Revision TKR Partial Revision Failure

[lovetocookandsew]

@Cementless Good to know that about the price in case my current one dies and I replace it with the Breg as we had talked about.

 

[eaglemom]

I absolutely love my Breg V Pulse. The two containers you put in stay cold all night. I have 2 sets - one in the machine and one set in the freezer. That way I'm always set.

 

[Cementless]

Here's a question for all: Should I be doing pre-op exercises like we do after TKR/revisions now?

I have kinda stopped in the last 4-6 months. I have no exterior swelling and my bend is 120 (130 pushed). Today I did the leg lifts, side lifts, heel slides. I can tell my quads are weak on the left TKR side. Afterwards, my knee feels sore. Since my tibial plate/component is loose maybe it is not a good idea to do them now?

I think the leg lifts would be OK? I was thinking about doing the squats. Everything is 30 reps at a time. I have not done the stationary bike in a very long time. I am just not motivated.

Tomorrow I have a nuclear stress test (chemical) for pre-surgery clearance. Today I had the blood work done. I start patch testing again on Sept. 10, 12, 14, with the results on the 17th. They are doing 3-4 bone cement which the OS uses and rechecking me for Cobalt, Chromium, and Nickel.

 

[sistersinhim]

I can't answer your question about your exercises. I am going to tag @Josephine our forum director and nurse to answer you.

 

[Desertgal]

I am scheduled for my revision on 9/25 due to internal rotation of the tibia component. I have not been able to bend beyond 20 degrees for quite some time. I asked my OS if I should go to PT ahead of the revision? He thought that was a good idea so I go once a week to work on my core, hamstrings, gluteus, etc. Wanting the muscles to be the best they can be for after the revision. I can’t do any that requires bending the knee. And, I don’t do anything that aggravates the knee. I am swimming 3 times a week also. I feel all has been beneficial for me. We shall see once I get to the other side! It also helps to pass time while you wait for your surgery date!

 

[Celle]

Should I be doing pre-op exercises like we do after TKR/revisions now? I have kinda stopped in the last 4-6 months. I have no exterior swelling and my bend is 120 (130 pushed). Today I did the leg lifts, side lifts, heel slids. I can tell my quads are weak on the TKR side (L). Afterwards, my knee feels sore. Since my tibial plate/component is loose.....maybe it is not a good idea to do them now?

No. I don't think it's a good idea to be doing those exercises, especially 30 reps at a time.
With a loose tibial implant, you're running the risk of that loose hardware doing some damage to your tibia.

There's no need to keep on doing heel slides - your ROM is already good. And stop pushing, to increase that bend. Pushing can also cause harm.

 

[SusieShoes]

I too think you should lay off the exercises for now. You have a loosened tibial plate and risk consequences a patient with original issue knees or a properly seated implant doesn't need to consider.

Exercises to strengthen your core and upper body are always good, of course. And you are getting exercise in the form of your daily activities, so it's not like you're a complete couch potato. There'll be time to strengthen your quad muscle later. Mine were very weak pre-op (years of barely being able to walk or stand because of the pain) but I did well enough after surgery -- bilateral in my case -- and they continue to get stronger all the time now.

 

[Josephine]

I agree with Celle and Susie. In light of your loose implant, you shouldn't do exercises. Any exercises!

 

[Cementless]

I started my second patch testing for 4 bone cements (powder and liquid portions separated) and a repeat of cobalt and nickel on Sept. 10th. As of today, no itching/rash...nada!!! Final reading will be on Sept. 17th and then I go for the hospital pre-admit testing & meet with anesthesia right afterwards. This has been so frustrating because each metal patch test and metal blood analysis are so different and now it shows I'm not allergic to bone cement, cobalt OR nickel!

Then I had a really BIG scare yesterday. I had a nuclear stress test (chemical) on Sept. 7th for my cardiac clearance. I went yesterday to pick up the report to fax to the pre-admit/surgery team and it showed on the ECG: "anterior infarct" but a normal stress test! I was so upset and called my cardiologist, faxed him the report. He got back with me today and said I did not have a heart attack and my stress test was normal! He said the techs must have placed the leads wrong to get that type of reading. My tests was not done in his office but in a hospital near where I live. I questioned the people doing the tests because there was not a doctor present, just techs, RN's and a 30 yr. old PA overseeing the test. Then a young cardiologist signs off on the report electronically!

My emotions have been all over the place thinking I had a heart attack!!! I feel like my heart is actually hurting now from all the stress.

 

[Jockette]

My husband has been referred to a cardiologist twice in his lifetime, once in his 50s and the second time at age 64.

Both times were the result of an error. The first time there was an error on the stress test machine and the second time the tech clicked the wrong line on the drop down box on the computer screen.

Both times scared and upset us very much.

I guess I can maybe understand the stress test mal functioning, but I find no excuse for the carelessness of clicking the wrong line on a computer on such an important test! It was an echocardiogram and I was in the room and the tech had some annoyingly rowdy music playing, it drove me crazy, I don’t know how she could concentrate on her job.

I hope you will be able to calm down now and rest well tonight. I’m sorry you had this experience.

 

[Cementless]

@Jockette, thank you for your input. I quizzed the 30 yr old PA and the techs how long they had been doing this without a cardiologist present and they said for the past 6-8 months. The reasoning is the cardiologists just don't have time to come over and monitor the test and pt's may have to wait 6 hrs., as oppose to the 4 hrs. It really is inexcusable for a cardiologist (even if out of school for 10 years) to sign off electronically with the conflicting information. They said this is the future of medicine.

btw: my patch test is showing some signs of slight itching, maybe in the cobalt and nickel area?

 

[sistersinhim]

The prices go up and the quality goes down. Thank God it was a false reading for you, though! This surgery is stressful enough without adding unnecessary scares to it!

 

[Cementless]

Breg Kodiak Cold Therapy is the $205 I was quoted not the Breg V pulse. The more I think about it, I don't want something around my knee pulsating around my knee when it is swollen and sensitive to touch. Now, I have to contact my OS for another prescription. There is always something trying to get my ducks in a row!

 

[Jockette]

I wouldn’t want anything pulsating either.

It reminds me of what happened in our pool recently.

You know that my knee has problems, here’s another example. My kids were visiting last month and we went to our community’s pool. The only ones in the pool were me, my husband and daughter, and 3 children ages 9, 7 and 4. The kids and my daughter were jumping in the pool making the water a bit “turbulent”, which is rare for our pool, it’s in a 55+ community, so when it’s our usual residents, we are calmly floating on our noodles and talking.

Well, my knee did not like the somewhat turbulent water. I guess I shouldn’t have been surprised, but I was. I finally just got out of the pool.

Silly Drama Queen Knee.

 

[Cementless]

Less than 2½ weeks before my revision and I feel the need to get things done or just do nothing. I am mentally exhausted.

I am suppose to have a contrast MRI of the brain every 2 years to follow up on my L. acoustic neuroma that was radiated in 2012. Just let it go because of all the other tests with my knee, etc.

I'm not sure I can squeeze that test in and not sure if the contrast dye (gadolinium) would be good for my knee/up coming revision. Any thoughts?

@Josephine if this could be a problem for surgery? I know I will not have it done for 6 months to a year once I have the revision.

 

[Josephine]

I doubt it. But even if it does cause a delay in your new knee, it would surely be more important to get this scan done first, no?

 

[Cementless]

What is the best CPM machine (continuous passive motion)? I had one the hospital loaned me after my LTKR (2016) and it worked but caused a great deal of bruising on the bottom of my thigh. Is one better than the other? I need more padding for the thigh area.

 

[Celle]

You might not need a CPM machine at all. They're not necessary and they make no difference to your eventual ROM. They're now considered a bit old-fashioned and many surgeons don't use them.

 

[Cementless]

Today during the pre-admit, I found out the OS has reserved a hospital day of 3 days!!! I was not expecting that!

 

[lovetocookandsew]

That's a good thing, IMHO. If you need the time it's already there; if you are doing well you can ask your OS to discharge you earlier. Better to be prepared for a longer stay and go home earlier, than to need to fight for more days if needed.