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

Bonnie, have you tried Lymphatic massage? Something makes me think you have already done that too.

I felt really bad about having the spacer exchange and open lysis----but, I am glad now that I did it. It was hard, I won't lie to you----where as I was gung ho with rehab for the two tkrs, I was Oh no, not again for this last surgery. I complained and complained---feel free to vent to me, I owe the universe some listening!!!
 
Bonnie, so sorry to hear that the scar tissue removal has not resolved problems with yoour knee. Is it possible your knee has been sliding from side to side all this time and caused your problems. Hang in there, we know you are strong, and keep us posted.

Hugs, Dorothy
 
turtle68 Dorothy, some things are beginning to make a lot of sense now. I have ALWAYS, ALWAYS had pain on the medial side of my knee. We used to think it was tendonitis, I used to get patches of dexatethone for it. It has always felt bruised on that side. Occasionally I feel like I am being pinched underneath the skin and if I move my knee just a certain way I get a sharp pain. My knee has NEVER not been swollen since my TKR, never been without pain. So yes, I wonder now with too much side to side movement have been the source of my pain on that side of the knee. I'll keep you updated.
 
Sorry to hear about the revision. Hopefully this will do the trick for you. I know you have been struggling to get answers and that is sometimes the toughest part of it all.
The side to side issue makes a lot of sense. How did he figure that out (when the other doctors did not?) Was it in the way he manipulated it or something else?


On another note: It was funny to me when you said, "I don't mind driving 30+ miles in all that traffic to the medical center at all. At this point it is about the right care and connivence means nothing to me now." When you live in Maine, it seems like almost everything is a 30+ mile drive- and what we call traffic would seem like nothing to others. When I was commuting to school from camp it would take me over an hour and one day I literally saw only 5 cars the entire trip. The only traffic that day was the wild turkeys, some deer, and a couple of moose :)
 
Coachie Hi Coachie, it is so good to hear from you. I have been thinking about you a lot lately and I was going to find your thread this weekend and write to you. I remember very well how you struggled with pain and could not get doctors to pay attention to it, until finally one took you seriously. I totally understand now what you went through.

As far as figuring out the side to side movement in my knee...my first doctor who did my TKR would not take me seriously. I went to see him numerous time during a 15 month period asking why does my knee hurt and why am I losing my ROM? He never took me serious, each and every time (which was many) I'd ask if it could be scar tissue? Each and every time he would reply, "That is highly unlikely" and tell me to go do PT. I've basically been doing PT for 3 years now.

So I found a new doctor that was recommended to me by a TRK patient here in Houston who described the exact same problems I had. Scar tissue which was not taken seriously for her either, until she found Dr. David Lintner. Dr. Lintner removed her scar tissue, she's had a revision too. So I saw Dr. Lintner and he immediately told me he could feel the scar tissue as soon as he put his hands on my knee. He did the surgery to remove it 8 weeks ago. I thought that this was going to be the fix for me but no such luck. The scar tissue surgery was a good thing, don't get me wrong. It has loosened up my knee from 85 degrees to 100 degrees so I am a little more functional. He said the scar tissue was the worst he had seen, in every section of my knee and wrapping around tendons. Since he is not a TKR doctor he referred me to Dr. Incavo.

Now, how did Dr. Incavo figure it out? Well when I had all the scar tissue everything in my knee was wrapped up tight like a drum. If you tried to wiggle my knee around, nothing was moving because it was intwined with the scar tissue. Now...having a scar tissue FREE knee, it was easy for Dr. Incavo to actually manipulate my knee in different ways because it had been freed up so to speak. I have ALWAYS had pain to the medial side of my knee since my TKR. It was dismissed as tendonitis. It has always felt bruised, I get a sharp stabbing pain if I move my leg in a certain way, something that can be as basic as standing up from the toilet. Walking for any length of time like "from one side of Costco to another" that side of my knee stiffens and hurts in the walking motion. Sometimes I feel like I am being pinched on the inside in there. It all makes sense now. My TKR is sloppy in the mechanism moving side to side way more than it should and not enough back and forward motion. It is solid in the bone , the implant itself does not work properly. So taking out the scar tissue gave my knee the space to move now and this is how they figured it out.

Never stop looking for answers people...there is an answer out there for you!
 
Coachie btw my 30 mile trip to the medical center takes 1.5 hours too, but that is because there are 100,000 cars!!!
 
Hi Bonnie, I haven't posted in a long while, but have been following your thread. and I am happy that you have finally found a solution. I also was simular to you in that I had pain on the lower part of my knee for about two years,kept going back to my OS,who took xrays and said all was fine. After many times going back he then said pain was referred from my back. After being referred to a phyiatrist and doing MRI and bone scan, she sent me to a revisionist, who took different angle xrays that immediatly showed my tibial implant was loose. He did my revision, (long surgery) almost 15 months ago. He did not want me to do Any PT for the first 3 wks, believes in letting the knee heal first. I did the ankle pumps, gentle heel slides and gentle stretches, and started PT in the 4th week., which went very well, no pain, no swelling. I also used ice and elevation all the time I was down, and did lots of walking for short periods. He believed just like the bonesmart mantra!! I am much older than you and not an atelete, but I do feel great and my ROM is exellent 130+/0.
Wishing you the best with your revision! Will be praying for you.
 
Oldie Wow Oldie you don't know how much I appreciate you writing to me. I guess it's normal to question yourself so hearing other peoples stories really lifts my spirits. Your ROM of 130 is excellent! I forgot to mention before but you reminded me. I was told I should see a pain management doctor and also go to counseling. This by a doctor who suggested that my pain was psychological. We have to keep seeking answers and not be pushed aside by doctors who don't want to bother. Thank you so much again for writing to me!
 
Orthodoc Hello...I found out from my surgeons PA that my doctor would be using the Stryker 6 bearing knee for my revision. I asked does it have a name and she replied it is a Stryker and and it has 6 bearings. I wondered if you knew which Stryker knee this was? They all have names and I'd just like to read about it. I guess that there are components for just revisions rather than what would be used for the first TKR.
 
Yes, the components used for revisions are frequently different than from primaries. In many systems, the surgeon may be able to use primary components for one part and revision components for another part. Other systems will use all revision components. There are several different levels of "constraint" among revision components. The use of these will depend on the available bone stock and the condition of the ligaments.

I am not familiar with the Stryker "6 bearing knee." Here is a link to Stryker's website discussing their revision options. I have some limited experience with their triathlon knee, but have never used their revision equipment so I can not give more comment on their particular system.

Orthodoc
 
Bonnie, is your Dr. Stephen Incavo. He's in the Chronicle this morning. He helped the 91yr.old wife of a late TX senator by replacing a 14 yr.old him implant and reconstructed her pelvic bone. It's in the City and State section. It sounds like you've found the best.

Dorothy
 
turtle68, Yes Dorothy Dr. Stephen Incavo is my new doctor that will do my revision. I feel very confident with him.
I am working today but sent Dave a note to save the newspaper for me when I get home later.
 
Sorry, I have not visited your thread to lend some support. I too had the scar tissue issue. I really did not feel that I was in the clear until 3 months after my arthroscopic clean out of scar tissue (at which point I reached 110). My ROM is good now (130) although I have excess laxity in my knee. I think you mentioned you had some laxity as well. I hope your next chapter goes well. This arthrofibrosis does result in extra pain and heat. It will be important in your next recovery to beb extra BS mantra careful. Arthrofibrosis thrives on inflammation. Something to ask about maybe is the use of radiation post op for adhesion control. It's being done in a few places but I have not heard any reports on how effective it is.
 
Thank you maryo52 I certainly will be asking about the Arthrofibrosis because if there is anyway to avoid that again, at least now they take me seriously about scar tissue and don't just tell me that " That is highly unlikely." . As far as Physical Therapy and adhesions thriving on inflammation, that too I will discuss in great detail as to what he wants me to do in Physical Therapy. None of my other doctors ever stated anything to do or not do, they just wrote RX to have Physical Therapy. While my new doctor Incavo believes in being strong before the revision, legs, upper body and core which I do now and I'll continue to do 3-4 days a week, he also gave me a list of specific things NOT to do to give to my Physical Therapist. I'd say that him doing that is a real good start.
 
This is a must read: broken link removed: https://www.kneeguru.co.uk/KNEEnotes/courses/arthrofibrosis-rehab-tutorials-dirk-kokmeyer-pt-scs-comt/principles-arthrofibrosis

I used this info when I ditched PT and designed my own rehab after my arthroscopy -- having observed that PT didn't help (and now I think they set me back although their heart was in the right place).

There are also tutorials on arthrofibrosis on there by Dr. Noyes. https://www.kneeguru.co.uk/KNEEnotes/courses/arthrofibrosis-12-part-course-frank-noyes-md/tragedy-arthrofibrosis-part-12-course

The problem as I see it is that the medical world thinks linearly (beat arthrofibrosis by outrunning it). But arthrofibrosis doesn't behave in a logical way. I had to walk a fine line between stretching each day and doing enough of nothing.
 
Thank you maryo52 for the links that your sent me. I just read through the first one that they say is part one, however the second link will not open for me saying that it is not a valid address. Could you possible reverify and send to me again?

Thanks you! :puppysmooze:
 
Down at the end of the Part I text, on the right, it says "Patellar Mobilisation (Part 2 of . . ." Click that. It worked for me just now.
 
Thank you maryo52, I've read through the entire parts 1, 2, 3. Sure makes a lot of sense. Actually it gives me more ideas for questions to ask my doctor.

It was days like yesterday/last evening/sleeping overnight that I wish I didn't have to wait till December 2 for my surgery. Just as much as I dread going through the pain of the surgery again, I can't even imagine the thought of living indefinitely like I am now. It makes so much sense now with the medial side of my knee hurting all the time. Had to take a pain pill just to go to sleep last night. But my Mom's visit for her 90th birthday is most important, she'll arrive November 12 leave on November 19, no surgeries being scheduled for Thanksgiving week so that puts me at December 2. My Mom (who gets around better than I do) is worried that her visit will be hard on me. I'll just fake it and take her to shopping, lunch, etc. and make sure she has a wonderful visit!
 
I HEAR YOU!! I had a 92 y.o. mom in my life when I had TKR. My recovery was horrid and I faked it. She constantly asked about my knee and I would sing-song that it was fine, and it was not for quite a while. (And during that time I begged for siblings to come help to no avail.)

I will tell you that my arthrolysis was Feb. 23, and somewhere around May 20th I decided to take a little trip. I had about 110 ROM at that time, and part of getting away for me was getting away from my knee routines. It was delightful, and I never resumed knee routines except earlier this year to get my quad up out of its deep sleep. And a wonderful thing happened back then after May 20th, which is the pain nearly went away. So I would recommend, seeing that you're not gaining ROM and due for revision, why not knock off the whole she-bang and do your best to enjoy life? This might lessen your pain, and who knows, maybe your knee will like a good long vacation.
 
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