TKR Pain in my TKR done in 2013 . Revision?

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Jun 13, 2013
Italy Italy
My TKR done in October 2013 is giving Me pain and is aching constantly it's now painful on walking. it's never been completely right. The patella has never smoothly moved. I could never do straight leg raises with that knee, because it had to click into place. I went back to see my surgeon for check ups he always assured me it was normal and it should improve but it hasn't. I always had my doubts. After my latest check up with a hospital orthopedic doctor he looked at the exrays And said it will have to come out. I nearly fainted. He told me its best to go back to the surgeon who did it. He also ordered an nuclear medicine scan using radioactive dye that will apparently show up my bones. The surgeon who did my op has now left that hospital and has gone to another hospital. What is the best way to approach this once I get my scan results?? I'm very disappointed and worried. I will have to pay privately to see my surgeon who did this.
That's sad. I suggest finding a revision specialist and not going back to the original man -- he messed it up in the first place.
How do you find a revision specialist? The operation was carried out in an Italian hospital via my state medical card. I'm considering speaking to a Legal Doctor Who specialises in bringing damage cases.
Welcome back, sorry to hear you are having trouble with your TKR.
Since the surgeon who did your knee put it in wrong, I would not let him near my knee again. Why give him a second chance, he is likely to do a poor job the second time.
Recommend you find a surgeon who specializes in revisions, they have the experience to determine what is going on, and determine a course of action. You will want to find someone who has no relationship with the original surgeon, professionally or socially.
To find a surgeon specializing in revisions you will have to call different offices and ask if the have someone. You can also check their websites. Some will say the do complex knee reconstruction. You can ask your primary Dr if they know of anyone.
Thank you got the advice I have found one revision specialist attached to a medical legal practice where I intend to ask for advice on compensation or at least to be evaluated properly after my scan comes back. I will have to pay privately for this and I don't have the funds. The person. Who did my op was head of department at a semi private hospital that was part of the state convention for operations.
Does anyone else have experience in pursuing a case legally?
I have not heard of anyone who sued a doctor for a TKR. But, I would NEVER go back to that doctor again--if he did a bad job the first time, he will not improve with time 2!!

I would not worry until I have seen the revision doctor---they are used to evaluating knees and deciding what is wrong with them. The second doctor that you saw did not give you good advice---who in the world would go back to someone who did a bad job??? That is asinine!! So, I don't think too much of his evaluation either. Wait until you see the revision doctor and have his opinion.
Thanks everyone, has anyone had a Nuclear scan before? The instructions say afterwards I should avoid being near children and pregnant women for a week or so as I'll be radioactive !!!! In Italian it's called Scintagrafia.
I would like to talk to someone on the forum who has actually had a revision.

I presume they need to do this to see whether the bone is infected?
The doctor who sent me for the scan wasn't very forthcoming other than saying I must return to the surgeon who did this!
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Members who've had revisions have a yellow banner on their avatar. You can search the members tab to look for those with revisions and read their threads. One of our advisors @newlybionic had a revision, but she's not on line right now.
They may just want to get a good view of the implant to see what has happened. Is this being ordered by the original OS or a revisions specialist? Are you experiencing any signs of infection? They can run blood work to see if your body is fighting an infection or even aspirated the tissue.
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Thanks, no I haven't seen a revisions specialist nor my surgeon yet. I went for a regular visit to an orthopedic in the hospital. Who told me to go back to my OS and to go for the Nuclear scan.
In the state system you get whoever is on duty. In order to see your original surgeon you have to pay privately, a system which I'm sure protects the surgeon from his mess ups. I have never seen he same doctor twice. It's pretty much as frustrating as hell.
I'm sorry to hear that your replacement was never right from the beginning. My original surgeon told me all along that everything was good with my knee. I work on my feet 10+ hours a day and I knew there had to be something wrong. Five months after my TKR I went to see a surgeon who does replacements and revision. I was told then it needed to be redone. My knee cap was not tracking correctly and the whole thing wasn't aligned properly. At 8 months past my original surgery I had my revision. It came out even better than the surgeon predicted. I do get some stiffness but no pain. I hope you can have the same experience.
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Hello Donna @DAJ
I'm sorry to read of your problems. I certainly would not let your original surgeon operate on your knee again.

I had a knee revision, from a partial to a total knee replacement, back in 2011. Although I was apprehensive, my recovery was no more difficult than my recovery from the original surgery.

I read through your 2013 TKR thread. It seems you had a horrendous time in hospital after your TKR and the after-care was not good, either. It doesn't sound as if the medical care system in Italy is very good.

At that time, you were talking of going back to South Africa to live.
Presumably, that didn't happen, but is there any possibility that you could go to South Africa to have your revision? Or to the UK, which I see you visited several times?
Do you have friends or family in either of those countries, with whom you could stay for your surgery and recovery?
I had a revision from a PKR to TKR on March 20th. My partial was done in 2011 and the same as yours was never really right. I went to a different surgeon this time. He did not do any radioactive dye scan, just X-rays. Too early to tell if this one will be different. Fingers crossed.

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@Celle thank-you so much for your comment and for reading my back story.
I had tried to forget how horrendous being in hospital in Italy really was, I nearly went out of my mind. I had set it all aside and got on with my life.
Suffice to say I won't be allowing my OS to touch me again I would like to tell him though, that as I suspected at the time, my knee was a screw up. It was one of three he did on me the first an osteotomy.

I really did consider going to SA (which has some of the best surgeons). But I'm not coveted by medical aid there and a private operation would cost a huge amount. Which I don't have.
As to UK I think it will also be out of the question in terms of cost I'm not entitled as a non resident. But I'm considering it.

You are right to say Italy has **** state medicine as I've discovered. I've seen doctors in my time that I wouldn't let anyone sit on bus next to. Recently a few in my province have been imprisoned in the north at one of the hospitals I was in for murdering numerous patients for FUN over years. It's astounding!! The A&E anesthetist and his girlfriend the nurse murdered her husband with insulin( he wasn't diabetic) she was taking his blood in to her 'friends' at work to test after doctoring it with glucose. Makes for interesting reading. Daily mail. Google it. Saronno hospital.

Anyway I guess I was hoping this TKR would see me OK for another ten years.
But now I'm not so confident about anything anymore.

I guess I'm wondering why I can't sue this doctor and demand to be made right by a revisionist
Thanks for the advice
Donna, I think suing would be a waste of time, and it would cost a lot. You'd need solid, incontrovertible proof that your surgeon made a mistake, and you won't get support for that from any other doctors.

Instead, of worrying about suing, try to focus on what you can do to help yourself now and in the future. Use the money you have to buy better surgical care, instead of wasting it on lawyers' fees.
It's very difficult to prove malpractice in the US, I don't know about Italy. But it seems many people would be able to do so if it was possible.
@KarriB because I felt so uncomfortable right from the start in hospital, I ordered my complete clinical file. Which tables every single action and drug admistration of the operation and hospital stay. I hope to take this to the Legal doctor. At the very least I should be put right by a revisionist expert specialist.
@Celle that is precisely the job of a Legal doctor in Italy . My cost would be only the consultation and since I am unemployed the state would have to bear the cost of the revision. I cannot possibly pay for that privately .
DAJ, I'd like to help you but I really wouldn't know how or where to begin!
But if you do decide to come to the UK, you know I'll help where I can.
since I am unemployed the state would have to bear the cost of the revision. I cannot possibly pay for that privately
But would the state give you your choice of surgeon, or would you just get one "picked out of a hat"?
Revision surgery needs a surgeon skilled in doing revisions.

I can't advise you about the legal situation in Italy, so I suggest you go and seek the advice of a Legal doctor, taking all the information you have. He/she will, presumably, tell you if there is any chance of success with your claim.
@Josephine thanks and that may happen. I'm getting increasingly tired of this life and if I can manage get some money out of my property I hope to get Old in UK.
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