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Revision TKR Never give up, keep trying, don't settle - that's me, Bonnie

Bonnie, I am so sorry that you have to go through this again. But, my friend whose knee was like yours also just had a revision to remove a Stryker---she got a Smith and Nephew knee built for folks with a nickel allergy. she is already much better at one month out after years of having a rom at 50. She has a rom of 90 for almost the first time.

Her doctor also found this at surgery and told her that he felt this was part of the reason that she had such aggressive scar tissue. She was infected with a pathogen
Propionibacterium acnes: An Underestimated Pathogen in Implant-Associated Infections. I know that we are not all alike- but it might be worth it to mention it to your doc. Kelly
 
Hi Bonnie,

I'm so sorry to read you're going through this again but you are one very strong lady, very kind and helpful. Let's hope this will solve the issues you've had. Will be keeping an eye on your thread. I think it's rotten the deal you've had with this recovery. The only thing that can be said, thank goodness for that doctor who's going to help you heal at last. Good luck Bonnie

Love Ann xxx
 
Thank you @skigirl and @Nana moon 27, your kind words really do make me feel better. You are like good friends to me who truly understand.

Today I went to the dentist and got my teeth cleaned two months early since I can't do it for 6 months after my revision. Tomorrow I'll get a flu shot and a pneumonia shot...just taking care of business pre op.

I have a new granddaughter who is one month old today 'Riley' (my first). I've been sad because I was going to watch her for my daughter two days a week when she returns to work as a school teacher on November 10. I can't do that for at least 6 weeks after my surgery because of having to be non weight bearing. My daughter says it's ok, because they need me to get better so I can care for her and play with her the way I would want to. She is right...
 
RunA42K said:
I have a new granddaughter who is one month old today 'Riley' (my first). I've been sad because I was going to watch her for my daughter two days a week when she returns to work as a school teacher on November 10. I can't do that for at least 6 weeks after my surgery because of having to be non weight bearing. My daughter says it's ok, because they need me to get better so I can care for her and play with her the way I would want to. She is right...
Click to expand...
Bonnie, what a wonderful, caring daughter you have raised!!! She has her priorities straight and is telling you true. This is but a blip in the many days you can spend with your new granddaughter. What a wonderful thought to look forward to having a functioning knee for all those good times ahead.

I'm interested in how this is working out. Did you have any type of metal allergies before your first knee replacement? If not, have you asked your surgeon if he feels like the allergic reaction could have developed over the many months and years of inflammation?
 
Bonnie, you have so many wonderful friends here who really care about you, and the brand new granddaughter you can care and play in X'mas period, there are so much hopes there, you will be good this time.
 
Oh Bonnie, how absolutely wonderful, a baby granddaughter. Congratulations. I have two granddaughters and three grandsons. My elder granddaughter is living with me while hubby is away. Her school is just down the road from where I live and her best friend round the corner. We are very close.

Anyway, Bonnie, what I am trying to say is, this will be such a huge motivator to get well. Your daughter is wonderful (clearly like her mom!). Give yourself plenty of time to recover so that you can enjoy your time with her, improved mobility. I have to be honest and say, take your time, don't bank on a minimum time scale of six weeks just in case things take a while longer. If they don't then that's a bonus.

I think you'll rock this revision. Good luck Bonnie @Birdy has summed it all up beautifully xx
 
Bonnie:

I have a Smith and Nephew and I am vary happy with it. I had similar symptoms with swelling and a bad patell clunk and excessive looseness. My allergy test was negative, had a revision two days ago and all went very well. OS decided I didn't need the upper component removed after all. Got upsides dramaticly on my spacer and a lot of work on the patella. I think once you get that allergic knee out you will be on the road to a good solid recovery. I would hate for you to have to continue like before. I sometimes wonder why they don't do these allergy test befor they put in a knee. Would save a lot of pain and surgery. Thinking positive thoughts for you. It's gonna turn out well.


Sent from my iPhone using BoneSmart Forum
 
Congratulations on your new granddaughter, Bonnie! :flwrysmile::yay::happydance:

Your knee will be fixed, so that you can play with her by the time she is moving around and playing on the floor. you'll be able to enjoy her as a toddler, too.
 
Bonnie, my bones causing problems before my revision, and Dr. Maale put me in a brace to help with the non-weight bearing. Have they considered that for you?
 
I have some pain in my tibia now but not all the time. I guess it depends on how I am moving my leg, how my weight is distributed, etc. I didn't talk to him about anything like that about prior to surgery. I think I need to put together a list of questions to email and ask.
 
Well I am just 19 days out now from my 2nd revision. My current knee gets worse and worse every week. I dread the surgery again but I need to get it done. I did find out that my next new knee will be a Smith and Nephew (nickel free knee) but I am waiting for them to get back to me with what model it is. My very first TKR was a Smith and Nephew Legion knee but that knee was removed in 2013 when my Stryker Triathlon Revision knee was put in. I have to laugh at that name...Triathlon...like one could do a Triathlon after getting that revision knee. I wish...only in my dreams!!

I asked about will I have a spinal or femoral nerve block in addition to general anesthesia and I was told 'neither' only general anesthesia. My first TKR I had the femoral nerve black, my first revision I had a spinal. Does this mean that when I wake up from the general that my pain will be off the charts? I'd really like to hear from someone who only had a general anesthesia with their TKR/Revision.

They said outpatient PT should start ASAP, but still non weight bearing for 6 weeks so I can't see PT being too aggressive.

So if any of you can think of any other questions I should ask, please let me know and again any input from those who had just general anesthesia would be appreciated.
 
Sonja and I both have Smith and Nephew revision knees that we like.
I had GA with a femoral block for my primary TKR, the femoral N. block did not work and I woke up in excruciating pain. The nurse quickly got morphine on board and my pain was gone ASAP. Knowing you have no pain medication with GA, they will have the pain medication on board before you even leave the OR. I would ask to be sure.
You could ask if they are going to use EXPAREL, pain medication put directly in the knee during surgery.
PT should focuses on your NWB mobility, stairs, ramps, etc. and a few gentle exercises.
Wishing you all the best with your upcoming non allergic revision,
 
Pumpkln said:
Knowing you have no pain medication with GA, they will have the pain medication on board before you even leave the OR. I would ask to be sure.
You could ask if they are going to use EXPAREL, pain medication put directly in the knee during surgery.
PT should focuses on your NWB mobility, stairs, ramps, etc. and a few gentle exercises.
Wishing you all the best with your upcoming non allergic revision,
Click to expand...

Hummm, I'll ask about the EXPAREL, I've never heard of that. Also Chris, what is NWB, talking about PT?
 
NWB-Non Weight Bearing.
Exparel is supposed to give a few days of excellent pain relief. A few members have had it, and liked it a lot.
Interesting the way your quote posted, ah you edited it, thanks!
If I think of anything else I will post it here.
 
Pumpkln said:
NWB-Non Weight Bearing.
Exparel is supposed to give a few days of excellent pain relief. A few members have had it, and liked it a lot.
Interesting the way your quote posted, ah you edited it, thanks!
If I think of anything else I will post it here.
Click to expand...

Oh, that was a no brainer...NWB! Thank you!! I'm going to e-mail them about that drug. They are so good about answering my questions right away. If I e-mail in the evening I have an answer the next morning. I've never had a doctors office as responsive as this.
 
Hey Bonnie, I did not have revision but TKR with general anesthesia there at Texas Orthopedic Hospital. I was surprised with the extremely low level of pain.
 
Bonnie, with my two replacements I woke up in excruciating pain but with my revision it wasn't that way. Dr. Maale didn't use a spinal or femoral block either. My revision is nickel free and it is the Smith and Nephew HK. Love it, love it, love it![emoji4]
 
Bonnie, I had GA with both knees and the spacer exchange. I am terrified of spinals---my back is one part of me that works fine right now and I don't want to disturb anything. Also, I personally think femoral nerve blocks are a bunch of hooey. I would never have one after hearing Camper Van's story. I had a PAIN Ball in my knee---which I now know was Exparel. I really had no pain with the knee when I woke up. Started taking oral pain meds the first day and really, I almost never had any pain breakthroughs. By the time the Exparel wore off, the oral pain meds were established. It works for one to three days---that is why you have t0 take oral meds from the beginning. The first one lasted 1.5 days, the second for 2.5 days.

I also want to tell you about my friend who is a ski instructor with me. She has had the same type of thing that you are dealing with. Her rom was 60 at the beginning of the summer. She got the same knee that you are getting and it has been like a miracle. When I called her tonight---she is at 7 weeks--her rom was 110.

Our OS, also found that she had an infection--probably for a long time. It was a little known infection and he said that a lot of labs culture for only one week, but to catch this infection you have to culture for two weeks. Here is the info that I have on it.






Biomed Res Int. 2013;2013:804391. doi: 10.1155/2013/804391. Epub 2013 Nov 6.
Propionibacterium acnes: an underestimated pathogen in implant-associated infections.
Portillo ME1, Corvec S, Borens O, Trampuz A.
Author information

Abstract
The role of Propionibacterium acnes in acne and in a wide range of inflammatory diseases is well established. However, P. acnes is also responsible for infections involving implants. Prolonged aerobic and anaerobic agar cultures for 14 days and broth cultures increase the detection rate. In this paper, we review the pathogenic role of P. acnes in implant-associated infections such as prosthetic joints, cardiac devices, breast implants, intraocular lenses, neurosurgical devices, and spine implants. The management of severe infections caused by P. acnes involves a combination of antimicrobial and surgical treatment (often removal of the device). Intravenous penicillin G and ceftriaxone are the first choice for serious infections, with vancomycin and daptomycin as alternatives, and amoxicillin, rifampicin, clindamycin, tetracycline, and levofloxacin for oral treatment. Sonication of explanted prosthetic material improves the diagnosis of implant-associated infections. Molecular methods may further increase the sensitivity of P. acnes detection. Coating of implants with antimicrobial substances could avoid or limit colonization of the surface and thereby reduce the risk of biofilm formation during severe infections. Our understanding of the role of P. acnes in human diseases will likely continue to increase as new associations and pathogenic mechanisms are discovered.

PMID:

24308006

[PubMed - indexed for MEDLINE]
PMCID:

PMC3838805

Free PMC Article

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[Bonesmart.org] Never give up, keep trying, don't settle - that's me, Bonnie
[Bonesmart.org] Never give up, keep trying, don't settle - that's me, Bonnie
[Bonesmart.org] Never give up, keep trying, don't settle - that's me, Bonnie
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This might be one question you want to ask your doctor. Our OS thought that this was the main reason that Lori had had constant swelling and adhesions. Kelly
 
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