PKR My Drama Queen Patellofemoral Knee

[sistersinhim]

Praise God the appointment went OK. I'm sorry you have no answers, but it might be that you are slower healing than others have been. Just hearing about your sister's toe could mean that it's just in your genes! You might want to try to slowly desensitize your spot. It sure did help my incision when I did it. Did he say anything about the piece of wood feeling? What about your swelling after last week's outing?

Just do what your knee allows you to do without having discomfort. Slow and easy with the knee always in control!

 

[Jockette]

Did he say anything about the piece of wood feeling? What about your swelling after last week's outing?

He didn’t know what to say about either. I was not surprised. At least he didn’t call it “scar tissue” like so many do.

Time will tell if I need another opinion. I’m not ready right now. I did ask for all my X-rays, MRI report and operative report. They will put it together and call me when it’s ready.

 

[sistersinhim]

At least he didn’t call it “scar tissue” like so many do.

! It's good that you asked for all those records. I remember I kept having pain on my medial side and when I read my surgical report that he had done a medial release. Well...duh, no wonder I still had some pain there! You just might find something out, too, that will explain your pain.

 

[Jockette]

@sistersinhim I would never have thought to ask for my operative report until I read on here someone did, I don’t remember who it was, it was a while ago, but it was probably you!

If I have any trouble understanding it I can show it to my son in law, he’s a doctor!

 

[Celle]

I did mention to him that several years ago my sister broke a toe and it took ages, probably a year, for it to heal. And that was just a toe! So he said maybe I just have slow healing genes.

That sounds to me like a comment designed to put you off doing anything about your knee. I've never heard of slow-healing genes.

I am praying for a better attitude towards my recovery, this past year has been a difficult time, both physically and mentally/emotionally.

I think you've had a wonderful attitude towards your recovery. Nothing in your attitude needs to change.

What I think you do need is a second opinion, from a surgeon who is skilled in dealing with problem knees and who has no connection, either social or professional, with your current surgeon.

You have a problem with your patellar tracking - you know that - and that is one of the main reasons for failure of a PFR.

"The major problems with isolated patellofemoral replacement have been persistent or recurrent maltracking which has been much diminished with the more modern broader prostheses; and progression of arthritis in the tibiofemoral compartment. The latter is unlikely for many years in the younger group with trochlear dysplasia but can occur in older patients; therefore careful assessment of the tibiofemoral joint is necessary."​

That quote is from here:
https://www.healio.com/orthopedics/...a-is-rare-but-can-offer-long-term-pain-relief

There's also a pretty scholarly report, here:
https://www.sciencedirect.com/science/article/pii/S1877056813002703

 

[sistersinhim]

Just hearing about your sister's toe could mean that it's just in your genes!

Don't listen to me, I don't know what I'm talking about! I thought it sounded good, but I am certainly no medical person! Maybe your sister wasn't a good patient for her toe! It's a good thing that Celle is a medical person and knows better than I do!

I would never have thought to ask for my operative report until I read on here someone did, I don’t remember who it was, it was a while ago, but it was probably you!

Yep, it was me. I was so surprised about he medial release that I posted about it on my thread. I wish I'd asked for one for all my surgeries! I had heard other people on here a year or so ago talking about their reports. When I had my year checkup I signed up for it.

 

[chrisknee]

@Jockette - good to hear the implant is still in the proper place - that is a big plus. That was a great move to get all of your medical records - if you need to see another doctor you will have everything already in place. I know you didn't get all the answers you were seeking but it is nice to know that things are not out of place!!

 

[Jockette]

Thank you, @Celle I will read those later, when the house is quiet and I can concentrate on it better.

I did wonder, before my appointment, if my surgeon would suggest some kind of “patch it” surgery and I was ready to say no, but he didn’t. I also thought he would suggest the other “go to” answer of PT to strengthen the leg, he didn’t say that either.

Why wouldn’t my surgeon tell me if the patella is mal tracking? If it really is does that mean he made a mistake and that’s why he won’t say?

@sistersinhim We do all heal at different rates so that’s how I took the genes comment.

Oh, and I forgot to say, he said something about we can’t take it back (the implant) and I said I wish we could, I’m so disappointed in how this has gone. I told him all I’d read before surgery about partials and that I had expected a 2-3 month recovery and he said yes, implying that’s what I should have had. Thankful I know from Bonesmart that isn’t true.

 

[sistersinhim]

We do all heal at different rates so that’s how I took the genes comment.

Good deal! Did he say anything about your knee not hurting when you had it taped?

 

[Jockette]

No, he didn’t.

 

[Celle]

Why wouldn’t my surgeon tell me if the patella is mal tracking? If it really is, does that mean he made a mistake and that’s why he won’t say?

I don't think it necessarily means he made a mistake. It's just that doing partials is very skilled and apparently PFRs have a tendency for the kneecap to not track properly unless special attention is paid to the trochlear groove. Even then, maltracking can apparently occur.

I think your surgeon could be a bit of an enthusiast for partials, so he possibly doesn't see any problem with yours. That's why I think it would be a good idea to get a second opinion.

 

[Jockette]

So mal tracking most likely wouldn’t show up on an X-ray?

 

[Celle]

No, I don't think it would, because it happens while your knee is moving.

 

[flyaway79]

My surgeon’s office automatically gave me a copy of my surgical report at my first post op appointment. I had to ask for the one from my original PKR with a different surgeon.

 

[flyaway79]

Sounds just like my last appointment. X-rays are good, manipulation of knee is good, don’t know why you are experiencing the discomfort you have......guess more time will tell.

 

[jaschembra]

@flyaway79 Me too!

 

[jaschembra]

I am glad your X-rays show the prosthetic pieces are solid and in place and now you will have all your documents available if the day comes to seek the 2nd opinion. I still do quite a bit of rubbing on my whole knee, and especially on the sides where it hurts. In my case, it now makes it feel good - but I do remember a day when I couldn’t hardly touch some areas or I was afraid too.

 

[sistersinhim]

Praying that your knee will quit hurting you and start tracking correctly!

 

[phrog]

Glad your appointment went well, Jockette - but of course, I wish the doc had more to say about why your knee feels the way it feels - and some suggestions for making it feel better. I hope the warmer weather that is surely coming soon will help it feel better. I'm glad you will have your medical records - always a good idea in case of future problems.

 

[Jockette]

@sistersinhim Thank you.

I was so happy yesterday that the surgeon did not say the things I didn’t want to hear. I’m sill happy about that.

However, rethinking the mal tracking thing, I am a bit depressed this morning.

I did not have mal tracking issues before surgery. I’d never even heard of mal tracking issues! The fact that that is a possibility/probability now, means it is the result of the type of replacement I had. Which tells me it’s not going to get better with more time and healing.

I’m just not ready to start a second opinion process. I don’t want more surgery (I know neither does anyone else) We paid a fortune for this surgery last year, even with insurance. My deductible was very high and this year it’s even higher. I have 3 years before I am eligible for Medicare. But surgery is probably the only fix for mal tracking due to the implant.

My copay for specialist is $60. I would need more than one opinion, and if they differ, which one do you believe? There are members on here who have had several opinions and still have no answers. And I have some rare issues that even Bonesmart doesn’t know what to say.

I just need to wait and process all this in my mind. I woke up very sad this morning thinking, what if this is as good as it gets. I truly was better off before the surgery.

I was looking at knee braces on Amazon a little while ago as I’m not going to be able to use tape all the time, my skin will need a break from the tape. All that pain and suffering to fix my knee to end up needing to tape it and/or wear a brace. But if tape and a brace help and will put off surgery for a while, then I guess that’s a good thing. It’s just sad that I have to resort to that.