sometimes you just have to accept that there isn't always an answer.

When I went last week I was really hoping (very odd I know) that he was going to say yes definite infection the treatment is this and then it would be sorted. But in the absence of a definite cause you have to trust in the doctors who have have multiple experiences of patients with the same / similar problems, and trust in what they believe to be the best option. The best chance of making it right. I am really grateful to my OS who as I like to put it called a spade a spade, was honest with what he said, gave me the good and the bad possibilities and let me decide based on how I would like to proceed - he never said just live with it he said the safest option with a known outcome (i.e. To stay as I am now) would be to do nothing. However the slightly riskier option would be the revision BUT with a good chance of improvement (to what degree is unknown) so I am very willing to take that chance, to make an improvement, to get back to living, taking an active part in my kids childhood activities, which is why I am looking forward to having the best outcome possible for me, without taking that chance I would regret forever settling for what I have now.

Would I have liked definite answers you bet but after quite extensive research I chose my OS for a second opinion, I fully trust and respect his decision (which I did not of the team looking after me between my original OS that did my TKR and then retired!) and he had admitted he is unsure of why but has offered me his best option and I am taking it there is no point at this stage for me to question further or regret and dwell on what has happened until now. Although I am a nurse I am not an orthopaedic surgeon, although I know MY knee fully I have never experienced any of these problems before in anyone else, I have not had years and years of experience and training in orthopaedics specialising in knee replacements in this and so I am trusting the knowledge, skill and experience of the surgeon I chose, and I fully accept that there isn't always an answer to the cause of everything but there are best options for treatment and I'm taking it and I'm not looking back.

Sorry this was a bit rambling.

Shortie x
 
Thanks Shortie,
You expressed everything all of us with revisions have had to go through to one degree or another. It is a complicated, complex, and confounding situation to be faced with. The surgeon who assisted my revision said to me, "sometimes you just have to look under the hood to see what exactly is the problem".
Thanks for taking the time to post,

See post 427
 
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Everyone's situation is different. It is difficult to make the decision I'm sure, especially when they can't find an infection. But, sometimes, we have to rely on our "gut" instinct and put our trust in our OS. The outcome for any revision is an improved quality of life!

@Shortie

I wish you much success in whatever you choose to do!:console2:
 
@Shortie,

We will be here for you!:happydance: I will get into my "Cheerleading" mode and get ready to cheer you on! I am proud of you for deciding you are ready to "live the best of your life!" There is so much to do! Start writing your bucket list!:yes!::egypdance::cool::cool::curtsey::wowspring::wowspring:
 
Sorry I've not been here for you the last few days. The road maybe rocky ahead but you have to think of the final outcome. I really hope that like me the final outcome surpasses all expectations. I couldn't have dreampt of the difference this new knee has made to me, it has been a life changer already. I am in less pain already than I've been in for the last FOUR years I've been on crutches and I'm not three weeks out yet. It is fully functional apart from the bend and that is coming slowly. I have to be careful I don't join the ODIC club. I went out twice yesterday. I can't say the same about the antibiotics I'm on, they sure make me feel rough, but it does come in waves.
 
Shortie said:
I fully accept that there isn't always an answer to the cause of everything but there are best options for treatment and I'm taking it and I'm not looking back.
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Shortie, I respect you. One's philosophy on life affects everything. Very best wishes
 
Hello Everyone,

I am very positive about having my revision as I really cannot cope with the pain, reduced mobility, missing out on doing things with my kids, not being able to work, worrying about my whole career as a nurse, being almost housebound most of the week, relying on everyone to do things for me, not sleeping and being totally exhausted all of the time, taking OxyContin morning and night (and other stuff in between) and the associated constipation and everything else that goes with a painful knee.

Everyone is different it's a fact! I have tried to post my reason why I am having my revision, and yes I do not have full answers as to what is wrong, my current OS who I fully trust and respect has been totally honest with me which I really respect as it would be so easy for him to fob me off. Whilst I have no one definite reason why my TKR is failed, there are as I have explained a selection of small things which are not perfect on my TKR which in someone who has no symptoms would not be of concern, however I do have major symptoms so they are of concern. I have since October last year had a selection of diagnostic tests, very specific physiotherapy, and yes there is no one thing that says you have x problem so we are doing this. So I have with discussion with my OS opted for a revision. Am I wrong in doing this NO!

In a previous post I made a comparison as to not knowing the cause of other illnesses for example diabetes I bet there isn't a type 1 diabetic out there who said I'm not having any treatment until I KNOW the definite cause.

Whilst my journey is not as extensive as others I have been through a lot and yes trying to put in to the past and not dwell on the fact that I may have not needed a TKR in the first place and if I have had other treatment I wouldn't have missed two years being active with my kids, I wouldn't have had to give up the running that I love, I wouldn't be in so much pain not, I wouldn't be worried that I may lose not just my job but my career all of this has been very difficult BUT I have to look forward, I have to have a positive attitude that this will work.

So am I questioning if I should have a revision despite not having a specific definite reason as to why my original one failed? Definitely not! An I questioning if my OS is wrong in suggesting a revision? Definitely Not. Am I questioning that my OS had not done everything he should before coming to this decision? Definitely not. Everyone IS different and just because I don't have a specific definite reason I am NOT wrong in my decision.

Thank you very much to everyone who has given me fantastic support.

Shortie x
 
Well said, I agree with your reasoning. I hope you haven't long to wait.
 
What a terrific post. You put me well and truly in my place. And furthermore its helped me to think a little differently/more constructively about how I will approach my second opinion on 8 July.

Just when I think BS cannot get any better I meet somebody like. x
 
Well what an eventful few days I have been in hospital since Wednesday night but not for me! My 11 yo son has appendicitis and had to have his appendix out yesterday - he is home now but quite sore - I am looking forward to my own bed tonight!

I have quite a bit of catching up with my sleep and all the posts on here!

Shortie x
 
best wishes to your son.
 
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