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Revision TKR Multiple knee replacements

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@Fractured had it tough what he went thru should never have happened. I agree 100% but he only had to deal with it for less than 3 years and granted those 3 years were rough. Not trying to compare or even say one situation is better or worse but the fact remains my first knee surgery was in 2003 and now close to 2020 a period of not quite but close to 17 years in dealing with knee issues. As far as feeling pressured, sure it would be nice to be home for Xmas but the real pressure is will this be it finally and when will I have a date for the surgery. To say that I am sick and tired of all of this is an understatement dealing with pain just stinks. A really good day for me is a 4 and I had a few of those the start of summer now the average is 5 or better. Some of the threads I have read make me so jealous within a month or 2 pain levels at 1 or 2 if only that were me!!! As many surgeries I have had I should be like the older tv show " The 6 Million Dollar Man " capable of all types of things. If I were to count up the amount of each revision including hospital stay etc before insurance kicks in a safe bet just in revisions over 1.5million and that does not include outpatient scopes or partials either. I would love to have this surgery soon just to get it over with and hope things will turn out better this time.
 
You may be "one of a kind" or at least "one of a small group" in that you've had so many surgeries. But a good reconstruction surgeon has seen cases worse than yours. They deal with mangled legs and joints that have to be put back together - and they do it. My point is that you've only had the input of one surgeon on this procedure and you are plagued with doubt about what might be to come. Perhaps you need the input of at least one and maybe two more surgeons before you can begin to feel some reassurance about your decision and what the future may bring.

If you're not willing to obtain additional opinions, that's okay. But to not get them and still feel so unsettled does not appear to me to be a wise approach. I still strongly suggest you talk to other surgeons. You're looking for good reconstruction surgeons who do at least 50 difficult cases a year. I know you say that your current surgeon is wonderful, but he's done one surgery on your knee already that didn't work out. Sometimes having some "new eyes" on the situation helps. We all know that no one can predict how this next surgery will work out. But you are more likely to be at peace going into it if you had the same diagnosis and recommendations from more than one doctor.
 
@Jamie I agree with you and believe it or not that is how I found Dr. Foster. He was suggested from some of the other Dr.'s I have seen. Granted he only has done 1 surgery on my knee and well the prosthetic did not last. I could have seen the Dr. that the ER referred me to but he does not have the same experience as Dr. Foster and my line of thinking he may not have thought of using the same prosthetic as Dr. Foster. Now there will be a fresh set of eyes at the time of surgery Dr Foster's replacement Dr. Ross was trained under him and also comes highly recommended. For what its worth I trust that I am in good hands. I just hope fingers crossed this will be the last time.
 
For what its worth I trust that I am in good hands. I just hope fingers crossed this will be the last time.
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I sincerely hope so too.
 
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NFenske said:
sistersinhim said:
I've had 6 surgeries on my right knee and 5 on my left. Each knee has had it's kneecap removed and not replaced.
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Glad your doing better but each time I was told this is going to fix it well it did not. At one time I was told a revision should last 10 to 20 years well I proved that wrong. For me at the most 2 possibly 3years this next revision is a new record 17 months. Since I live in Richmond the go to hospital for specialized care is VCU and the surgeon I am currently seeing is Dr. W Foster. He deals with primarily cancer patients. In the event the patient has bone loss due to a tumor he replaces the bone loss with different prosthetic devices. Unlike the other surgeons I have had he has been honest well maybe too honest he never said I was going to be pain free. The prosthetic that he is going to use on me will insure no more dislocating of the knee but the surgery involved is going to be major I already have a longer prosthetic going from the joint into the tibia. From what I understand it will be a somewhat lengthy surgery. Fingers crossed that this one will work but at this point I have my doubts. If in the event this does not work having the joint fused might be an option. Granted no more bending the leg but I was told that patients that have had that done have far less swelling pain level reduced quality of life is much better.
I need to stop thinking about all of this its driving me nuts maybe I will wake up tomorrow and no more knee problems YEAH RIGHT.
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I JUST read this whole thread. I came in today because I'm having horrendous pain 13 months after my knee replacement revision. Three knee surgeries in four years. Frankly, reading all you have gone through scares me. I'm at my wits end after only three. I did have the meniscus cleaning twice in 2005 which is what started all this. Unfortunately, I have other physical issues as well. 40+ surgeries since I was 18. I'm 54 now. I'm waiting to see a knee replacement failure specialist in Fairfax VA. I see that you live in VA as well. I can't get in to see him until Mid Jan. In the meantime, im headed back to my original surgeon because the pain has become so severe. So, two failed replacements. Doesn't seem so bad compared to you. My one big issue is pain control. After my MANY surgeries, my tolerance to pain meds has become very high. I need so much more to relieve the pain. Actually, I get no relief at all. So, the revision a year ago was HELL. The surgeon wouldn't prescribe strong enough meds. So, I basically ended up being tortured.

This may interest you. I started going to a pain clinic because I have all over body pain and will never be pain free again. Sounds like you could use help, also. I'm in the process of preparing to have a pain pump surgically implanted. It goes directly into the epidural space, so uses a tiny amount of med compared to what you would take orally. They said Im reaching a dangerous, no go zone. Pretty soon, pain meds won't help. So, I can't get another revision until I get the pump situated. Once that is done, which can take months, I can consider getting the knee redone.

I wish you well!
 
@napper Pain stinks I deal with it 24/7. I have some suggestions these are not perfect but they help. You should look into a Medtronic Pain Stimulator it works similar to a Tens Unit big difference it placed inside you. The rechargeable battery is placed inside you ( mine is below ribcage ) and a lead goes to the nerve in your spine that causes the pain in your knee. The downside to this you have to recharge the battery ( its easy ) every couple of weeks and once the battery wears out you need to have it replaced but its every 9 years approx. This is not perfect but it does make a difference. Another suggestion have you tried Diclofenac Lotion? When my knee is acting up a put some on my knee rub it in and it gives me temporary relief. Only suggesting this because I was getting hooked on pain meds, I understand pain it stinks but the more pain meds you take the more your body builds up a tolerance ( that dumb saying " been there done that " ) it took awhile but once I was off of the pain meds my high level of pain did go down and no it did not go away completely I have days that being miserable is an understatement. For awhile Gabapentin was helping at one time at the start of summer pain level was at a 4 now well a steady 5 plus but that is due to needing another revision due to loosening and dislocating the knee less then 2 weeks ago. Another thing I use frequently is an ice pack and elevation with a pillow under my knee. My biggest hope is maybe this next revision will help but that remains to be seen.
Yes I agree recovery from a revision is no fun I hate it and what gets me there are those that have had a TKR and within a month or two they feel great. In my case it takes approx. 18 months and even then still have issues. MY current surgeon here in Richmond told me considering the amount of surgeries I have had I will always have some pain unfortunately he is correct.
 
NFenske said:
@napper Pain stinks I deal with it 24/7. I have some suggestions these are not perfect but they help. You should look into a Medtronic Pain Stimulator it works similar to a Tens Unit big difference it placed inside you. The rechargeable battery is placed inside you ( mine is below ribcage ) and a lead goes to the nerve in your spine that causes the pain in your knee. The downside to this you have to recharge the battery ( its easy ) every couple of weeks and once the battery wears out you need to have it replaced but its every 9 years approx. This is not perfect but it does make a difference. Another suggestion have you tried Diclofenac Lotion? When my knee is acting up a put some on my knee rub it in and it gives me temporary relief. Only suggesting this because I was getting hooked on pain meds, I understand pain it stinks but the more pain meds you take the more your body builds up a tolerance ( that dumb saying " been there done that " ) it took awhile but once I was off of the pain meds my high level of pain did go down and no it did not go away completely I have days that being miserable is an understatement. For awhile Gabapentin was helping at one time at the start of summer pain level was at a 4 now well a steady 5 plus but that is due to needing another revision due to loosening and dislocating the knee less then 2 weeks ago. Another thing I use frequently is an ice pack and elevation with a pillow under my knee. My biggest hope is maybe this next revision will help but that remains to be seen.
Yes I agree recovery from a revision is no fun I hate it and what gets me there are those that have had a TKR and within a month or two they feel great. In my case it takes approx. 18 months and even then still have issues. MY current surgeon here in Richmond told me considering the amount of surgeries I have had I will always have some pain unfortunately he is correct.
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Funny got should mention the stimulator. I'm in the process of getting a pain pump. Same idea as the stimulator, but uses meds. The good thing is the very small amount of meds it uses in your spinal fluid will relieve me pain. Instead of the oral meds that don't work anyhow. That's why I'm so bumbed my knee is acting up. I'm ready to go forth with the surgery, after getting the testing and thinking all summer about it. I'm scared to do it, but think it will give me quality of life. I also got side lined when my artificial knuckle broke and I had to have that done. Seems I can't win. I'm meeting with the pain pump surgeon on the 10th. Hoping to get the surgery done at the end of the month since it will be free. I've met my catastrophic out of pocket, so the rest of the year is free.

I've been issuing the D cream. Not working.

Thank you for your response. I'm sorry you've been through so much!
 
It seems we both started off the same way torn meniscus. What amazes me is how a relatively simple outpatient procedure has turned into a mountain of BS!! Like I wrote even though I suggested these things does not mean they are great in fact the most I can say is they help but that is about it. I went to Ikea at Potomac Mills by the time we were done my knee was screaming at me and when it gets that bad my patience is gone and all I want is to get home and ice. You think your bummed look at me 18 surgeries just on the Left Knee 6 of those are replacements and lucky me hopefully this month the 7th revision and instead of 18 now it will be 19. Trust me I hate all of this!!
 
@sistersinhim I have the Medtronic Spinal Cord Stimulator. It was originally put in after I had nerve damge from a weight loss surgery. When the battery died after 5 years I had a 2nd one put in 2013 this one besides covering the nerve damage from the weight loss surgery they also have a 2nd lead that sends a signal to the nerves on Left leg that help with my constant knee pain. Its not perfect and yes there are days that no matter how I adjust the knee hurts.
 
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Just spoke to my Surgeon Dr. Foster one way or another my surgery will be done in December!! The only question is when there are 2 Dr.'s replacing Dr. Foster 1 of them can only do it on Friday's with Dr. Foster only problem they have to get with the person that schedules the OR to see if they get get time. The 2nd Dr. has plenty of openings the only real issue I would have to drive a little further for follow up then the other which is 5 to 6 minutes away. So YIPPEEE!!!
 
Do let us know which surgeon is going to do the surgery and what date, and we'll add it to your signature.
 
@Celle I should find out tomorrow in my case instead of one surgeon there will be 2. I know for a fact 1 will Dr. Foster the 2nd not sure yet. If they can get time in the OR on a Friday this month it will be Dr. Ross if not it will be some other time with his other partner ( forgot her name ). Not that it matters at least to me I also remembered I had a few scopes at the Richmond VA Hospital prior to seeing Dr. Nordt. No matter how I look at it it stinks having had all these surgeries and still need another what fun!!
 
Surgery is scheduled!!!!!!!!!!!! December 13th 2019 revision #7 The two surgeons that will be doing the surgery are Dr. Foster and Dr. Ross. I will be home for Xmas but odds are very good I am not going to be doing much except for maybe when I start at-home PT what fun!!
 
@Jamie Things fell into place. I was worried for nothing. If you read above next Friday!! Dr. Foster called me and said after reviewing x-rays and notes etc they can leave the prosthetic part attached to the tibia alone and ( I think he said replace a part of it ?? ) but they have to remove the part of the prosthetic attached to the femur if all goes well????? the surgery will not be as bad as he once thought. Time will tell.
 
I'm so glad to hear that you have some resolution in all this and a surgery date. The fact that the surgeons won't be replacing the entire implant is good and may help you in recovery. The "part" that may be replaced as part of the tibia component is likely the plastic spacer that sits on the flat plate of that part of your prosthesis. This all sounds good and I'm happy it has eased your mind.
 
@Jamie Thanks! I am guessing the new prosthetic will interchange with the other? Based on the image:

OSS™ Orthopedic Salvage System Compress® Device – Zimmer Biomet | Limb Salvage

Surgeons: Explore the OSS Orthopedic Salvage System, a comprehensive, modular platform designed to offer surgeons intraoperative flexibility in limb salvage
www.zimmerbiomet.com www.zimmerbiomet.com
The plastic seems fairly easy the fun part is the replacing the the part attached to the femur. In a way I am glad they do not hopefully have to replace the part attached to the tibia its a fairly long prosthetic which means more work to release it from the bone and hopefully less pain.
 
I'm going to assume that your current implant is a Zimmer product which will allow a new femoral component to work with the existing tibial piece. Do you have any x-rays that you could post? I should have asked you about that earlier, but see I didn't.

1575498126667.png

This image shows that the tibial component has a "peg" that fits with the femoral stem shown and a number of other femoral options. The Zimmer system gives your surgeon a lot of flexibility to use the upper stem that will hopefully give you the stability you need. It is possible, if your current femoral stem is loose, that removal will be fairly easy. But at any rate, surgeons have all the tools they need to do the removal with the least amount of trauma to your bone.
 
@Jamie No one responded in pre-op thread so maybe you can answer?? Considering I had an infection after rev.#4 should I be overly concerned this time?? The odds however small are still greater then someone who has never had an infection and having been thru one really hope not to go thru another.
 
You should be concerned about infection always. It's especially important to know the infection rates for the hospital where your surgery will be done as well as the rate for your surgeon and make sure they are not excessive. I'm assuming you don't have any immune deficiencies - that's a different matter that would need to be discussed with your surgeon. You shouldn't be at any greater risk because you had a previous infection that has been resolved.
 
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