Revision TKR Partial Revision Failure

[Kandy]

Oh Cementless,

I just spent the better part of the afternoon reading your entire thread from start to finish. You have been through quite a rough time. I understand really liking a surgeon and feeling confident in him, then going to feeling like he betrayed you or did a 180 on you. It happened to me with my original spine surgeon, but that journey led me to an amazing surgeon who took a chance on me and gave me back my life. In light of what you found out about the NM bone scan, do you still feel like you have lost confidence in the revision surgeon? It sounds like he doesn't know how to help you.

I just want to reach out and give you a big hug. I live in Central Texas and can give you a name of a great revision doc in Austin, but sounds like you do not need one as you have many choices in the Houston area. It is completely unnerving to not have answers, or to have different answers from different doctors. I am glad you are going back to the first 2nd opinion doct that you saw in 2018. For now, try to put that all aside and just focus on enjoying the holidays. Hugs, sweet friend.

 

[Cementless]

@Kandy, thank you so much for sharing your thoughts. I needed a post like yours because I have been so stressed about all this that it is starting to affect my Afib. I had a small episode last June and one briefly on Nov. 30, the night before I saw my present Ortho revision surgeon. My house is all decorated for Christmas and my maids came today. The only thing I need to do is make a grocery list and go shopping. In Texas where I live, we are expecting a very hard freeze!!! It is supposed to go down to 10 degrees here on Thursday night.

 

[Jockette]

Very nice lights!

I know how stressed you are but I hope you are able to relax, at least for your holiday celebrations.

 

[sistersinhim]

I love your tree! I don't remember ever seeing one like that before. How unique and beautiful!

 

[Layla]

Wow! That is some serious lighting on your tree. I love white lights. So pretty!

Stay warm in the cold temps on Thursday. Something I'm used to this time of year as a Northerner.
@Cementless

 

[Kandy]

I love the tree!! Wow! We did not manage any outdoor lights this year. We were supposed to go to NW Houston (your neck of the woods) this weekend, but our family in Houston became ill. So, we are just going to chill by the fire as the cold spell comes through.

Cementless, we have more in common besides a bummed knee and living in Texas. I was also recently diagnosed with Afib. My doc wants me to do an ablation procedure, but that is waiting on figuring out what I am going to do on my knee, which is waiting on the metal allergy testing results. I am checking for my allergy results daily.

 

[Cementless]

Hello Everyone!

FYI: Something I found very interesting about NM Bone Scans: they may read positive up to 5 years after a revision or failed TKR! No wonder my present ortho surgeon said, "he doesn't believe in bone scans". I found this out by talking to a former HS classmate that is a retired radiologist yesterday.

I decided to contact the radiologist that read my recent NM bone scan. I told him what my orthopedic surgeon said and he agreed about NM bone scans and revisions. He said, when he read my NM bone scan, he did NOT know it was a revision. He wrote an addendum:

Addendum

** ** ** ** ADDENDUM #1 ** ** ** ** Please note that the left knee prosthesis represents a revision. Unfortunately, bone scans are not as accurate in assessing a revised prosthesis and tend to show higher uptake even in the absence of a complication. Thus, the bone scan findings in this case could occur without loosening and must be combined with clinical assessment.

Addended by Fisher, Ronald Evan, MD on 12/27/2022 5:00 PM

 

[Cementless]

Today, I have made a decision that will be the number 1 priority for the second opinion orthopedic surgeon to address: my patella button must come out! Either he removes my whole knee cap or tries to replace the patella button. I know I have osteolysis and my knee is so weak, I can barely put weight on it, example: climbing stairs.
I had to go up in our attic to check out where the water pipes need to be cut off in case of another hard freeze. It was pitiful trying to climb those stairs and painful. Such a sad situation.

There is no way I would let my revision Ortho I have now do that surgery! He has already expressed how difficult it is to remove a press fit patella button. He has only done that twice and one of the surgeries was " a disaster!" Again, his initial reaction was my knee cap will be "obliterated". I'd say NO confidence there!!!

 

[sistersinhim]

In my opinion, you'd be better off without the kneecap. rather than trying to replace the button. I'm doing fine without 2 kneecaps. You would, too. If the patella is causing all the pain, then I think it needs to go.

 

[Cementless]

Nightmare of ALL nightmares: I fell after getting out of the shower on Jan.4th around 10:30 am. It was on my left revision leg! I broke my left hip/femur and back at L-2!!! An ambulance was called and then I was taking to a close by trauma hospital.
The partner of the revision ortho took my case and he did surgery the next day.
I have been in the hospital for a week!
Now, when this hip gets better, my painful kneecap will have to be addressed along with the tibial plate that might be loose?
They only sent me home with 20 tablets of Tramadol!!! I need to call my new ortho for more pain pills.

 

[Cementless]

I am in a Don Joy heavy duty back brace when sitting and standing.

 

[Jaycey]

@Cementless So very sorry to hear about your fall! I hope you can get that pain controlled. If you can't reach your surgeon's office, try your family doctor. It's important to stay ahead of the pain. Take care!

 

[EalingGran]

So sorry to hear of your troubles. Praying for you.

 

[sistersinhim]

Oh no, you didn't! I hate to hear about your fall and breaks. I pray you can heal quickly.

 

[Cementless]

I am trying to stay ahead of the pain. I am alternating Hydrocodone 10 mg with 325 Tylenol and Tramadol 50 mg, every 6 hrs.
I forget BoneSmart's pain schedule. Maybe someone can repost it for me.
My left knee hurts mostly when I walk with the walker to go to restroom and sink to brush my teeth. The back brace makes everything more difficult. I am in the recliner most of the time.

 

[Flashlight]

I am so sorry this happened to you. I know a lot of hospitals have pain med protocols on discharge. I found my PCP was more helpful than the surgeon. Hopefully you won't have to wear the back brace for a long time. Should you be wearing some kind of knee brace while walking? Take care.

 

[beachy]

@Cementless
I'm so sorry about your fall!
I don't know what the Bonesmart pain med schedule is, but I am taking the hydrocodone-acetaminophen 5-325 2 every 4 hrs since tkr on Wed. Not as strong as yours unless I take 2.
Will your doc allow every 4 hrs?

 

[beachy]

I should add that I'm not taking Tramadol

 

[Cementless]

@beachy, I take the 50 mg of Tramadol in between the 10mg of hydrocodone/325 mg of Tylenol plus 1 extra 500 mg of ES Tylenol. I am pretty sure I am not going over 4,000 mg of ES Tylenol.
We have a long ranch house and I have walked it twice with my walker going from one recliner to another recliner. Someone is always with me walking.
This by far was the best day I have had.

 

[Cementless]

@Flashlight , I think it is too soon for my knee brace. I am pretty bruised up from the surgery. Black & blue. They didn't have a chance to stop my blood thinners.