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

Your recovery is incredible - I'm so happy for you. And yes that was our ship coming back a day early because of the norovirus. Fortunately, no one in our group got sick, and we had a great time. The knee seemed to hold up fine, we went on a couple of excursions which involved some hiking and I neglected to put on walking shoes, so suffering from a very sore, blistered toe and my whole right leg is swolen, but other than that I am very happy with my 11 month old knee. Could never done the cruise, much less the hiking a year ago.

Dorothy
 
So once again you people who are reading this...if you have a TKR that hurts for too long, you feel something is not right, you never seem to completely recover, then please go get a second opinion from a revisionist.

Oh Bonnie, what to do, what to do. I am nearly at the one year stage and I don't know what to do for the best. If another person could feel what I am feeling, perhaps they would say `you're fine, what's the problem'. Its a situation where my knee is not all that bad, but neither is it all that good. The hardest part of all is that walking is uncomfortable. I wont go into more detail I've done that previously on my thread. The advice I've been given is go back and see the OS. But I think he will say `everything is fine give it more time'. If I go for a second opinion from a revisionist he might say the same, or he might say I need a revision (when all people are selling is melons, they offer you melons). I am terrified at that prospect of needing more treatment. I just keep hoping time will do the trick.

As you have had such a wonderful experience from the revision, I imagine you would say go get the second opinion. But what if I did have a revision and it was WORSE than it is now - no two people are the same. I guess I have nothing to lose by just TALKING to another surgeon???????? Carol
 
Oh Bonnie, what to do, what to do. I am nearly at the one year stage and I don't

As you have had such a wonderful experience from the revision, I imagine you would say go get the second opinion. But what if I did have a revision and it was WORSE than it is now - no two people are the same. I guess I have nothing to lose by just TALKING to another surgeon???????? Carol

Oh Carol @patient 99 , I do feel your pain and frustration. You are right, no two people are the same. I started going back to my OS at about 11 months post op, I started my backward spiral. He would always say "everything is just fine" he'd take an X-Ray and tell me my knee was perfect. I kept believing in him because I needed too. But I kept going back for a year and a half, less ROM, more pain. He always dismissed me as everything was fine, go have more Physical Therapy.

So at 2 1/2 years I finally listened to my husband who all along kept telling me, "something is not right, you need to see someone else." In my heart I knew he was right all along, so I did go to see another OS. When the doc said my knee needed to be redone, that 80% guarantee he could make me better than I was. But said that is was my decision and did not pressure me at all. Our appointment was done, he left the room saying think about it, no rush and if I decide to go ahead, just call the office to schedule.

I was scared to death, I turned to my husband who said "80% is pretty good odds." He said, come on...you can think about it, let's go home and you can always call back." I didn't get up, I sat there with my eyes welled up with tears and told him, "My TKR was the most horrible thing in my life, I never want to go through that pain again...but I have to do it. I can't live the rest of my life the way I am now." I couldn't go up and down stairs, could not walk on grass, could not pedal a bike. I could not walk for any reasonable length of time (like grocery shopping) with out pain and the limp getting worse. My ROM was getting so bad, I was finding it difficult to put on my socks and shoes, I could hardly reach my foot. When I'd stand from a sitting position the initial weight bearing was incredibly painful until I got moving, but even moving, not pain free. So before we left the doctors office, I scheduled my surgery.

I didn't know if it would work, I worried I'd be like this forever but I knew I could not stay like I was forever either. It was a quality of life that I wanted back so I had to take the chance. So 2 years 8 months after my original TKR, I had my revision. You know the rest of the story...it was a night and day difference from the first TKR, I kept waiting for the horrific pain but it never came. ROM leaving the hospital with the first knee was 52 degrees, ROM leaving the hospital with the revision was 90 degrees. I've never looked back, it was the best choice I ever could have made for myself. I could now say..."So this is how it was supposed to be!"

Only you can make that choice, maybe you need more time. I was in denial for a long, long time, thinking it was me, not trying hard enough. You just have to ask yourself, "Can I live the rest of my life the way I am now, do I want to live the rest of my life the way I am now?"
 
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You know the rest of the story...it was a night and day difference from the first TKR, I kept waiting for the horrific pain but it never came.

Thank you Bonnie. Just one more thing. Could you tell me what a revision actually involves? I'm assuming they have to remove the original hardware and replace it with something else. I imagine they don't have to saw your leg in 2 places like the first time. But I have read that getting the original prosthesis out can be difficult because its all covered with organic matter, and that this can once again disturb nerves and can lead to a build up of more scar tissue. Did they say recovery is generally shorter with a revision? Carol
 
@patient 99 Yes the revision is taking out the original implant. Of course I was sleeping but was told it came out without any difficulty. No they do not have to saw your bones off again (probably why there is less pain) but they will smooth the surface again with the saw (I think the saw, I watched a You Tube video of removal) to be ready to have a clean, smooth fit with the new components. Recovery is pretty much the same time wise, incision healing, achieving ROM etc., no one ever said it would be shorter, but in my case with less pain and more ROM right from the start, my recovery is indeed shorter. I asked my doctor about scar tissue while I was in the hospital and he was not worried about it in the least bit even though I'd had a problem with scar tissue before. As far as organic matter, I've not even heard of the before. Both the OS and his assistant assured me that taking out the implant was quite easy and didn't worry that there would be a problem. My surgery took the same length of time as my TKR. My scar is just longer, but who cares??? I have a good, functional, pain free knee! Everything was just such a pleasant surprise!
 
@patient99

Hi Carol, I'm, jumping on Bonnie's thread to talk about revisions, too. (Sorry, Bonnie!).

I had a partial (PKR) revised to a TKR, so it did involve some bone cutting.
My PKR failed suddenly when the plastic spacer between the metal components broke. (That's a very rare thing to happen, so don't go worrying about it.)

By the time I had a surgery date, I had been on crutches for about 6 weeks and, even though I tried not to put any weight on that leg, I had had the metal components rubbing on each other. This resulted in little metal filings at large inside the knee.

As well as cutting the bone to fit a full prosthesis, the surgeon had to clean out all the tissues affected by the metal filings. In spite of that, the operation took no longer than a normal TKR.

Nobody told me that recovery would be quicker. As I remember, it took about the same length of time. However, my second recovery was much less painful, because I had found BoneSmart and I followed the mantra.

Like Bonnie, I have a great result from my revision!

@RunA42K I've followed your earlier story and I'm thrilled that things are going so well for you now. :dancy::yay::happydance::spin:
 
Like Bonnie, I have a great result from my revision!

Thanks Celle. When I last saw my GP she said I must give it a year. My year is nearly up. I don't know which way I will go at present, but your input will make my decision a lot easier. Who knows the next 3 weeks to D Day might make all the difference. If this sounds like a touch of denial its because it is. :what:
 
@patient 99 ,
Like you I have had a difficult painful recovery, I obtained 3 second opinions about 9 months after my surgery, they all said pretty much the same thing, wait and see it will get better. I selected the closest OS (30 miles) to take over my care. When I saw him in October 2013, told him about my painful knee, he started ordering blood tests (negative) and a bone scan (tons of inflammation). He recommended revision. He has a new partner, a well known revisionist from San Francisco, I asked for a second opinion from him. He did an even more through exam and recommrned either a knee brace, or a revision for my loose knee. I have opted for a revision and will be having one on April 15th.
Am I scared, yes, and relieved at the same time that I finally have an answer to my pain.
I think what all of us are saying is get a second opinion, from what I have read here the recovery is about the same for the revision.
Good luck in your search for some answers,
 
Like you I have had a difficult painful recovery,

I wanted to read your thread so I could find out what went wrong that required you to have a revision, but I couldn't find your thread title (just the thread titles of people you had messaged). Could you tell me what it is. Carol
 
@patient 99 my doctor said that sometimes there is no definitive reason that a knee fails, but if the TKR is swollen, stiff, painful, loss of ROM are all reasons for a revision. You don't have to have all those symptoms but in my case I did. I just kept waiting for when I'd get better, but I never did. The obvious reasons of course ARE infection and loose stems. Neither of those affected me. I too went through bone scan, knee aspiration, CT scan,then a scope surgery for scar tissue. All my tests were negative except that I had lots and lots of scar tissue removed. Just my conclusion...after the doctor told me that my components had too much side to side movement and was sloppy and my biggest source of pain was on the medial side, I think that, my first knee continually irritated and inflamed the soft tissues, thus, swelling, pain, scar tissue and loss of ROM.
 
@Celle, please don't worry about jumping on my thread, not at all. We are talking about revisions and both you and I had one, Carol @patient 99 wonders if she needs one, and @Pumpkln is going to have one. If we can be of any help it's fine to be right here.

Also Caryl I watched several You Tube videos of implant removal prior to my revision and there was one with the metal that was shredded off into the soft tissue. Might be interesting for you to see. I know that some people can't look at that stuff, it doesn't bother me, I wanted to know what was going to happen to me.
 
Took me two hours to catch up with you, Bonnie! Glad to see your progress and your happiness with the outcome.

Hugs.

Well thank you so much @PooShay for spending two hours with me. Come back more often...you are always such an upbeat inspiration!! Yes, I've had a good revision for sure, but still have work yo do. Ironically the past 3 days my non TKR knee, the left has been hurting me more than the revision knee. Oh Lord...please not again!!!
 
I watched several You Tube videos
Hi Bonnie, don't know why it didn't occur to me to watch You Tube revision videos - particularly as I watched several on TKR. Anyways I have now. Couldn't make my mind up if revision looks even worse than first time round.

What did strike me as odd. You know that tight band feeling that is so common and which I still have, when they were putting the knee back together there was nothing which looked like it could cause that phenomenon. Sometimes the more you delve the more confusing things seem (I've read the article in the BS library).

I did quite a long walk today. No pain (as we usually use the term), but my knee is very tight/stiff on the inner side - it just refuses to loosen up. Anyways will start to set things in motion with GP/OS if no improvement by 22 February.
 
Hi Carol, @patient 99 I too ALWAYS had the tight band feeling for the entire 2 years and 8 months, it never went away, most of my worst pain was on the inner/medial side of my knee. Now after my revision, I don't have that, don't have the tight band stiffness, it's just amazing!! I peddled the bike at Physical Therapy today, no problem. They also gave my God given real knee some attention too. No doubt too much compensation for over 3 years!!
 
Of course I am not there yet, Physical Therapy continues to achieve more ROM, but incredibly I am totally pain free already!! :egypdance:

Hi Bonnie....I've been lurking here for over a year, but this is the first time I've come out of the shadows. I'm very happy that you seem to be having good success with your revision. I'm particularly happy for you that you are pain free.

Frankly, reading your story caused me some concern about whether or not I wanted to go through with a TKR on my left knee. In the end I went ahead and had my knee replaced on 11/11/13. My experience to date has been as positive or more positive than any other account I've read. I do not credit that to anything other than perhaps a really good surgeon and luck.

My surgery was performed on a Monday and I was released to return home the following Thursday. I saw a PT in home the Saturday following my surgery and by that time had already spent short periods riding my recumbent stationary bike. When the PT saw me ride the bike he was very surprised. The rest of my recovery has pretty much gone the same way. We went to Hawaii on January 22nd for a week where I participated in a 15 mile bike tour and did some light hiking and crawling over lava fields. For the past five weeks I've been walking on a treadmill 1.6 miles (30 minutes) and riding my stationary bike 6 miles (30 minutes) daily. The last time my ROM was measured it was at 135. That is the good news.

I'm not totally comfortable and while I feel good when walking or on the bike, I do have some aches if I have any twist or side loads on my leg. When folks ask me how I'm doing and I honestly I describe how I feel they just say you're doing really great quit your complaining (note to self: do not provide too much detail in the future when people ask). As long as things are pointed in the right direction and aligned I feel fine, but cross my legs or get some twist and I know it. I also have some discomfort climbing and descending stairs over my kneecap extending up into my quad. I do not have any bone or joint discomfort, it is all soft tissue pain. I'm wondering if you or some of the others can tell me if this is normal or something to be concerned about. Like I would say to my PT when I had a question this may not be your first rodeo but it is mine. I've run out of insurance so PT is over for me and now I need to find answers else where.

I really hope you have all your expectations met as you recover and get used to your new knee!!!
 
@Mtnrick
I hope Bonnie won't mind if I give you my 2 cents on her thread(which is becoming like a "local thread" coffee shop) .

I had side ways and twisting discomfort for a good 6 months and even today I am not surprised if i feel something when I move my knee a certain way. It used to happen when I would be getting into the drivers side of my pickup and would pull my left leg in last. It would also happen when I would move my leg across the mattress in preparation for getting up. Not every time but perhaps half the time. Over time however the amount of discomfort and the frequency dissipated and now I can't recall any recent events. My Dr in November said that in general the soft tissue problems can easily take a year to resolve so I would not be too concerned. I have no other pain when hiking which used to be impossible or biking which has never been a problem.

Your recovery sounds like it is doing well so one key as you probably know is not to overdue and keep the elevation and ice therapy at the ready. Also unless advised otherwise I would keep your strengthening and stretching program in place for a while as this will help the soft tissue and I would keep working on muscle strength until you have it back to normal if possible. If you get any new persistent pain have it evaluated.
 
Patbike thanks for taking the time to share your experience, I appreciate it!! I understand your comment about getting into your pickup truck. I have a pickup and if I don't remember to have the seat all the way back, getting into it can get painful swinging my leg in. I am not able to open the door all the way in my garage and it makes it pretty hard to get my leg in without dragging my toe across the door and door frame. That is the kind of thing that reminds me I'm still healing.

I'm fairly confident the soft tissue issues will go away over time, but I am a little bit of a type A kind of person so waiting for it or not knowing what to expect does not sit well. Your comments are well received and appreciated.

BTW I hope Bonnie doesn't mind that also I asked others for their knowledge. I'm not up to speed on the local protocols.
 
@Mtnrick @patbike Please don't give a second thought to asking questions and replying on my thread, we are all here to help each other, so it doesn't matter where that help is.

As far as soft tissue recovery, that is something I never experienced with my first TKR. Not a day went by in 2 years and 8 months that I didn't have soft tissue pain, thus that was in part to my needing a revision. As for now I am still a work in progress with soft tissue healing. Right now when I have soft tissue pain, it is on the medial side of my knee which occurs just like you said with some twisting and with moving my leg stretched out in bed feels uncomfortable...it's those lateral movements. I know it will all be ok in time, I am just 9 weeks post op so I have a ways to go yet.

With the beginning of my recovery being so good, the best will just keep on coming. I worked today for 6 hours and 40 minutes, then went to the grocery store and I have NO knee complaints of any kind!! Yesterday I peddled the bike at Physical Therapy and that makes me very happy. Tomorrow is another Physical Therapy day so I'm looking forward to peddling that bike again!

Btw @Mtnrick...Welcome! Glad that you stopped lurking and joined in... and,:thankyou:for reading my thread!
 

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