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PKR with Problems

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DebR

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Apr 7, 2009
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Location
New York,United States
Hi Guys,
I signed in a few months ago after a right partial knee replacement and the support and information was wonderful! I am now 5 months post partial and still having way to much pain. I went for follow up again the other day and the OS says he thinks I now need a total knee replacement. Either the fit of the partial was not right or the cement has come undone. He sent me for bloodwork, to rule out infection and will be calling me tomorrow. To say I am depressed is an understatement!!! I did PT, exercises etc and now feel like I wasted the last 5 months. I am definitely going for another opinion but not real sure where to go from here. I cried all day Thursday, now I am just angry! There was never any discussion of sizing of the prosthesis, maybe the arthritis has increased, maybe the cement came loose? What am I supposed to do with that? I am still on Percocet, and work everyday, but am so uncomfortable I end up limping again half way into my day. I want either another x-ray,or something to prove what is wrong before I go through this again. Don't know if I am a candidate for any kind of MRI because of the metal. Any guidance you can offer at this point will be greatly appreciated
Thanks so mucg, Deb
 
Re: I have a date!

Deb, I am so sorry to hear that you may be facing another surgery. You are doing the right thing by getting other opinions....you might want to get several before you agree to anything. I would make sure at least one is from a revision specialist. This is someone who takes on the more difficult cases after one surgery has been done.

No one can predict the outcome of a partial knee replacement. Many times they do the trick and the knee is just fine for a long period of time. But in other cases, any surgery on your arthritic knee (mine was "only" an arthroscopic surgery for torn meniscus) can hasten the arthritis (loss of cartilage). It sounds like this may be what happened in your case. Either that or the possibility that the prosthesis has loosened should be easy to detect with xrays. And after a discussion with a couple of doctors, you'll know what you have to do.

My heart is with you, hon....this is not fair after you have done everything just the way you were supposed to! Please continue to post. I care about you and how you're feeling!!!
 
By the way, Deb...I moved your post and mine to a thread of your own in the recovery forum. It will get better attention here with posts specific to your issues. And it will not derail the other thread where it was first posted.
 
Deb
So sorry to hear about your problem. But getting at least a couple of other opinions will give you some direction to go.

When you get the proper KR you will be glad you did.
 
Thanks so much, kind of new at this and didn't know how to move it! I really appreciate the support. Kind of hard to explain to anyone that hasn't had this done.
 
Yes, Deb.....that's what BoneSmart is all about....being able to provide that support you need from people who know EXACTLY how you feel. We're here for you.
 
I have written this post twice now...grrr!!! Someone does not want me to give you some words of encouragement.:cnsl:

You last few months do not sound like you have gotten any opportunity to enjoy the potential of this surgery (PKR or TKR). With the right surgeon, the right prosthesis, and the super glue cement...you are going to REALLY experience a better life. No doubt that you are discouraged, but think how much you have learned that can help others go through tough times. I hope that you can find a bit of hope:wink:

You will be walking and doing the things that are impossible now...need encouragement...read some of Ski's posts. She's one of our poster girls who has recovered and returned to a normal life (it would NEVER be normal for me) for her. Her adventures make me realize that WE can do it!!!:thmb:
 
I know you are so right about having the right surgeon and some quality of life. I now have to begin to find the right surgeon. I was reading also about the quad sparing TKR on the bonesmart home page. I have alot I need to find out. I first need some answers as to how this happened so soon after the partial. I think I read somewhere that it is possible to have a CT scan of the leg to help diagnose the problem because I do not think I can have an MRI due to the metal in the knee. It is just still so fresh in my mind, all the PT sessions, trying to get around, and trying to pee in the itty bitty bathroom in the hospital!! I know I remember some wierd things. I cannot thank you guys enough for the quick responses. It will help me start off my week in a better state of mind then I was a few hours ago. I live in the Hudson Valley area of New York, Orange County. If anyone knows of an OS that is familiar with revisions from partial to total knee, or any questions that I really need to ask please send them my way. I am so done feeling like this, and need to move on to a better quality of life. Thanks again, Debbie
 
Hi Deb (and everyone) If you need a TKR thats fine I think you will be fine.I do agree if this Dr cant do a parl I would be a lil afraid to have him replace the whole thing....Maybe get a second opinion make sure about the Dr that is soooooooooo important believe I didnt and paid for it.....I hoe thing go well for you...Please keep us posted...And Welcome......:)
 
Deb, to find SkiGirl and her posts, type her name into the advanced search function to search by user and all her posts and threads will appear.

As for a doctor, you can (broken link removed: https://bonesmart.org/clinic_lookup.php to search for surgeons in your area.
 
Well, this is the downside of partials. Very few people have arthritis confined to one area of a joint as it just doesn't work that way. Even if the other compartment looks okay, sometimes the patello-femoral joint (behind the knee cap) is damaged as well. I'm always leery of them for just this reason - it's a bit of a lottery as to whether they will last a few years or a few months. Must say I'd never have thought a joint that took a downturn after only 4 months would have been suitable for a partial in the first place but .....

I doubt it's come loose so quickly and I also doubt he's used a wrong size as that wouldn't account for your pain. I think your surgeon made a bad choice in doing a partial and if I were in your shoes I would NOT let him near it again.

Actually, even I was wanting to know if replaced joints could be scanned and so I asked my good friend when she scanned my good knee recently. I asked her if my replaced knee was at risk and should I keep it as far away as possible and she assured me it was okay. That the materials the implants are made from are quite okay in the MRI scanner and that she does them quite often with no problems.
 
If you want to know more about adhesion's (scar tissue) and why they happen, you can look here MUA (manipulation under anaesthetic) and adhesion's
This is actually a Jo post.
I hope she doesnt mind.....This she give ya what you need. U did have one only because after are the struggling and exercises I could only bend 68 to many surgeries and scar tissue, They out you under and bend you knee far to break all the tissue up..It works well for me....I am now 129 ....Lil sore in the beginning but that was all. Good Luck I hope this helped.....

MUA (manipulation under anaesthetic) and adhesions
Josephine ...
go to search and key this in.....
 
Thank all of you so much! I am reading more and more posts and trying to wonder what the hell my OS is doing? I saw him on Thursday, 5 days ago for my 5 month post op partial knee replacement. I tell him all the pain and swelling am having from my knee down through my ankle, and how in the last month I feel the pain is different, NOT better.He examines my knee and then tells me I now need a TKR. He did draw blood for c-reactive protein and sed rate to see if there was an underlying infection. It is now Monday and still no phone call. I asked him to do an x-ray but he said we did 3 and they were all fine. No mention of an MRI, CT, sonogram etc. How does he diagnose the problem with no films of any sort. He did tell me I should feel free to see another surgeon for a 2nd op, and he would set me up with one of his partners! I am now researching 2 doctors at the hospital for special surgery. The one I wanted to see (first choice) is booked through the end of Jan. 2010. I will call someone else tomorrow. Should I just wait for that appt to have some films done or request them here and take them with me? My OS here said if the blood was elevated, he would aspirate the knee and send the fluid out. I don't really want anyone sticking a needle into the prosthesis before they really know what is wrong. So frustrating
 
In my opinion, he should have taken a current xray the day you saw him. DO NOT see any of his partners. They are HIS PARTNERS....guess what their opinions will be!!! The same as his!!!

You need to see doctors in totally different practices. I wouldn't worry about trying to get new xrays done to show them. But once you do get an appointment, go to your original doctor and get copies of all your films. You may have to pay for them, but it's worth it for the new doctors to see what your history has been.

As for the test...call his office tomorrow and ask. And keep bugging them until you get a result.

As for the doc that's booked through January, call back again and ask if they could see you on an emergency basis. Or have your primary doctor's office call to make the appointment for you. They have ways of getting through.

I'm afraid if you do have elevated blood levels, you would need to confirm that you did or did not have an infection. That is a very serious matter if you do have one and it must have immediate attention. But if it was me, I would rather have one of the new doctors do the aspiration.....not this guy.....your description of what he's done makes me very nervous.
 
Hi Deb

I agree with Jamie, you need a new doctor and I would not let the old one do a thing. You have a right to copies of all your films and medical records to take to a new doctor. For the doctor that is booked, Jamie is correct to have your primary doctor call and tell them this is an emergency and if he really can't see you, he should be able to refer you.

Good luck.

Simon
 
Oh no no call him and please make sure you are 100 percent on board with this Dr. meaning make sure you totally trust this Dr. I wouldnt see one of his partners I would go completely out of the group. Im glad you are seeing someone else its your knee you get one real good shot at a TKR make it worth it....I do feel for you with all the running around...You will find a Dr that wont give you a run around. If hes doing it now forget it he will later....Always here to talk to you please feel free.......Do what is best for you and be comfortable.......You know what your doing you sound like you have a great head on your shoulders you will do whats right....:) Really I didnt with my first Dr even though I saw signs but did it anyway and ended up with another Dr and still making up time but its all getting better............Good Luck...:) Sorry i think I posted over Jamie....or at the same time....:(
 
Ok, will do. Didn't think about primary calling this physician. The other 2 I am debating on are also working with the doctor I wanted to see and have been for a long time. Chief's of their dept etc. I am really trying to locate a revision specialist as was recommended here. I do understand that going from a partial to a total knee in a span of only several months might be alot to take on, but compared to what some of you have gone through its not. A really bad time right now with work and taking so much time off but will have to do whats best. Hard to know a really good time, sooner and hope I am better for the holidays, or wait for the first of the year when the weather is not nice and not much else to do (ha-ha). I guess it will depend on how long I can be this uncomfortable and of course what the right OS says. You guys make it really easy to talk. I have a wonderfully supportive family and caring friends but none have had joint surgery, so when I get cranky its nice to do it here where everyone understands!!!! Be in touch soon, thank you
 
LOL...crank away here, Deb....that's part of why we're here!!!
 
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