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Revision TKR Partial Revision Failure

My surgeon never said a word about a CPM machine, and I didn’t have one. I did ask my PT about it (before finding Bonesmart) and he told me they were old school. It all depends on the opinion of who’s in charge.

I’m so glad I didn’t have one. I have low back issues and I really think it would have bothered my back, laying there with my leg at a predesigned angle and moving continuously. I think if it ever comes up in the future I will respectfully decline, or if that doesn’t work, flat out refuse.
 
@Jockette, thanks for your input....I think I am going to forget the CPM machine.

I have not been sleeping well because of anxiety leading up to the revision. I am anticipating having "post op blues". I just read (@Josephine's) the articles on not sleeping and depression. Excellent articles describing the situation. Is it OK to take Prozac with all the pain pills when the depression hits? I do remember being really depressed a few weeks after my LTKR while I was on Narco. Felt emotionally better on Tramadol but feel like the Narco would be better for at least a couple of weeks after surgery for severe pain.

Just thinking about getting the house cleaned, the prep before surgery, clean sheets on the bed the day before surgery.....now we have to board our doggie a day earlier because she is not allowed to sleep with us (me) the night before surgery makes me sad. I am in the worry mode. I will need loose clothing to put on while in the hospital and afterwards because I remember I didn't want anything touching the very sensitive incision.
 
Well, I have had 2 Metal blood analysis done 09/2016, 08/2018 and 2 patch testing 07/2018, 09/2018 for bone cement, cobalt and nickel.....and none of them matched!!! I guess the good thing is, I am not allergic to any of the bone cement my OS uses. Not sure what to make of the moderate reaction to cobalt done in July with the patch testing, and now just a little itching with barely a reaction. Nickel not reactive on the patch testings but mildly reactive on the blood analysis this August. I assume the OS with make the best decision for the correct implant.
 
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I think your OS will know what to do with your test results. If he or she thinks you need an implant type they don’t do, they can refer you to a surgeon who has experience with that implant.

You don’t appear to be highly reactive to the main metals used. A person can be mildly reactive to a metal and still have a successful implant which includes that metal. I am mildly reactive to nickel (patch test) and went ahead with bilateral implants that include nickel. My allergist explained to me how reactivity differs from allergy, and I made the call. I am 16 months post-op and have had an excellent recovery, with no signs whatsoever of any problems or reaction. So speak to your allergist and your surgeon about your concerns and what they think. You have to be comfortable with whatever they — and you — decide.

Having knees replaced, much less revised :console2:, is a serious decision. The tough part is there’s no 100% guarantee on anything!
 
@SusieShoes, I have complete faith in my revision OS but like you said there is no 100% guarantees. He is planning on using a Zimmer trabecular metal implant for both the femur and tibia with sleeves and cones. The metal from what I have read is Tantalum.
 
I don't know anything about Prozac, but I do know a little about recovery from a TKR and a TKR revision. Not everyone will go through post-op blues or depression. I didn't have any actual depression or blues, but I am ready to have this recovery well behind me. I also had days of sheer boredom since my mind was ready to go, but my knee wasn't. But that's not really depression, just normal reactions to a long recovery. I realize that some people go through some pretty significant blues after this surgery, but some people don't, or they may have an occasional pity party, or frustrating day, etc. I don't think I'd take any pills for it though, as it is generally a short lived reaction to all you go through with this surgery and recovery, and it won't last forever. I think it would be better to allow yourself to feel what you feel, knowing it won't last forever, instead of taking a pill that changes your natural chemistry. I'm not talking about someone who has a lifelong condition, that's a totally different thing; rather I'm talking about short term reactions to a major surgery. I'd be aware of different things we can go through during recovery so as to recognize them if they do hit, but don't go into it expecting the worst, just hope for the best. JMHO.
 
I think the post op blues hit a great many surgical patients. When the time comes for my next TKR I’d like to have a plan. My depression came out of boredom, so if I can plan ahead for some good tv or movies I think I’ll handle it better. My plan with the first knee was to read, but I couldn’t concentrate enough to read anything and this frustrated me along with the knee. So I’ll have something new on my kindle, some old favorites I could reread (just in case) and something good to binge on TV when I need it.
 
I agree-having plans for entertaining yourself during recovery is important. I had tons of shows recorded on my DVR, and a ton of other stuff available on my laptop, tablet and phone, plus I have a smart TV so can use that to watch youtube, and so on. I also had a few books, which I added to when I found I was able to concentrate from the beginning due to not being able to use narcotic pain relief. (I also have the Kindle app installed on my devices, but personally prefer an actual book whenever possible) I was still bored often, but managed to find things to do to get through it until I was able to be up and around more and more.
I still need down time, so still have things ready to watch and read. But, I never went through actual blues and/or depression; maybe because I had things to occupy myself a lot, or because I wasn't taking pain meds that tend to cloud your mind, or because I'm naturally an upbeat type, or maybe all of the above. Who knows...I just know planning ahead helps with a lot of recovery issues that can come up, or do come up, so reading this site thoroughly and often is an immense help for planning ahead for your recovery.
 
Have any of you tried the Active Skin Repair Hydrogel that BoneSmart is promoting thru emails?
 
I can only speak from my personal experience. I had a TKR on my right knee in 2011. I was in constant pain even 4 years later. I kept going back to my surgeon and she was trying everything in the book to get it better but it wasn't happening. Finally, in 2016, she ordered an MRI and sure enough, it showed it was loosening. I was referred to another surgeon who does revision knee replacement and he said if it loosened enough where it broke off, it would do an awful lot of damage inside my knee. So, long story short, I voted for the revision surgery. There is still pain and not a lot of range of motion but I didn't like the alternative. In November I'm having TKR surgery on my left knee. I hope I have better results.
 
Cementless said:
@sistersinhim, another knee forum recommends "Bio Oil" and it is cheaper.
Click to expand...
You cannot compare something like Bio Oil and the Active Skin Repair Hydrogel. Bio Oil is a product that has the potential to soften and smooth skin and that's as far as it goes. It cannot be used on an open wound. Active Skin Repair Hydrogel is the same solution (hypochlorous solution - HOCL) your body uses to fight infection and heal. It can be used on open wounds and is an effective anti-bacterial agent. Used as soon as possible after surgery, it has the potential to greatly reduce the development of scar tissue in the first place by creating a healthy healing environment in and around your incision. It is a completely different process than trying to reduce the appearance of a scar once it has formed.
 
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@Jamie, thanks! I guess one should wait until the sutures are removed and the incision looks healed to use Active Skin Repair Hydrogel?
 
Active Skin Repair Hydrogel can be used on the wound at any time, even before the sutures are removed.
Here is a link to the information about this product.
bonesmart.org

HOCL-Working

ACTUAL BONESMART USER BeBe 187 DAYS OUT FROM SURGERY No Scar Shield 96 DAYS OUT FROM SURGERY Scar Shield used for 28 days Hypochlorous (HOCL) Solution
bonesmart.org bonesmart.org
 
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The active ingredient in Active Skin Repair Hydrogel is the same naturally-occurring substance used by our own body to kill bacteria and reduce inflammation. It’s completely safe to use on wounds, even open ones. One thing I like about it is that because it helps reduce inflammation directly in the wound, there may be less scar tissue produced as a result.
 
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Exactly, Susie! Hypochlorous Solution (the primary ingredient in Active Skin Repair Hydrogel) is even used on large open diabetic wounds to promote healing and kill bacteria. So it definitely can be used on a new incision. That's when it does its best work and what makes it unique from other products on the market.
 
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I'll chime in here about the cost. Considering how long that bottle lasts, it isn't really that expensive. It may seem expensive at $35 a bottle, but it lasts for a long time. You only use a tiny bit on your scar each time you apply it, so it goes a long way. If you put a small amount on your fingertip, then spread it on your scar only, it will cover the entire length of your scar with that one small amount. You'll figure out right away how little you need to use on the scar, and will then learn to place that small amount on your finger tip to start with. Just make sure you wash your hands well before each application.
 
Apparently my revision OS does not like to use muscle relaxants but prefers Gabapentin. I prefer the muscle relaxants and do not want to take Gabapentin due to all the bad side effects. He also routinely puts his TKR/revisions on an antibiotic for 10 days post surgery (Cefadroxil 500 mg bid).
His Pt's also attend a group joint clinic while in the hospital for PT exercises. Not sure I like that.
He plans to use the Smith and Nephew Implant (no cobalt, no nickel with bone cement).
 
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