Revision TKR Partial Revision Failure

[Cementless]

I had a Dexa Bone Density yesterday and I have osteoporosis! In 2018 it was osteopenia. I am so lucky I did not break anything with this recent fall. I need to start exercising/walking. My bones feel so fragile and I am still so sore!!! Feeling down.

 

[Jockette]

Is this a change from the osteopenia, or in addition to it? (I don’t know much about the condition.) I’m sorry you're still hurting, I would feel down, too.

 

[Jo Wo]

What a relief! Take it easy and give it time to heal.

 

[eaglemom]

So glad your x-ray's didn't find anything broken. It will take time for your soft tissue to heal.

Your dog had to have been scared also. Glad she stayed right with you.

 

[Cementless]

Is this a change from the osteopenia, or in addition to it? (I don’t know much about the condition.) I’m sorry you're still hurting, I would feel down, too.

@Jockette:
Comments from the Doctor's Office
Dear Ms. W.
I reviewed your bone density report:
The bone density of your Left femur neck has not shown any significant change since the study that you had in 2018 and still remains at the osteoporosis range, putting you at high risk for fracture.

Your total femur bone density showed osteopenia.

Your lumbar spine bone density has slightly deteriorated in comparison to your study in 2018 and is now considered as osteoporosis.

 

[Pumpkin]

Cementless,
Looks like it is a change from osteopenia to osteoporosis, meaning you are at risk of fractures.
Since you fell recently, most likely you are at risk for falling, guessing you knew that already.

I need to start exercising/walking. My bones feel so fragile

Ask your doctor for a referral to PT for a falls risk assessment, strengthening and balance exercises, and education in how to prevent falls.

 

[Cementless]

Besides a lot of Calcium/Vit D and weight bearing exercise, what is the best thing/drug for osteoporosis? I don't want to do Fosamax, etc.

 

[kneeper]

^that would be the thing to do if you don't want to do one of the osteoporosis drugs. Your doc may make some recommendations at your next appointment.

 

[Cementless]

I have been wearing 1 lb wrist weights and 1.5 lb ankle weights for 2 hrs each morning. Started riding my stationary bike 2- 3 x's a week, doing leg lifts like we do in PT after a TKR. Walked on the treadmill for 15 mins, once.

My recent concern is my L hip hurts more after I have done the leg lifts! I can't get my L leg as high as I use to. Makes me think I might have a stress fracture in my left hip that did not show up on regular x-rays. I am in the process of contacting my OS to see if he will order a MRI of my L hip, femur, and knee. Feeling a little discouraged. It has been 1 month since I fell. I read, if you have a stress fracture of the hip, they don't want you to do much weight bearing so your bones can remodel.

 

[Cementless]

Continued L Knee pain (same knee) and internal swelling post Revision 10/06/2018.

My left knee continues to swell internally, and I have small to moderate pain at times. Think I need an MRI of the Left Knee to see if the patella button is loose or any tears around the knee cap. When I do my occasional leg lifts, my left knee feels weak and heavy to lift. It just doesn't feel right. Occasional Celebrex 200 mg helps.

Also, I started Prolia injections on March 9, 2022 for my osteoporosis. I was wondering if that would effect my revision? Does any one on the BoneSmart Forum take Prolia injections for osteoporosis? I don't plan to continue with it.

 

[Jockette]

@Cementless I moved your newest post into your own thread so that you’ll have it in your history.

 

[Cementless]

I don't know if I have patellofemoral instability but my kneecap is unstable, not loose. I saw my orthopedic doctor that did my revision this past Weds., June 22 and he was so humble. He finally admitted that he should have replaced my patella button when he did my revision Oct. 6, 2018! He thinks I would have more issues now if he tried to replace the patella button because I would lose so much more bone. In my heart, I knew this was the problem. I'm so sick of doctors not getting it right the first time they go in. My patella button also has cobalt in it which I am allergic to.

 

[Cementless]

He said to strengthen my muscles around my knee, leg lifts, recumbent bike 15-20 mins, stand on one leg at a time for balance, wear a knee brace as needed, walk, take Celebrex as needed. He offered PT, but I declined.
I think he is afraid I will sue him which I will not. He went out of his way to spend time with me, even hugged me big! He is highly rated and dose more revisions than just about anyone...maybe 5 or more a day. He said very apologetically, I missed one area in the revision. My other knee hurts but it is more from compensating for the revision knee. He gave me a cortisone shot in it.

 

[Cementless]

@Jockette: Can you rename my thread to: "Left Knee Revision: Partial Failure".

 

[Jockette]

Title changed!

 

[Jockette]

He finally admitted that he should have replaced my patella button when he did my revision Oct. 6, 2018! He thinks I would have more issues now if he tried to replace the patella button because I would lose so much more bone. In my heart, I knew this was the problem.

My patella button also has cobalt in it which I am allergic to.

I remember you have always suspected a problem with your patella button. Does he think he should have replaced it with something that doesn’t have cobalt in it?

So how does strengthening your muscles around your knee help you feel better if the issue is the cobalt?

 

[Cementless]

I remember you have always suspected a problem with your patella button. Does he think he should have replaced it with something that doesn’t have cobalt in it?

So how does strengthening your muscles around your knee help you feel better if the issue is the cobalt?

I ask him if he thought it was the cobalt that was causing the problem. He said, "no, I think it is the kneecap". At the time he did the revision, he did not think the patella button had cobalt in it. He thought it was titanium. He should have investigated it more. Mine was a long, complicated revision. I think he felt OK with the way my knee was tracking at the time and took a short cut.....is my guess. He does 5-6 TKR or revisions a day, 5 days a week. Mine was around 2pm and he was probably tired. Who knows? He said the internal swelling, pain is from the scar tissue from all the surgeries I have had on the knee (2 torn meniscus repairs before the TKR). My knee is unstable and sometimes when I step off a curb, it feels like it could break in two. I wear a knee brace a lot of the time and it stabilizes the knee.

I don't walk with a limp, I guess I should be grateful of that.

 

[sistersinhim]

He said the internal swelling, pain is from the scar tissue from all the surgeries I have had on the knee

I'm sorry, but I have to disagree with this. I've had 5 previous surgeries on this knee before I had the TKR and I've had no problems with scar tissue. I think the cobalt in your button is your problem. Have you considered another opinion?

 

[Cementless]

@sistersinhim : He finally admitted that he should have replaced my patella button when he did my revision Oct. 6, 2018! He thinks I would have more issues now if he tried to replace the patella button because I would lose so much more bone. In my heart, I knew this was the problem.

 

[sistersinhim]

There have been others that have had numerous revisions. There is no reason, that I know of, why you can't have that button changed. You shouldn't have to put up with this when there is a way to fix it.