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

I saw my OS today, the two year check up. I told him how disappointed I was because I am going backwards. My knee hurts on weight bearing, it even hurts when changing positions while sleeping at night. Each morning it is HARD to go down the stairs. Any side to side lateral moves hurt and the medial side of my knee is tender to the touch as though it is bruised deep inside. I was worried that he would just brush me off, like I have heard here many times from others trying to find help, and doctors telling people they are just fine...He says that there is NO reason why I should not be able to get my 130-135 ROM back because I had it once before. I used to be able to pedal my bike but now I can't I am just going backwards. He said he was sure that I did not have an infection, X-rays showed my knee looked fine, but he admitted that you can't see all on an X-ray and is sending me for a bone scan to rule out any loosening of the implant. If that turns out ok, then he will start looking at what he can do with the soft tissues, MUA or Scope to look around for scar tissue. I've always said that I am just waiting for the day when I can wake up and not think about my knee, that day has not come yet for more than two years now. At least now I know he will work with me to get to the root of the problem. For that I am very thankful!

Moving day is just 10 days from today...so busy and so much to do. I'll be so glad to have June arrive and then maybe I can be somewhat back to a normal routine and not have stairs in my house!!
 
I got in for my bone scan yesterday. Dumb me, I had forgotten what a "bone scan" was. A couple of years ago I had a bone density test and it was done in 10 minutes. But when they sent me to nuclear medicine yesterday and started talking about injection I then remembered I did this back in 1997. I was not prepared for it. I drove in night mare traffic to get there at 4:12 for a 4:00 pm appt., got registered in, paid my co-pay then they told me where to go. The technician told me, I will give you an injection now, take a scan of the soft tissue, then said I would go get X-ray and come back in 3 hours for the actual bone scan. "I said, are you kidding me??" I did realize what this procedure really was. So being that it was rush hour traffic time and I was 15 miles from home, I just stuck it out and wasted time for 3 hours. I did leave the hospital and got something for dinner, looked around in a electronics store, sat in my car and listened to satellite radio and returned at 7:30. I finally got home at 9:00pm from my 4:00pm appointment last night. At least it is done and now I just have to wait to see the doctor after I am done moving. Hopefully it will open up some new doors for answers for pain and loss of ROM that we can start working on.

Jamie, I did see the PRP doctor who does the prolotherapy but guess what? He will not touch me until he knows that my implant is indeed sound and healthy. My OS also will not address my issues until he knows my implant is sound and healthy, so I am just in a holding pattern for now. I would think that if after the bone scan they thought I had an infection that they would call me to come in sooner...you think? What worries me is that I had one tooth (#19) a big molar that became infected twice and had two root canals on the same tooth. Finally they decided that the root of the tooth had a crack in it and could not be saved so March 22, I went in for an extraction and bone grafting. It worries me that I've had so much infection with the same tooth in my mouth over a long period of time, and yes they did have me take antibiotics but each time, but not until the pain surfaced to know that I needed antibiotics. Does that make sense? RestAssured, when you had infection what were your symptoms and how fast did they come on? I know that yours was MRSA, but infection is infection.
 
Bonnie,

The first thing I noticed was that the skin was warmer around the incision site. It had a red streak running across it! Then, when they "guaranteed me" it wasn't infection I went home from hospital.

Then I started feeling unwell, sort of like the flu symptoms but no flu.

It progressed to pain and I started having trouble putting my leg down for any length of time.

After that the knee split open and the pain intensified!

I felt like I had lead weights tying me down all the time. I was tired, weepy, cranky, you name it!
MRSA is awful and I wouldn't wish it on my worst enemy! Not even the one who gave it to me!

I hope I helped you. With an infection, some of these feelings usually present themselves.

Keep me posted! I will be praying for you! :angel:
 
Bonnie,

If it is a loose implant, are you going to let the same OS put n the new one? How long have you been hurting?
 
RestAssured it is too soon to think about replacements, I just have to hope that this pain and stiffness is from scar tissue for the best case scenario. I walked around Lowe's this evening with my husband for about 45 minutes. My knee was swelling and stiffer the more I walked. My incision is always warm, has been for some time.
 
RunA42K said:
RestAssured it is too soon to think about replacements, I just have to hope that this pain and stiffness is from scar tissue for the best case scenario. I walked around Lowe's this evening with my husband for about 45 minutes. My knee was swelling and stiffer the more I walked. My incision is always warm, has been for some time.
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Bonnie,

Oh, goodness! I'm sorry if I gave the impression that I thought that would be the outcome! No, No, Np! I am praying that it IS something much simpler! You have dealt with so much already! I will be praying for a simple fix for your situation! :friends:
 
Hi Bonnie, Just wanted to wish you well with your move and hope you're already enjoying not having to navigate stairs every day. Dorothy
 
Thank you so much turtle68, yes we are moved now. It's been an exhausting and stressful several days, but we are in our new home now with lots and lots of boxes to unpack! We are exhausted and crazy tired. I was up and down the stairs of my old house numerous times today because I went back over to clean. I am done now, looked all the keys inside, left and called the realtor to let them know that we were totally done with the house. Have some very happy people moving in now with 3 kids who are just itching to jump in the swimming pool! I loved my backyard and pool, but I love my new house more. We will put a pool in too, hopefully by July we can get started. My knee is totally killing me. Achey pain down into my tibia. I just have been on it way too much. I had my bone scan and will see my OS in The Woodlands next Wednesday to see what he has to say. In the meantime we'll be here unpacking for the next two days before returning to work Tuesday. It is all worth it in the end...it is just a little work getting there!

Thanks for checking on me!
 
[Bonesmart.org] Never give up, keep trying, don't settle - that's me, Bonnie
(well no so far). Bonnie, I am exhausted just reading about your move. You'll have to get back to work to get some rest.:heehee: Enjoy your new home and let us know what the doc has to say.
 
Well, I am looking for a little moral support tonight bottomshollow, Jamie, RestAssured, skigirl Josephine. I went for the results of my bone scan this afternoon. I just knew that my doctor would say...Everything looks just fine and then I would say, "Well, why does my knee hurt so much then?" Well, it didn't go that way. The doc walked into the room and asked me how my knee was feeling and I told him that it was hurting quite a bit. He then told me that the bone scan showed that there was activity going on. That although a bone scan will tell you that something is wrong, it will not tell you what is wrong. The two main things that are of worry he said are infection or loosening. The first on the list to find out is infection. They sent me to the lab for blood work and next I am going to a radiologist for an aspiration of my knee to get fluid to test for infection. I was not believing what I was hearing. Although I wanted an answer as to why my ROM got so bad, and WHY my knee was so painful again, especially weight bearing...deep inside I didn't really think that anything could be wrong with me...denial is what I was in. During my visit with the doctor and after my appointment all I felt like doing was crying. Depending on the blood work and the aspiration of knee fluid, if I have an infection does that mean that automatically, I'll have to have this knee redone? If the implant is loose will I need a revision? I was in a state of shock sitting there listening to the doctor. I really thought that he'd tell me that I just over used my knee, but he didn't, he told me that something was wrong and now we need to find out what it is.

When I stand up from a sitting position or after a drive in the car, those first few weight bearing steps are quite painful and I have an obvious limp. I have that tight clamp feeling around my knee and almost like a pinching feeling around the knee. Yes it is swollen, it always is. Flexing my quad like you'd do with heel pumps is painful in the joint just below my knee cap. Sometimes I have a deep ache down into my tibia...

Once I get the knee aspirated I will see my OS two or 3 days afterward. What does this sound like to you experts? Is it loosening or an infection? Either way, does that mean a revision? I am scared and depressed because the thought of that horrendous pain again of a TKR scares me a lot. The only upside right now is that there are no stairs for me to climb. Yesterday I tried to peddle a stationary bike. I used to have the seat setting on #2 height, I had to put it higher to #4 and still could not peddle anywhere close to what peddling should be, and it hurt!

Guess all I can do now is wait and worry...
 
I am so sorry to hear about your bonescan results. It's so difficult to know what to do and impossible to keep from worrying. I had a serious UTI a few weeks ago and was really worried it would go ino cellulitis and then the knee. They could tell from the blood results that the infection the seriousness of the infection, and then later confirm that it was gone.

Sending good thoughts your way.

Hugs,
Dorothy
 
RunA42K,

Ok, first let's break this down. He said he saw "activity" on the bone scan which usually shows up as bright spots. Did you see the scan?

Second, if this is an infection, you will need a top notch revisionist to take over because it will be a late onset infection. Dr. Maale is a pro at those so you have a great resource!

Third, if it is loose, something caused it to become loose, such as something eating away at the cement most likely.

Fourth, don't let OS tell you "you need a two stage revision if that is the outcome!" Dr. Maale does a one stage, and uses the Smith and Nephew HK knee which is every bit as flexible as my other one, and it has taken a lot of punishment and never dislocated.

Fifth, you have a network of friends that are very familiar with this procedure, so if this is the outcome, we will be with you every step of the way! :)

My prayers are with you that this is not infection or loosening, but if it is God can see you through it! Contact me anytime! You know I am always here for you! :friends:
 
Bonnie, I was sorry to hear about your knee---you are right infection is the thing that I fear most---I would have felt the same as you---shock mostly and then fear. There are several ways of dealing with infection, as Sonja has mentioned. I have to admit that since you live in Texas, I would also see Dr. Maale as he seems super competent and so nice as well. Sonja has lived through three infections and she is still here to talk with us. It can be done, although, of course, there will be some down time, which is what an active person hates the most.

It it is loosening, a revision is not as bad as the initial tkr as you don't need the bone cuts. But, I always say to wait and worry AFTER you know what is wrong. if you worry about an infection and it is a revision--you will have wasted some mental energy.

I do think that Sonja is correct though and I would see a revision specialist if I had to have one. If I lived in Texas, I would have to see Dr. Maale after Sonja has raved about him for so long. You will find a way to get through this Bonnie---that is our strength, I had to find a way to get through the open lysis of adhesions and the spacer exchange---did I love it?? NOOOO. Was I happy about the extra rehab??? NOOO But, I did it so that I could remain active and you will too.

Let us know as soon as you hear about your knee. I send good thoughts your way, try not to get too down yet.
 
Aaawwwww, Bonnieeee! Not nice for you.
((((((((((((((hugs)))))))))))))) ((((((((((((((hugs)))))))))))))) ((((((((((((((hugs))))))))))))))
RunA42K said:
if I have an infection does that mean that automatically, I'll have to have this knee redone?
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Sadly yes. And long term antibiotics.
RunA42K said:
If the implant is loose will I need a revision?
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Again yes. Infection can cause bone die back thus causing loosening. But that can also happen without an infection, what they call an 'aseptic' loosening. Let's hope it's just that.
 
Josephine, what exactly is 'aseptic' loosening? What are the actual symptoms of infection vs just loosening?
RestAssured, no I did not look at my bone scan, I am sure that I would not been able to see what a doctor sees anyway. Where in Texas is Dr. Maal? skigirl, yes being active is such a big part of my life. I decided that although I can't do a lot with with legs right now, I have decided that instead of sitting home worrying, I am going to go workout today. I can do upper body and core. If I have to got through this surgery, as least the rest of me will be strong. I will find out sometime today when I go to the hospital for the aspiration.
 
RunA42K said:
what exactly is 'aseptic' loosening
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In medicine, the 'a' in front of a word means that it's the opposite!
Thus asymptomatic means no symptoms, afebrile means no fever and aseptic means no sepsis or infection.
RunA42K said:
What are the actual symptoms of infection vs just loosening?
Click to expand...
They are the same for both. That's why doctors have to run tests so see which it is.
RunA42K said:
Where in Texas is Dr. Maal
Click to expand...
Fort Worth broken link removed: https://dfwsarcoma.com/about/dr-maale.php
 
Bonnie,

Waiting and worrying is the hardest part and so understandable, believe me! When I was in the hospital after the washout and debridement, I "knew" it was MRSA but had to wait 4 days to get the official results. When my OS came and sat on the edge of my bed with tears in his eyes I knew. It was something I didn't want to know and depression set in for a while. No matter if you are ready for something or not, life throws curveballs. Your husband has come through so much! Let him be your inspiration right now! :yahoo:
 
Well, so far no scheduling for the aspiration of my knee. They say that the radiologist needs to see an X-ray of my knee to see if he can even do that. So they are waiting now, contacting the doctor so they can supply my X-ray.

Another thing I forgot to mention was that over the Christmas holiday I had a big lower molar (#19) start hurting me. I could not get in to see anyone until after New Years Day. Turned out to be a tooth that had a root canal in 2010. They did another root canal on the same tooth after I took antibiotics for about a week. When I was supposed to come back one moth later in February to have the permanent filling put it, it was hurting again. They referred me to a periodontist thinking that the root/tooth was cracked below the gum line. I had to wait until March 22 , when they extracted the tooth because it did have a crack in it. So for the better part of 4 months at least, I had this cracked tooth that was letting bacteria seep into my blood stream. I wonder if this could be a possible source of infection???

Looks like I need to change the title of my thread...I don't run, I can no longer pedal a bike...but I can do weights, sit ups and push ups!
 
Bonnie---what a bummer---and the story of the tooth makes my blood boil---why didn't your dentist put you in as an emergency since you have a tkr? Grrrr Sometimes people refuse to use their brains.

The waiting has got to be the worst. I would do what you are doing also in the gym, it helps me to work out. Also, if you have access to a pool, you can put on a belt and "run" in the pool. It is a great workout and feels good.

I am also active and faced with the second tkr, I decided to do some things I have always wanted to do--so I began to knit--took a little course at a yarn shoppe. I work in my studio, but I planned some hand sewing into my life so that I had something to do while sitting. Also, I stocked up on dvds---some of them artist things and some of them like Downton abbey. I enjoyed all of the above---it opened some doors for me. Kelly
 
Almost 7 pm now and no one ever got back to me on scheduling the aspiration. Why do people take so long? I guess as long as they are not having the problem there is no rush! Maybe I will hear something tomorrow which is Friday and if not, then wait all weekend wondering...

Kelly, I thought the same thing too about the dentists. Actually it was on Endodontist who did the two root canals on the same tooth. When I left his office with him telling me I'd have to see someone else I was already having pain and actually had to ask him for an RX for antibiotics. By the time the Periodontist saw me, the pain was gone because I was taking the antibiotics. When they said they could not take care of me until March 22, I asked about antibiotics until that time. I was told, don't worry, we will call in all your meds before your procedure, but if I started hurting again before March 22 to give them a call. Well I was not hurting on March 22, but all that time I did have a crack in my tooth which was brewing another infection no doubt. I took antibiotics for two weeks after they extracted my tooth.

I did workout for 1 1/2 hours this afternoon with weights for upper body and core as well. I did feel better for doing that but I almost decided to come home and sit in a chair instead. I am glad that I went!
 
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