Kevin Finn
junior member
I just had fluid drawn from my right knee (TKR on November 10, 2008) to see if I had an infection. Fortunately, the results were negative. However, I have learned very much in the past few weeks regarding patient pain and patient rights.
My surgeon told me that he could not attempt to get fluid out of my knee (It has been swollen and bulging since January) due to the risk of infection. Just two seeks later he told me I actually had a glob of blood in my knee and that he could not draw it out. He said to, "Keep doing what you are doing, but go easy."
I left for a thrity day trip to California. I was able to make an appointment with a surgeon in Redding, CA who drew a vile of yuck from my knee in order to test it for possible infection. It turned out be negative (Thank God!), but here's the news---He took several digital xrays. He showed me the pictures and said there was no indication my surgeon used cement on my tibia plate. He said the patella button was only place where cement was used.
This surgeon asked me how old I was. He was surprised I was sixty six. He implied that not using cement relies on bone growth into the tibia implant. My surgeon has NEVER spoken to me about this, but my impression is that he knew when I complained of constant pain and burning that bone growth had probably not taken place. I think he was just hoping I would heal and go away.
I went to southern California and saw a friend of my son's who is an Orthepidic Surgeon. He also was surprised my tibia plate was not cemented. He also said his group ALWAYS uses cement on the tibia plate. He said if the bone does not grow into the prothesis, a revision may be necessary to install cement under the tibia plate.
Why do I mention all this? Because I now know my surgeon's withholding of information from his patient is sickening! He apparently feels he has no obligation to involve his patient in decisions following complications. What if I had had an infection? He was willing to let me suffer without either explaining his reasoning or mentioning his decision to not use cement on the tibia plate.
My guess is that it is unlikely the bone will adhere to the prothesis because of the "full area" in the knee is filled with blood and fluid, wetting the area and not allowing adhesion. I may be wrong, but I sure have the right to wondeer under the circumstances. What does this mean?
I suggest that patients, when having long term complications, ask pointed questions and do so in writing. Althought I did with my surgeon, he ignored my questions and kept saying, "Continue what you are doing." He never asked me what I was doing. He will now receive a registered letter with several direct and pointed questions about my progress or lack of progress.
Moral of the story: You can't rely on all surgeons to act quickly when faced with possible problems. If they want to live on hope, they have an obligation to explain why they are doing what they are doing. If they are evasive, they should not be trusted. The patient MUST take control of their own situation and demand an analysis from the surgeon. This should not be threatening to a good surgeon. If the surgeon is wurth his or her weight in salt, they should involve the patient in decisions and why they are taken.
I have no interest in litigation, but I assure you all that my surgeon will regret not informing me of the fact he chose not to cement my knee. Maybe that was a good decision, but he should have told me when I expreienced constant pain and swelling near six months out from TKR!
All surgeons are not equal. Second opinions are good when complications arise. Requiring information before surgery is reasonable. Placing total trust in a surgeon because one does not want to ask challenging questions is not good. KNOW WHAT KIND OF PROTHESIS IS LIKELY TO BE INSTALLED IN YOUR KNEE AND WHETHER THE SURGEON HAS HIS OR HER PHILOSOPHY REGARDING THE USE OF CEMENT.
I hope this little disertation is helpfull. Jo gives great help to us all. My input is just from a "not too happy" patient.
Kevin
My surgeon told me that he could not attempt to get fluid out of my knee (It has been swollen and bulging since January) due to the risk of infection. Just two seeks later he told me I actually had a glob of blood in my knee and that he could not draw it out. He said to, "Keep doing what you are doing, but go easy."
I left for a thrity day trip to California. I was able to make an appointment with a surgeon in Redding, CA who drew a vile of yuck from my knee in order to test it for possible infection. It turned out be negative (Thank God!), but here's the news---He took several digital xrays. He showed me the pictures and said there was no indication my surgeon used cement on my tibia plate. He said the patella button was only place where cement was used.
This surgeon asked me how old I was. He was surprised I was sixty six. He implied that not using cement relies on bone growth into the tibia implant. My surgeon has NEVER spoken to me about this, but my impression is that he knew when I complained of constant pain and burning that bone growth had probably not taken place. I think he was just hoping I would heal and go away.
I went to southern California and saw a friend of my son's who is an Orthepidic Surgeon. He also was surprised my tibia plate was not cemented. He also said his group ALWAYS uses cement on the tibia plate. He said if the bone does not grow into the prothesis, a revision may be necessary to install cement under the tibia plate.
Why do I mention all this? Because I now know my surgeon's withholding of information from his patient is sickening! He apparently feels he has no obligation to involve his patient in decisions following complications. What if I had had an infection? He was willing to let me suffer without either explaining his reasoning or mentioning his decision to not use cement on the tibia plate.
My guess is that it is unlikely the bone will adhere to the prothesis because of the "full area" in the knee is filled with blood and fluid, wetting the area and not allowing adhesion. I may be wrong, but I sure have the right to wondeer under the circumstances. What does this mean?
I suggest that patients, when having long term complications, ask pointed questions and do so in writing. Althought I did with my surgeon, he ignored my questions and kept saying, "Continue what you are doing." He never asked me what I was doing. He will now receive a registered letter with several direct and pointed questions about my progress or lack of progress.
Moral of the story: You can't rely on all surgeons to act quickly when faced with possible problems. If they want to live on hope, they have an obligation to explain why they are doing what they are doing. If they are evasive, they should not be trusted. The patient MUST take control of their own situation and demand an analysis from the surgeon. This should not be threatening to a good surgeon. If the surgeon is wurth his or her weight in salt, they should involve the patient in decisions and why they are taken.
I have no interest in litigation, but I assure you all that my surgeon will regret not informing me of the fact he chose not to cement my knee. Maybe that was a good decision, but he should have told me when I expreienced constant pain and swelling near six months out from TKR!
All surgeons are not equal. Second opinions are good when complications arise. Requiring information before surgery is reasonable. Placing total trust in a surgeon because one does not want to ask challenging questions is not good. KNOW WHAT KIND OF PROTHESIS IS LIKELY TO BE INSTALLED IN YOUR KNEE AND WHETHER THE SURGEON HAS HIS OR HER PHILOSOPHY REGARDING THE USE OF CEMENT.
I hope this little disertation is helpfull. Jo gives great help to us all. My input is just from a "not too happy" patient.
Kevin