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TKR Patella Clunk

If loosening is confirmed, it is my understanding that it is necessary to have the surgery done to correct it. I think if mine really was loose I wouldn’t have been able to last this long with it. It will be 4 years in March.

The fact that I don’t have a lot of pain, and “only discomfort” is what let’s me get away with putting up with what I have. Some times that discomfort is worse than others, though. I wish I’d gotten the good outcome most get, but I didn’t.
 
Thanks Jockette,
I would say that my symptoms extend to more than discomfort. I could even put up with the clunking, despite the severity of this.

Certain movements (walking downstairs for example) result in a very painful 'jarring' sensation in the knee which I don't think should happen in a successful TKR procedure. Similar sitting down, getting up from sitting position.

Extension and flexion of the knee enhances the clunking and can also be painful, although not all of the time.

That the symptoms are not settling and appear to be worsening doesn't fill me with optimism moving forward. Wouldn't have thought that I could get to four years like this.

Yet, I am sure that if my X Ray in September had picked up anything, I would have heard something. Although my symptoms have become more acute since then.

Would a physical examination of the joint by my surgeon confirm any loosening? If so, I would pay for a private consult with him.

I hope that my GP can provide some guidance for me tomorrow! Although the guidance and support provided here has been invaluable!
 
Scouseman said:
Certain movements (walking downstairs for example) result in a very painful 'jarring' sensation in the knee which I don't think should happen in a successful TKR procedure. Similar sitting down, getting up from sitting position.
Click to expand...
These are the exact reasons I had mine done. They were the only times I had pain before my replacement. That pain is gone now, but I have several other issues that I didn’t have before. Compared to what I have now, I didn’t know how good I had it back then!

I agree that you shouldn’t have pain at those times, and I hope your doctors will take you seriously and find the source of your pain.
 
My surgeon did provide me with his personal statistical outcomes of TKR to allow me time to consider going through with the procedure.

85% Total Success
10% Complications, infections, patient disatisfaction. Revisit of procedure.
5% Worse thing that patients had endured. Made matters worse. Regret having had it done.

Of course, I took the chance that I would be one of the 85%.

Not quite in the 5% yet, but I am a bit worried!
 
Scouseman said:
Would a physical examination of the joint by my surgeon confirm any loosening? If so, I would pay for a private consult with him.
Click to expand...
That along with a fresh x-ray may confirm. And given the current situation, if you can afford a private consultation I would get your GP to refer you. I'm assuming he does revision work?
 
Thanks Jacey!
Fortunately, my surgeon is also an expert in the field of knee replacement revisions!

I would imagine that, combined with a fresh X Ray, a physical examination by the surgeon would provide a diagnosis?

Let's see what my GP advises tomorrow!
 
Dear All,
Result of my GP telephone consult.

My GP advised me that the X Ray taken of my knee in September was unremarkable. Comparisons were made with previous knee X Rays post TKR that showed no change.

However, it was suggested that, should I experience further symptoms, a referral should be made to my Consultant.

My GP reminded me that such referrals need to be triaged via the musco skeletal specialists first. (In the UK anyway).

However, as I am technically still under the care of my surgeon, (review in November 2021), he suggested that I telephone my Consultant's secretary next week to request an urgent review.

My GP will still process a referral from his end.

So, the wheels are now in motion to have my TKR assessed.

Whilst hoping that it is not a loosening, my symptoms do not enthuse me moving forward!
 
@Scouseman So glad your GP is supporting your need for an urgent referral. Hope your wait isn't too long!
 
My tkr was a camera assisted surgery. I have two small cuts in my shin area where the camera went in to assist the surgeon to measure and correctly place the implant. Perhaps you could use another method to check what's happening inside your leg other than an X-ray. Good luck.
 
Received in the post just now an acknowledge ment of my GP's referral to the musco-skeletal department for an assessment of my knee. Maybe it will not be too much of a wait?

What are the chances of the new joint not fitting in the first place? Remote, I would have thought, but there must be some reason for the symptoms that I am experiencing!
 
Good Afternoon Everyone,
A brief update.

This afternoon I had a private consult with the Knee Surgeon who replaced my knee in November 2018. On the plus side for me is the fact that he specialises in Knee Replacement revisions, so I am in very good hands.

With regards to the clunking in my knee, post a thorough examination, in which the surgeon was able to feel the significant degree of clunking, the cause of this was attributed to my kneecap not tracking accurately over the joint. The cause of this was the many surgical procedures that I have engaged in since 1990 (repair to ruptured ACL being the first of many), causing extensive scar tissue, together with the scar tissue caused by the TKR itself.

The surgeon advised that the knee felt stable to him but wanted to explore further and has arranged for an MRI scan of the knee. Apparently, the type of material used in the new joint (Genesis II) is suitable to endure an MRI scan without any risk.

I will keep you updated!
 
@Scouseman Thanks for the update! Sounds like progress. Hope you don't have to wait too long for the MRI.
 
Hi to all.
Just had my post MRI Scan follow up consult with my shrgeon.

The MRI scan revealed that I have Patella Clunk! Irregular tracking of the knee cap.

Perhaps this is something that other forum members are aware of?

I have already referenced the skill and experience of my surgeon, particularly with regard to revisions of TKR.

Within this context, I would appreciate your take on his initial advice going forward.

Initially, Physiotherapy to build up the VMO muscles on the inside of my knee. My surgeon is of the opinion that this might just realign my patella.

If this option proves to be unsuccessful, then I need to see the surgeon once again.

Now, I appreciate that the Internet can be a dangerous thing.

However, Patella Clunk is one of the primary reasons for patient disatisfaction post TKR. It appears to be a tad more than irregular tracking, with nodes appearing behind the patella.

Yet my surgeon did not appear too fused about this symptom. My symptoms are chronic!

Any advice or reassurance guys?
 
Many people who get knee replacements have a noisy patella for a while during recovery. As you noted, it is a fairly common complaint. As the muscles strengthen during recovery, the clunking noise usually goes away as the patella settles in to it's proper alignment. So the physical therapy your surgeon recommended is a good first step to try and improve the situation for you.

The fact that you have what sounds like fairly significant pain with the clunking noise could be an indication that the maltracking is relatively severe. I'm assuming you don't have a patellar button and it may be possible for your surgeon to add that if the therapy doesn't get the job done.

You are wise not to just let this go and try to live with the pain. You don't want to put yourself in a position where the patella receives any further damage. Please let us know how things go. Don't give up. You have a good revision surgeon (hopefully) who should be able to get this resolved for you.
 
Hi Jamie,
Many thanks for this!

Is it normal for this symptom to be present two years post TKR?

I do have a patella button.

Of course, I will fully engage with the Physiotherapists in an attempt to put things right! Hopefully, that will be enough!
 
Happy New Year everyone!
I do hope that your recoveries are going well?

I am now just over three years since my TKR.

I have been seeing my Surgeon who has reviewed X Rays and recent MRI scans and diagnosed Patella Clunk.

In an attempt to assist matters, intensive Physiotherapy was arranged, to build up the VMO muscle around the knee.

Unfortunately, this regime has not helped matters and I am due to see my surgeon some time soon to discuss next steps.

The clunking is signficant, and at times quite painful.

Whilst I have no regrets in having a TKR, I would prefer not to have to endure this particular side effect!

As a young recipient of a TKR (I was 56 when I had the surgery), I don't particularly relish the prospects of having to live with this.

I was wondering if fellow TKR recipients have experienced Patella Clunk and how it was managed.

I feel that my next step may well be surgical intervention, via arthroscopic procedure.

I would appreciate any advice that you may have!

Thanks in advance!
 
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