TKR 'Need some postive re-inforcement regarding Conformis knee'

[PaulF]

I had LTKR in October 2018. The first year was OK not wonderful, still took NSAID everyday, but could play tennis and do what I wanted. However knee was trembly and would throb in the shin if I was sitting too long.

However that all changed at the beginning of this year when, after bending the knee with a little too much pressure on it, it became very painful to walk. I also began experiencing back pain, specifically sciatica, which has become chronic but manageable.

I relate it to the surgery and the fact that my left leg is longer that my fight by 0.6 inches. The leg has always felt too long especially on the lateral side (outside). I was on the couch for three days. Slowly after 9 months, I can walk again and manage some tennis, but it hurts everyday. I am considering a revision, but two surgeons said it is stable, can not find anything wrong, and not to do revision except as last resort.

Another surgeon recently told me I am a candidate and is ready to schedule me. I still have pain everyday, mostly throbbing when at rest, but functional with weight bearing etc. But walking is problematic for longer spans like over a mile. Any advice or can anyone share real experiences with Revision.
Thanks

 

[lovetocookandsew]

Welcome! While no one can make the decision for you, I can offer a little insight. First off, my OS, and others, recommend only doubles tennis after a TKR.

I had a revision 2 1/2 years ago due to allergies to the metal, and a lot of non-stop pain, and really had no other option. The recovery from it, for me, was easier than my original TKR, but sometimes that's not the case. Every surgery and recovery is different, but one thing that's basically the same is that recovery is not a cake walk.

I think what I'd do first is make sure all three surgeons are revision specialists, and do many revisions each year. Then, after finding out who are actual revision specialists, I'd weigh all my options, assess my quality of life and then begin to make my decision. I'd maybe even go back to talk to any who are revision specialists for more info. If none of them are specialists, I'd definitely keep looking for one. What makes me hesitate somewhat is that two surgeons said no and your third opinion said ok. I'd wonder a bit when it's two vs one, but you can delve a bit deeper first by looking into their specialty. You really should visit a revision specialist, unless you already have, as a regular OS may not have the experience of a specialist. He may be perfectly qualified to do a TKR, but revisions are different.
As for the pain, it's a good idea to ice it when it's painful; ice is a good pain reliever, even two years down the line.
I would also ask them about the leg length and back pain; if related to your knee, it's another reason to consider the surgery, although maybe not a deciding factor.

In the meantime, I'd lay off the tennis for a bit and allow my leg to rest for a while. Ice it, don't do anything too strenuous, and see what it feels like in a week or two.

Would you please give us the date of your TKR, and any other knee surgeries, so we may make a signature for you?

 

[newlybionic]

Hi @PaulF. I’ve had a complete revision on my left knee and am planning a revision on my right knee. I actually did much better after the revision surgery than the original TKR. My right knee has become painful and losing range of motion. No loosening or problems with poor bone growth. Nothing concrete to fix, but it just isn’t working very well for me. My OS is a revision specialist and he feels he can help me by doing a full revision and checking the underside of the knee cap for problems there. I’m going for it. I want to be able to do everything I used to do before the surgeries.

 

[PaulF]

Love to cook and Sew,

MY LTKR was performed on October 1, 2018. It was a Conformis Knee. Is there somewhere in my profile I should add this information as well as previous history?

 

[Celle]

@PaulF I have added your surgery and its date to your signature.
Thank you for telling us the full date.

 

[PaulF]

Hi @PaulF. I’ve had a complete revision on my left knee and am planning a revision on my right knee. I actually did much better after the revision surgery than the original TKR. My right knee has become painful and losing range of motion. No loosening or problems with poor bone growth. Nothing concrete to fix, but it just isn’t working very well for me. My OS is a revision specialist and he feels he can help me by doing a full revision and checking the underside of the knee cap for problems there. I’m going for it. I want to be able to do everything I used to do before the surgeries.

newlybionic,

Thank you for sharing your experiences. I am wondering how the revision feels now that you have had it for over 4 years, especially after experiencing the original TKR. I am not afraid of going through the surgery and rehab again, but I am worried that it will be worse not better. Right now, this knee is functional but uncomfortable everyday. It keeps me from moving about as much as I used to before the surgery and my ability to walk longer distances is less also. So I guess there are just no guarantees but it is encouraging to hear your story and your desire to have the right knee done. Best of luck on the upcoming procedure.

 

[PaulF]

Welcome! While no one can make the decision for you, I can offer a little insight. First off, my OS, and others, recommend only doubles tennis after a TKR.

I had a revision 2 1/2 years ago due to allergies to the metal, and a lot of non-stop pain, and really had no other option. The recovery from it, for me, was easier than my original TKR, but sometimes that's not the case. Every surgery and recovery is different, but one thing that's basically the same is that recovery is not a cake walk.

I think what I'd do first is make sure all three surgeons are revision specialists, and do many revisions each year. Then, after finding out who are actual revision specialists, I'd weigh all my options, assess my quality of life and then begin to make my decision. I'd maybe even go back to talk to any who are revision specialists for more info. If none of them are specialists, I'd definitely keep looking for one. What makes me hesitate somewhat is that two surgeons said no and your third opinion said ok. I'd wonder a bit when it's two vs one, but you can delve a bit deeper first by looking into their specialty. You really should visit a revision specialist, unless you already have, as a regular OS may not have the experience of a specialist. He may be perfectly qualified to do a TKR, but revisions are different.
As for the pain, it's a good idea to ice it when it's painful; ice is a good pain reliever, even two years down the line.
I would also ask them about the leg length and back pain; if related to your knee, it's another reason to consider the surgery, although maybe not a deciding factor.

In the meantime, I'd lay off the tennis for a bit and allow my leg to rest for a while. Ice it, don't do anything too strenuous, and see what it feels like in a week or two.

Would you please give us the date of your TKR, and any other knee surgeries, so we may make a signature for you?

lovetocookand sew,
Thank you for sharing your experiences. I do believe the surgeon who is ready to do the revision does a considerable amount of revision, but how does one assess or find a revision "specialist" versus one who just does them less routinely.

 

[lovetocookandsew]

We have a surgeon locater area here at BoneSmart. It's at the top of the page, in the tool bar. That's a good place to start. I'd also ask any surgeon you've spoken to how many revisions they do per year, and for how many years. I'll also tag @Jamie as she may have more knowledge in this area.

 

[PaulF]

Hi

I have a Conformis knee and I am not very happy. I was pretty good until the one year mark at which point I started to have pain at rest especially at night. Fast forward to now which is 2.5 years out from the TKR, and I have trouble walking any kind of distance. My pain is especially troubling in the hamstring mostly, and several other Orthopedic docs have told me that the knee is not infected or loose except in the AP direction (front to back). This could indicate a torn PCL thought they also tell me that is not a normal or likely occurrence. However, one Orthopedic doc suggested that the PCL may have shredding form the implant over time. There is also an issue with my lumbar section of my back but I must say that prior to TKR I never had any back issues at all. One's gait might change from a TKR and that is something the doctor should discuss with you. My doctor did not.

It is a very hard decision, one I put off a long time. In retrospect, I do not feel that I am not really better off than the before the TKR.

 

[Roy Gardiner]

@PaulFIt sounds like you are following up the problem, but have not yet found the answer. I suggest you search for a revision specialist, one who fixes up TKRs that have gone wrong or are sub-optimal.

 

[Ddole]

Thank you for this thread. I’m two years out and still in pain. I saw a revision specialist who said one part is too big. I go for a bone scan Tuesday. While I don’t look forward to doing this again, I too am worried about it getting worse. I do wish there were more stories about revision and especially successful ones.

 

[PaulF]

I have seen multiple additional specialists but none of them feel that I am a candidate for a revision. One of the doctors is a revision specialist who was instrumental in the design of one of the better revision knees. He told me that he might make my situation worse and I should just accept the current knee and it should last me for 30 years. Apparently, they like to have a reason they can point to other than "it just hurts" But still, I live each day with regret and pain especially in this hamstring that does not seem to respond to PT, exercise, meds, etc. It is depressing.

 

[AfterCare]

In your original post you mention that your operated knee is now longer than the other. I wonder 1. how common this is and 2. how this is NOT supposed to cause back problem (since the back is now out of allignment)

 

[PaulF]

That is the point. There are many complications that can arise form TKR. Most good orthopedic surgeons will discuss the risks with you. But I doubt that any, including mine, would mention a leg length discrepancy and subsequent change in gait that could result in life changing back problems such as what I am experiencing. I had a leg length CT done (post TKR) and the radiologist found a 1.2 cm difference in my leg with the operated leg being longer. I can feel it when I just stand up and sense the weight bearing distribution.
The orthopedic surgeons I have seen to evaluate this have all avoided validating this phenomenon stating that it is impossible to make the leg longer from TKR. I respect them all but that is what I have experienced.

 

[PaulF]

AfterCare,
What has your experience been as you have had both knees done?

 

[Sisterpat]

Paul, I too have had both knees done within 9 weeks of each other. I do not notice a difference in length of either leg nor have I ever heard of this. My back is very sore but I know that is from all the time sitting and sleeping in a recliner with my legs elevated.
i have no clue as to what you can do at this point. Have you ever considered going to a chiropractor? They are very good with back issues no matter the cause.
i hope you find relief soon.

 

[AfterCare]

I had a leg length CT done (post TKR) and the radiologist found a 1.2 cm difference in my leg with the operated leg being longer. I can feel it when I just stand up and sense the weight bearing distribution.
The orthopedic surgeons I have seen to evaluate this have all avoided validating this phenomenon stating that it is impossible to make the leg longer from TKR. I respect them all but that is what I have experienced.

According to my surgeon it is quite normal for the operated leg to "become" longer post-op. It actually doesn't, but one of the things that happen is that the surgeon will straighten a leg that may have become bow-legged. This happened to me as well and caused quite a few problems as I tried to become more mobile. I was even told to keep using my walker all the way up to the next surgery (next week) to assist with stability. As my other leg will be straightened, I look forward to them both being the same length again.

 

[PaulF]

We’ve had members get the spacer exchanged for a different size and did well. I’m sorry he wants to wait so long to do that, if that’s what it needs, but it will give you more time to heal, as multiple procedures in a short time can take quite a toll on the knee. Also, waiting gives your knee time to improve, which might be all it needs, which could avoid another surgery.

Just be careful with the PT. You are still healing, so don’t work too hard with it, and don’t do anything that increases pain and swelling, as that will be counterproductive. Too many PT’s really don’t understand this year long healing process for this recovery.

Hi Jockette,

I had L Tkr in September 2018 using Conformis. first year pretty good, however after that it went donwnhill. I have seen quite a few surgeons to get some help, none who do Conformis but all saying that I'm not bad enough for a revision and said to leave well enough alone. Also I went back to the original surgeon 3 times and he told me that the knee was fine and the stability was "in the sweet spot" But something had changed in the knee which has given me more clicking when walking that during the fist year as well as considerably more pain ( even when trying to sleep). BTW, the original surgeon stopped using Conformis after only a few years. I am very active and pretty consistent with PT and exercise. Bottom line, I recently went to another surgeon who has been doing Conformis for 10 years and he said he can help me. He has recommended a poly replacement and will evaluate it for any other abnormalities while in the compartment. Can you please direct me to the other memnbers who have had the spacer replacement so I can communicate with them. I am not great at using this website so your help is appreciated.

 

[Jockette]

Hi @PaulF

I moved your recent post to your recovery thread so all your history will be in one place.

Here is a search for “spacer exchange” You can click on these links to read about others who have had this procedure. I think most have been happy with the change.

Search results for query: Spacer exchange

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