TKR Not quite 3 weeks post-op

[Jamie]

I'll tag @Josephine for you.

I agree that you might take a rest from anything but the stretching exercises for a week or so and see if things improve. Has your surgeon mentioned an MUA?

 

[NewMoM]

My doc wants to go beyond MUA. He wants to (this is really going to lack technical finesse) 'shave down' the plastic pieces in the joint, so it can move more freely. I'm certain he'll also manipulate it at that time. My PT thinks maybe the joint used is too big and that's why he's talking about revising it. Anyone have any experience/advice there?

Also, mostly all I'm doing now is stretching. My PT has stopped going so hard because it's obvious it isn't getting us anywhere.

 

[Tamsmom]

Wow NewMom, that sounds tough but in the end you can't have a too big of door knob ( I mean joint) in your body! Best if luck to you!


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[Jamie]

Let's see what Josephine has to say about that recommendation. I've know of surgeons who go in and exchange the plastic insert in rare cases, but have not heard of anyone "shaving down" and existing one.

I need you to create a signature that includes your surgery date. To do this, mouse hover over your username at the top right of the screen. Choose Create a Signature from the drop down menu. This way we can easily tell how far out from surgery you are when providing advice.

As I calculate it you are about 2 months out. I'd say it's way too soon to do any invasive surgery on your knee. In fact, we usually tell patients to wait longer than that for an MUA.

Also, are you doing exercises for your extension? It is usually the most difficult movement to regain and it takes time. These are gentle passive things you can do daily to help your knee straighten.

If I may ask, where are you located in the US....city and state please? And can you tell me where you had your surgery done?

 

[NewMoM]

You're right, 2 months today. I did the signature.

I'm not excited about having anything surgery, but PT and OS are telling me it's not going to fix itself.

The thing I do the most is lay across my bed with my leg hanging off...hoping gravity will pull it down. At PT we add weights and work it more. Most of the time at home, I try to not push it as hard, just looking for consistency. My OS wants me to sit in a straight chair (kitchen type chair) and put my leg on an identical chair and sit that way. I was supposed to start with 5 minutes every hour. I can't even make it that long. Too painful. It really makes the sciatic pain come back in a hurry too.

I live in Overland Park, KS (suburb of KC), and had surgery at Overland Park Regional.

 

[Jamie]

Well, since I live in Kansas City too, now I'm curious....who was your surgeon?

 

[NewMoM]

Dr Stitt. He's really good. I've went to him for years. He's won awards, came highly recommended. But I can't help but wonder if something truly is wrong..
I think I mentioned before, but now I can't remember...my PT thinks my joint may be too big. I don't know. I just know that I'm basically in the same place I was 2 weeks after surgery and not getting better at all. I'm not trying to blame him. I just want to be better.

 

[skigirl]

I think Jamie is going to be the one to help you the most since she is also in Kansas City---I will tell you though that I had the spacer exchanged in my knee---in my case for a bigger one and it was not as bad as the original surgery at all. and, it did make my knee more stable.

Was your leg bent like this before the replacement?

 

[NewMoM]

I know someone that had TKR 2 weeks after mine and she's in great shape. Back to work, not even using a cane, better than ever. I think I'm going to see if I can get into her doc for a second opinion. I'm REALLY glad to hear the second surgery wasn't as bad. Of course, I know they will manipulate it too, so that'll add some pain, I'm sure.

My knee would go to about a 20 before I did pre-op PT. We got it to about 8 regularly. So, not totally straight, but nothing like this. I could walk before. Now I can't on my own. My OS also made sure it would go totally straight in surgery. I woke up with an immobilizer brace and my leg totally straight. That changed as soon as we took the brace off so I could use the restroom, though.

 

[Josephine]

I was going to answer your replies to my questions but other comments have made that redundant as you will see!!

My doc wants to go beyond MUA. He wants to (this is really going to lack technical finesse) 'shave down' the plastic pieces in the joint, so it can move more freely.

He cannot and must not do this. Plastic implants are not shims to be trimmed and adjusted. They are carefully moulded and made with a near perfect finish to prevent particles becoming free floating within the joint and causing problems. On no account must they be used if even scratched much less shaved down! The very thought! If the plastic is too thick - a very real possibility in my opinion - then it needs to be exchanged with the next size down.

My PT thinks maybe the joint used is too big and that's why he's talking about revising it.

I quite agree.

My OS wants me to sit in a straight chair (kitchen type chair) and put my leg on an identical chair and sit that way. I was supposed to start with 5 minutes every hour. I can't even make it that long. Too painful. It really makes the sciatic pain come back in a hurry too.

Exactly so - another reason to suppose the implant may be too big.

Dr Stitt. He's really good.

Oh really? All evidence to the contrary in this case.

He's won awards, came highly recommended. But I can't help but wonder if something truly is wrong..

And I think you are right to suspect this. In fairness to Dr Sitt, even the best surgeons make errors. They are after all, human beings.

But the final conclusion is that you a) need a second opinion and b) quite likely need a revision. Although I would also add that to be in this much pain and such at 2 months out is not good. Something's amiss.

 

[NewMoM]

I even asked the person that was with me in the office when doc said it....without her seeing what I typed, she said he said they may need to be 'shaved down'. Maybe he was putting it in layman's terms for me, but that really is what he said.

I have asked my friend for her OS's info that she had such good luck with. As soon as I hear back from her, I'm calling. Something has to change. This isn't going to fix itself, I feel.

 

[referee54]

Before anybody goes in and does anything, I agree with the idea of getting a second opinion---possibly a third one, too.

I certainly would get an OS who specializes in revisions to look at your knee and the pictures as well as the surgical notes. If you do need a revision, it is paramount that an OS who specializes in them takes care of you.

 

[NewMoM]

As an update...I've been given the names of 3 great OS's. I've called all 3 to set an appointment for a second opinion. Not asking for them to do anything but talk to me at this point. No one will see me. No one will talk to me until I'm a year post op. No one wants to get in the middle of this. I was told each time to go back to my OS. I explained I intend to. I just want to talk to someone else at this point. Shut down at each turn. I hope I don't have to wait a year to talk to another OS. I'll keep trying, but not sure how to get around this if no one else will even talk to me.

 

[NewMoM]

I go back to my OS on Thursday. I'm nervous. Never was able to find an Ortho that would talk to me, so my only choice is to go back to the one I've lost faith in. I know patience is needed, but I don't think I can spend the next 9 months like I am to wait until another doc will talk to me. All I can do is hope for the best and hope I come up with the words to get my point across without angering my doc too much. I don't want him cutting on me with a bad attitude! From the things you guys here have said, plus my PT, and my own research, I'm convinced the joint is too big. Nothing has improved. My ROM is 93/25 at the very best. Hoping we can set another surgery date when I see him Thursday. I just want to be able to walk again. I'm in much worse shape than before surgery and beyond frustrated.

 

[Tamsmom]

I truly hope you get some good news tomorrow...this is hard enough when recovery is somewhat "normal"

You are in my thoughts and I said a quick prayer.




4/1/2014 TKR

 

[Wednesday]

Hope all goes well. Thinking of you.

 

[NewMoM]

Thank you. I found out from my PT today my OS plans to put me on a CPM machine for a couple of months. That's confusing to me. I feel like that's something that may have helped at 2 weeks post-op. But at 12 weeks?? I am not hopeful. I feel like it's going to hurt too bad at this point because my leg is stuck already. I don't know. Just more and more frustrating.

 

[Jamie]

NewMom.....I apologize for not getting back to you sooner. You say you got three surgeons recommended and none would talk with you. Were any of them with Dickson-Diveley Orthopedics? If not, I suggest you give them a call and see if you can meet with Dr. Danny Gurba. If at all possible, don't even mention your surgery date when you call to schedule the appointment. Just say you are having problems with your knee and need to talk with him about it.

 

[NewMoM]

So I shouldn't tell them I want a second opinion? I don't want to get there and be turned away because I wasn't up front with them. Is that normal? To just not tell them until they see me? Dickson-Diveley was not part of the list, but thanks for the name!