PKR My Drama Queen Patellofemoral Knee

[Jockette]

I do not have another appointment scheduled, I’m going to let my mind ponder all this for a while.

Did your current surgeon feel confident he could correct your leg? If he’s as good as other doctors say he is, I bet he’d be really careful if he did the revision. I’m sure he’s not happy with how this turned out.

It’s so hard to make this decision and there are many factors involved.

 

[jenng2003]

@Josephine Thank you so much for taking the time to do that. I really find all your diagrams much easier to see than the ones I google.

@kayow11 will be happy to see this, too, as well as others, I’m sure!

I have circled the area where I have the most discomfort. Still waiting for the gabapentin to kick in. 2 weeks down. Hopefully some relief by next weekend?

Thanks again!

******************
So I too have nerve issues, diagnosed by an emg/nc test. My pt and surgeon thought the nerve was damaged at the fib head (the area you circled), but it ends up it’s above that and behind my knee. As for gabapentin, call the dr. My surgeon started me slow and increased every 2-4 weeks (I now take 300 mg/3 times a day). I have some nasty dizziness and headaches from the med so we don’t know how long I’ll take it, but I’m keeping that dose for now. The slowly start you to allow your body to adjust to the medication.

 

[sistersinhim]

Every once in a while I will have twinges in my lateral tendon. Even after this long of a time. Of course, I have had 2 of those through the years. During the tkr, he released my medial tendon. That will still have little pains, too. I just have to concede to the fast that I'll never have pain free knees. As long as they are better, that's what counts!

It seems that anytime something in these knees is done, it takes a long while for them to heal all the way!

 

[triciaski]

@Hood1980, my experience is very similar to yours. At the time of my lateral release and patella scraping, the surgeon recommended I get both knees done because they were both out of alignment. After the first surgery, though, there was no way I was ever going to have knee surgery again.

But, many years later, I then injured my other knee and had arthroscopic surgery on the injured knee for a torn meniscus. When the surgeon did the meniscus surgery, he said my MRI showed some wear and tear and spurring on my patella that he would "clean up" for me. Because of my experience on my other knee, I told him not to touch my patella and not to get very aggressive with filing and scraping anywhere in my knee. Recovery from that surgery wasn't too bad, and I didn't have the terrible pain under my kneecap, but it wasn't particularly successful, either, and here I am 3 years later with a PKR.

Although I'm only 3 weeks in my recovery, I've got to say that this is going much better for me than the recovery from the lateral release and patella scraping, and I was soooo much younger then. I think the patella is particularly sensitive and in PKRs, it remains intact and still moves around in the knee, so I wouldn't be surprised if it's the source of much of our pain. Most of the pain and pressure I'm currently experiencing seems to be coming from the area right underneath my patella.

--Tricia

 

[Hood1980]

Thanks Tricia. It does make sense. My patellas were trash. I have suffered from patella Alta since I was 12 and because of them not staying on track, they have caused me lots of issues over the years. The Surgeon yesterday explained to me that in my upcoming revision, I’d keep my patella that was fixed during my TKR, but everything else would go. No more CR joint. So maybe less patella pain in my revision, but I would have clipping of ligaments (ACL and PCL) and possible quads. . How do you prepare mentally for these surgeries??? It makes my heart race just to think about it. I think I could handle it, if I knew I’d be better off than I am now, but I don’t get those reassurances, which on top of all the pain and suffering make me reluctant to try again. [emoji22]


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[kayow11]

I have had tinnitus since I had a cortisone shot in my knee a few months before my first surgery. Mine is manageable, but it is a constant, unchanging, high pitched ringing that is always there.
So miserable that everything seems to have side effects.
Has the gabapentin been helping you?

 

[Jockette]

Has the gabapentin been helping you?

After 3 weeks of side effects I couldn’t live with I ditched the gabapentin, and no relief of the discomfort that I was taking it for anyway.

And I emailed the surgeon’s office early Monday morning to tell them that, and today is Friday and I have not heard back from them. At this point, that is fine with me. They must think I’m just a cranky person.

 

[sistersinhim]

I was going to ask you if you had heard from them. This OS is not for you! It has been made obvious to you! Any more thoughts of going to another one?

 

[Jockette]

Any more thoughts of going to another one?

Not at the moment. My X-ray says there’s nothing wrong. That’s the first thing they look at. I don’t want to travel a couple of hours to get blown off again. I went to one of the best for a second opinion. He obviously doesn’t think there’s anything to do.

 

[sistersinhim]

I understand how frustrated you are and your reasons for not searching for another one at this time. I pray that your knee settles down and becomes pain free!

 

[Jockette]

This surgery took me from the frying pan into the fire.

 

[beachy]

What a helpless feeling that must be! There must be a doctor that can help you! I'm not too sure about the surgery you had, but would a TKR help the problem? Duh.....just curious because I am clueless about your problem.

 

[Jockette]

@beachy A TKR might help the problem but I’d have to find a surgeon who thought so.

My problem is that I had arthritis in both knees, only in the kneecap area. So my surgeon said I needed a partial so I had the surgery in the left knee, since that one was worse. (another thing I’m thankful for is that he didn’t offer to do both knees at the same time with this type of partial!!)

When I read my surgical report I found out I also had a lateral release done.

I have not recovered yet, today makes 16 months. I am very sorry I ever heard of partial knee replacement, Patellofemoral in particular, and I wish I had known to wait until the arthritis had spread further until I needed a total.

I also seem to have some kind of nerve damage, my knee feels horrible the second I put pants on, like something big and hard immediately swells up in the knee.

My surgeon has no answer for me and neither did the very experienced second opinion revision surgeon.

 

[beachy]

That's awful. I'm so sorry. Shame you can't get names of surgeons close to you from this forum.

 

[Jockette]

There are lots of surgeons close to me but they would all know of my surgeon, or at least the group he’s in. If you need a second opinion it’s best if that surgeon has no association with your current surgeon.

And my X-ray looks fine, so they won’t look any further.

 

[sistersinhim]

 

[kayow11]

Wow! Some of us here on Bonesmart, are in the predicament category . A PKR was mentioned to me early on, but I waited longer until I felt I needed a full. I do know that nerve healing takes extremely long. Both of us, though different, have unusual symptoms it seems.
I just keep hanging on to the possibility that my situation will take much longer than most, and that in another 2-3 years from now, I will be doing great! My revision OS said this can happen, and that the knees can keep improving for years. One of my friends who had bilateral TKR ten years ago said she kept getting better for 5 years postop. She is still doing wonderful. Some here on this forum have said the same thing.
Hope deferred makes the heart sick, this is a scripture I have thought of many times. I refuse to let my "semi-invalid" status rule my mind or future. I am choosing to anticipate healing and a better quality of life in my future, with prayer and trust in God, and that He has my best interests in His heart.
Some people's bodies just rebel after trauma, but eventually many things heal up enough to be more functional, and hopefully we are both in this category.
I know how it seems like drudgery to deal with this 24/7. Everything in our life centers around the knees, how it feels, and what we still can't do.
My 12 month old knee is more temperamental than my revision knee. It always seems to swell and feel painful in the same spot. But I do notice that overall, it hurts a little less when standing such as with cooking, etc.
I am not in your shoes, but my thought would be to just wait a bit longer, then assess. You always have the option to go back to the search. Time can be the best medicine.

 

[Jockette]

I just keep hanging on to the possibility that my situation will take much longer than most, and that in another 2-3 years from now, I will be doing great!

This is what I’m hoping, too!

Some people's bodies just rebel after trauma, but eventually many things heal up enough to be more functional, and hopefully we are both in this category.

My second opinion surgeon told me:
1. Some people’s bodies just don’t like the implant.
2.Not everyone gets a good outcome.
3. Sometimes doing it over can make it worse.

Not the most encouraging news, but he must believe it or he wouldn’t have said it. And just because a person doesn’t get a “good outcome” doesn’t mean their leg is ruined. I think it just means, it didn’t go as well as some others.

While I was unhappy with how the appointment went, and that I felt I was not heard, I do have a lot of respect for this man and I truly believe he knows what he’s doing.

I have function. In a chair I can get a decent bend. I think the bend continues to improve.

He could have just done the revision and made money on me, to “make me happy” and hope for improvement, in spite of those 3 things he told me. But he didn’t, and I’m glad he didn’t. If it’s not truly needed, who wants to do this over again.

And you’re right, nerves take a long time to heal. I was told that by a GP a long time ago.

So, I’m with you, @kayow11, we’ll wait this out together.

If/when the time comes that I need a revision, I’ll know. I’m not there yet. In the mean time, I’d like to give my knee more time to heal and settle down before we go in and traumatize it all over again.

Thanks for your words of encouragement!

 

[kayow11]

@Jockette, you're welcome. When I express words of encouragement, it also helps me too.
Yes, let's just wait this out and see what happens. It is the best option at this time. I have had three surgeries, and I surely will NOT have another one unless something breaks. Some of our bodies just take a long time to get used to new parts hopefully.
I still have pain with several things and my function isn't great either, but it has slightly improved and I am thankful for that. Our mental attitude has so much to do with everything in our life. I have learned to stop comparing myself to others because it just makes me discouraged. My body is unique as everyone's is, and is on its OWN schedule.
After my last OS appointment a week ago, he also alluded to the fact that some people don't have great outcomes. Not all people heal up well, or take MUCH longer than the norm. But it is done and over with now, and I just am planning to Heal up from this point on. Looking back is not going to help me mentally or physically.
God has my life under control, thankfully!

 

[sistersinhim]

I think it just means, it didn’t go as well as some others.

I'm right there with you, ladies. I'm disappointed it's not better than what it is, then I think about how I can now go down stairs frontwards now, instead of backwards, can ride my bike and get out of the kayak without having to practically sit in the water to do it! No, it's not perfect and I have to be careful the way I move it, but being able to do things I couldn't do makes me happier than before! I pray you ladies will get there, also!