Revision TKR Nearly a year after and still a lot of pain<

[Celle]

I've had a revision and it was no worse than the original surgery. It isn't a given that a revision will be more painful or harder to recover from.

 

[Jamie]

Cathy, I too have been in constant pain with a tight band feeling for over a year. I went last month to my 12 month visit and was told that my X-ray looks fine and that I should be all better by now. I said I don't know what to do and my doctor recommended that I go get a second opinion and that maybe another doctor would see something he is not. So I scheduled an appointment next month for a second opinion. I am 57 years old and this has been the most awful experience. I am hoping to at least get some encouragement that I will be out of pain and stiffness.

@Ruru2017.... Welcome to BoneSmart. Why don't you start a thread of your own here in the knee recovery forum so we can talk specifics about your issues? It's not possible to do that in another member's thread without derailing it. If you need assistance to start a new thread, click on the Help & Info tab at the top of the page and then on the How To Use This Forum link. There are lots of short articles there to help make your time on BoneSmart more enjoyable.

 

[cathy61]

Hi again everyone

Update - saw my consultant for 1 year check. Still lots of pain and swelling when walking all at front of knee, despite the revision. He said if it's still the same in 6 months (it's not really changed in the last 6 months!) then he will go in again .. He said I should have redone the kneecap after all but no guarantees that this is your problem! I had the kneecap resurfaced during my original TKR and the second opinion showed it had a 'very oblique cut' , possibly causing impingement on surrounding soft tissue. Second surgeon said it didn't look too bad during revision but now seems to be changing his mind as everything else looks ok on X-ray ...

Has anyone had their kneecap resurfaced more than once? I have weaker bones so am wondering how tricky an op this is ? Feeling very low as you can imagine. And just wanting my life back! Cathy

 

[Josephine]

To be perfectly candid, I wouldn't recommend it as the patella is a very small bone and there is really only one shot at trimming it to take the patellar button. Though 'weaker bones' wouldn't be a factor in that. Usually that term is applied only to the long bones like the femur, tibia and fibula. I hope I haven't made you even lower by that.

 

[cathy61]

Thanks for the advice Josephine. I feel gutted!
I am getting a second opinion on this next week! All my knee pain is around the kneecap area and I can't help feeling it's to do with the way it's been resurfaced as it doesn't seem to be tracking at all well as I can hear clicking noises there. I am prone to inflammation and seem to be getting a type of synovitis all the time now during movement, no pain at night though.
The surgeon seemed to think it could be redone, but I will wait and see what another revision expert says. I am travelling to Bristol to see him. This knee journey never seems to end, meanwhile I can't walk more than about 2 minutes without significant pain and am only 63, up until 3 years ago I was playing golf, jogging and hiking!
Cathy

 

[Cratchit]

Hey Cathy! I`m sorry your 1yr FU appointment didn`t yield the answers you were hoping for and I`m really sorry you`re feeling so low - quite understandable after all you`re going through. I`m glad you`re seeing another surgeon. @Giantstu is also seeing a surgeon in Bristol, could be it`s the same one. Have a look at his thread, Josephine has put a bit of info about him on there. If it`s the same one he`s a very nice looking chap!

I do hope you get some answers and solutions soon. Being in constant pain is so debilitating and really does get you down. The fact that you don`t get pain at night suggests that it is an ambulatory thing so I`m thinking your gut instinct may well be right.

 

[Josephine]

I'll be interested to what the chap in Bristol has to say.

 

[jacksv153]

Following as I am having my revision in 4 weeks.

 

[cathy61]

I will keep you posted after I have seen the consultant. My story isn't too normal so don't be worried about a revision jascksv... many people have a good success with it. It's just that I now may need a revision of kneecap plastic button, if that's the problem and it is looking that way...and may not be possible to do. I have every confidence in the consultant I am seeing who did my second opinion and is very thorough.

 

[cathy61]

Hi all
As promised my report after seeing the consultant in Bristol.
He said no to redoing the kneecap as there's too high a risk of fracturing the bone and weakening the patella if resurfaced more than once ( I think the original surgeon did a less than perfect job of this as one side of the patella is narrower than the other, it's not a straight cut) He said, also it's not necessarily the cause of my ongoing inflammation and pain and seemed a bit puzzled.
He has offered to do keyhole surgery in 6 months for exploration but also to try and remove any obvious pieces that may be impinging and causing pain e.g a bone spur has grown on the patella. Meanwhile he pointed out that some people are left with kneepain which may/ may not improve over time. He has suggested I get referred to a pain clinic in the meantime. Great!.?
I am trying to remain positive but can't help feeling gutted that even after a revision I am still in more pain than with the arthritis! Cathy

 

[Josephine]

Oh you poor thing you! Those are not the answers you wanted to hear, are they?

He said no to redoing the kneecap as there's too high a risk of fracturing the bone and weakening the patella if resurfaced more than once

Sadly this is true. The patella is already a small bone of little substance and one really does get only one shot at it. Attempting to recut it offers a real risk of it just falling to pieces.

he pointed out that some people are left with knee pain which may/ may not improve over time. He has suggested I get referred to a pain clinic in the meantime.

Sad but true but the offer of an arthroscopy might produce some improvement. There's not a lot anyone can do to offer you anything more comforting than that. Though you could seek another opinion which I can help you with if you like.

 

[newlybionic]

Cathy I'm so sorry that you are going through so much with this knee. I hope you can get someone to help you with the pain so you can be more active than you are.