Newbie to the Forum! Hello All!

[gloucesterman]

Well I am new here but like many not new to knee problems! I had an Oxford knee device implanted less than one year ago and have had all sorts of problems. Firstly I developed stress fractures under the tibial implant and now have been told the tibia implant has moved and the femoral implant was never installed correctly in the beginning. I have had several opinions and all agree that I have no choice but to have a total knee revision at this time. The problems are so bad that the implants are causing more damage to the tibia. In my searches on the net I cannot find any comparisons between the different products that are avaliable. I have found such companies as DuPey, Zimmer, Stryker, Biomet, Smith & Nephew to name a few. My problem is which one to go with? Each surgeon is trained in only one or two so they will sell the one they work with only. I am hoping to get some info from the folks that have them and hear what they think. Initially I was a perfect candidate for the Oxford and am very dissappointed at the outcome. Sorry to say I cannot give details about the cause of the stress fractures so please bear with me on that. I am 56 yeras old in great shape thin so my weight is no issue. I am a former bicycle racer and have worked out my whole life. My concerns are ROM, rotational abilities and longevity of the implants so let me know what you all think. I have another appt Monday with a revision specialist and would GREATLY appreciate any info you can share with me.
Good Health To All!

gloucesterman

 

[ttlncsc]

Hello Gloucesterman,

I am 6 weeks post op from a rt. knee replacement. It has been a significant journey with ups and downs. Everyday brings minor improvements.

I have a significant medical background in medical-surgical sales and vascular medicine (30 yrs +). My science background and being across the table from hundreds of physicians has served me well.

My advice is find someone in your area that does the most knees. Someone that specializes in knee and hips only has the volume to not have any learning curve issues. If there is an orthopaedic specialty hospital near you, even better. To my knowledge there are no studies that show one brand of knee is better lasting than another. Most MDs use the brand that they were trained on or the brand that gives them the best service. Gone are the days where guys will let a vendor significantly entertain them for a hunk of business.This is where the detective work comes in.

You have a more unique situation due to the fracture and redo issues. You might want to check and see if you can find someone who has significant redo referral practice. Someone that does >100 knees per year was a target of mine. My MD does over 200 and only does knees and hips. His practice also has a significant PT/rehab area in several locations. I felt he and his team would make the difference.

Visit a hospital and talk to the nurses on the knee floor. Talk to the physical therapists. Be nice and hand them a pack of cookies or some fruit. Tell them what you are trying to find out. Generally, a healthcare professional will let you know who they would want to work on them or their family. Explain that you are not interested in anything other than an honest professional opinion and your best chances for a great outcome.

I discussed several knees with my MD. He routines uses a DuPey knee. He likes the design and the rotation feature that he feels will add to function and longevity. He would have used the other knee I discussed but after talking with some friends who are ortho guys in other states. The recommendation was go with brand comfort and recommendation of the doc.

Honesty and frank discussions should lead you down the right path. MDs in this field are outcome focused.

Hope this helps, Tom

 

[gloucesterman]

Hi Tom, I am located in Chicago and will be seen Monday at Rush Medical Center by an orthopaedic revision specialist. Rush is rated in the top twenty hospitals in the US and there Ortho Dept is excellent from what I gather, but after my recent experience I am rather gun shy to say the least.
Thanks for the reply!

gloucesterman

 

[Josephine]

Hi, gloucesterman - for a moment there, I thought that must mean you came from the UK!

I suggest you read my post How to choose a surgeon and a prosthesis which gives this very advice.

Personally, I don't think you should worry overmuch about which prosthesis. They're all pretty much of a muchness, having been tried and tested and all seem to be giving around the same results both in the short term and the long term.

You said the significant thing: "The femoral implant was never installed properly in the first place." That is the biggest and key thing. No implant is going to perform well if it isn't inserted properly. The vast majority of failures are due to faulty technique, pure and simple. Same as infections are due to transgressions of aseptic technique somewhere by somebody.

So choose your surgeon with care - as it says in my post, he needs to be doing at least 5,000 knees per year! In your case he should also be an acknowledged revision surgeon. Revision is a speciality all of its own. Do not go to a surgeon who only does primaries or who just does a few revisions here and there. You need someone with proven expertise.

Actually, the Oxford is a great knee and has stood the test of time very well, though it has had many reincarnations over the years as they all have. I can promise you that it's failure would be most unlikely to have been the fault of the prosthesis itself but to poor surgical technique when it was implanted.

 

[gloucesterman]

Hi Josephine, Thanks I found your article just after my rant above, and made a copy of the questions also!! Perhaps I should have said I was from Gloucester by the sea aka The Perfect Storm! The captain of the Andrea Gail (Billy Tyne) was a friend of mine when I was living there. I went swordfishing also in the summer months and then went tub trawling for groundfish in the wintertime!
ANYWAY Thanks and hopefully I will have a positive meeting with the specialist I am seeing Monday. What a bumpy ride!
Gloucesterman

 

[JudyS]

Jo,

I thought the same thing and of course my eyes went right to the OXford!!

Welcome Glousterman (I know I got the spelling wrong) Good Luck on your apt.
Judy from the hippies