PKR with Problems

[Motherofmany]

Deb,

Sure hope your GP is able to get you in sooner with a new OS! So sorry for all your pain and frustration. I don't understand why your OS didn't do new x-rays at your check up. Mine has everytime I go in to compare, particularly when having difficulty.

I agree with Jamie to call his office tomorrow and get your test results. Will be praying for good results and no infection. Keep us posted.

I too was glad to find someone who has been through this and could relate and advise. So feel free to post and vent whenever. We understand.

Blessings,

 

[Josephine]

A point you might find of interest ... I was talking with my surgeon today, he referred to himself as not being a 'part-time' knee surgeon. We got to talking about hemi's and he said he was going off them in a big way, that his latest figures have shown he is converting almost 10% of them at the present time. He also shared that at knee conferences, it's a common comment amongst knee surgeons that they are doing the same. He said he thought it was ironic that the Oxford web site were making such claims of longevity because they are, quite patently, not true.

Interesting .....

 

[DebR]

Thank you for that Josephine. That update is very interesting......I did call my OS today and he finally got back to me that there is no infection.He said he still recommends the TKR. I tried nicely to explain that that's not going to happen unless someone tells me what's going on in there. I told him i wanted a scan, x-ray something. So he recommended a three phase bone scan and an indium scan, which I scheduled for this Monday. Maybe then I will have more information. I am calling tomorrow to schedule an appt with an OS in NYC and I have applied for all of my medical records so that I can take them with me.

 

[Jamie]

Go, girl! You're in the driver's seat now!!!

 

[Jayne]

Deb,
Where do you live? I can recommend my surgeon as he has won the best in knee/hip replacement in 2007. Unreal guy. About 49 and he is not pushy. Just cares you are okay! I was amazed at his treatment of me. I don't want you to cry but I understand your frustration. I have had both knees replaced this past June. I am dealing with some muscle aches and want off the meds.
My thoughts and prayers are with you.
Jayne

 

[DebR]

Hi Jayne,
God, both knees? I hope you are getting better everyday. I know about the meds, I am still taking 3-4 percocet everyday, but without them I don't do much. I have a dear friend who had TKR about a year ago and still occasionally needs his perc. His doctor has basically said, if you need them, then your body needs it. When it doesn't, you just won't take it anymore. It's that simple! So don't worry about that, you are still in a real recent post-op period. I live in Orange County, New York-Near Middletown. If you know of someone closer I would be happy to make an appointment! I really appreciate the info. Keep up what you are doing, and try to not get too depressed. It's not easy, but I found that good food, good books and great movies help.Talk to you soon,Deb

 

[DebR]

Ok, so I went for the bone scan the other day and my NEW partial knee prosthesis is definitely loose!!!!!!!! after 5 months. I have requested my medical records from my previous OS, but who knows how long that will take. I am in the process of finding a revision specialist. I have called the hospital for special New York City with names I was given personally from people that had their knees done, but they are not revision spec. The hospital is amazing in their response time, but are very direct as to who treats who. Sports injury, knee replacements etc. I did receive the name of an amazing doctor in Hackensack, nj, but unfortunately he does not take my insurance!! Very frustrating.Still researching. I have still not heard the results from my original OS 5 days later. I work for general surgeons and one of them got the report for me so I could know the results as soon as possible, nice huh? If there is anyone out there that has some knowledge or names of knee revision specialists, I would really appreciate the information. Everyone I talk to cannot believe that the thing is loose so soon after surgery, but the bone scan was crystal clear
Thanks for the help,Deb

 

[calling_all_angels]

Deb,
I can not help you with a Doctor. But I did want to say how sorry I am that you are having a problem finding a OS that does revision's. I find it hard to believe that you Old OS has not even called you yet.
Being from a "really" small town I have always thought that you could find anything at anytime in NY.
I will pray that you find the Doctor you need soon.

 

[DebR]

Thanks, me to. I'm working on it!

 

[petuniafish]

Gosh Deb,
The problems you are experience are a pure nightmare. You sound like a very strong woman to be dealing with all of these variables. I had an Oxford PKR placed in April 2009, so we are nearly at the same place. Just had an Xray 3 weeks ago and OS said things were fine. I have a torn medial lateral ligament tho, and feeling woo-woo-woo for myself because probably going to lose my job. It sounds as tho, while it might be difficult, you have a little more understanding employer.

But wow, what a difficult path. Makes me feel a little less sorry for myself! I know a revision specialist in SF but he's not going to be under your insurance coverage! Your friends and family must be freaked out, but NO ONE knows how difficult this is who has not been through it.

Jo, I was fascinated by your revealing conversation with your OS about hemis and the Oxford in particular. Yikes!

 

[tooyoungforthis]

Hi Deb,
I just had a revision done July 23 and it took some time to find a doctor. I live in N.J. and the doctor I when too was in Philadelphia. Let me know if you want his name and number.

 

[giulia]

Hi Deb
Russell Windsor at Hospital for Special Surgery did my LTKR on Aug 10. He does revisions and difficult knees. I didn't need a revision, but I did need someone who had a lot of experience doing difficult knees. My knee was about 18 degrees valgus and had a 10 degree hyperextension. I can't say enough good things about the surgery. My leg is wonderfully straight with no nerve damage. I'm bending to 120, extend to a mere 0, and have been walking with a cane since day three. If I can help you in your search, let me know.
Best of look in finding the best surgeon for you.
Giulia

 

[Josephine]

Ok, so I went for the bone scan the other day and my NEW partial knee prosthesis is definitely loose!!!!!!!! after 5 months. I have requested my medical records from my previous OS, but who knows how long that will take.

Well, that's not good enough! That smacks of very poor technique for it to come loose so quickly. If you need any interpretation on your notes, give me a shout. Though you sound like you have appropriate contacts already which is good.

 

[DebR]

Thank you all so much for your encouragement!!Philadelphia is about 2 1/2 hrs away so I think I will look up Dr. Russell Windsor at Hospital for Special Surgery, since I am only about 1 to 1 1/2 hrs from NYC. I agree Josephine, I think the technique used was at fault and the physician!!! As soon as I receive my records, I will read and promise to ask for help with any interpretations I may need. I need to get moving on this, I know, but somehow mentally I am not ready. When I read what some of you have had to deal with this really isn't so bad. The time off work is definitely a concern since I feel like I just did this only, I will be off longer than with the partial knee. This will be the 4th surgery on this 54 year old knee in the last years. Two arthroscopies, one PKR and now a TKR coming up. I need to get this better because the depression is starting to kick in. I don't necessarily want to do anything because I am always uncomfortable, although some days are definitely better than others. Now I have added the (little) fear that this will get even looser as I go about my day to day life. You guys keep doing what you are doing because I can't tell you how nice it is to be able to talk to ya!!

 

[Texas]

Hey Deb I agree getting moving on it the depression cant get bad sometimes dont let it get to far.........I can post and bug you everyday to keep your mind off of it..lol.....kidding !!!!!!!!! Just try to keep your spirits up I know its tough.............Dont feel like yours is less then someone else........yes others have worse problems but it doesnt make your any less........hang in there keep us posted !!!!!!!!!!!!!.......)

 

[DebR]

Hi All,
I just got thinking (which could be dangerous!) If this partial knee is loose, are there things I should not be doing? I mean common sense obviously, but has anyone heard of this becoming worse within a short period of time? My OS says he means micro-loosening (whatever that means), but the bone scan was pretty clear. Jo, have you ever heard of this becoming an emergency? I keep thinking I can take my time and find the right revision specialist , which I will, but is this thing ok for the next couple of months?
Anyway, just thought I would post the question since nobody that I ask has any idea.
Thanks again,Deb

 

[Pat29627]

I guess just going in and re-gluing it is not an option?

Before surgery, did your doctor tell you that he couldn't be positive that he could do a partial just from looking at the x-rays, that he'd have to see inside the knee to be sure the lateral side was fine?

What kind of problems have you been having with it? My doctor had said I had tendonitis and unlikely but possibly a stress fracture. The tendon area doesn't hurt to push on it anymore, so I don't know why the knee hurts so bad when I first start walking on it.

Pat

 

[DebR]

Actually no, he said I was the perfect candidate for a partial knee replacement!! I just received some reports of x-rays done 2 years ago and it clearly states there is damage in all 3 compartment, osteoarthritis. The pain is always there, sometimes it's just a constant ache and burning, and sometimes is a sharp pain. My OS said the post-op films looked great, and did not feel the need to do this again. I requested the bone scan (three phase) which showed loosening. I will be going to the Hospital for special surgery in NYC, and see what they say.

 

[Josephine]

Hi All,
I just got thinking (which could be dangerous!) If this partial knee is loose, are there things I should not be doing? I mean common sense obviously, but has anyone heard of this becoming worse within a short period of time?
I keep thinking I can take my time and find the right revision specialist , which I will, but is this thing ok for the next couple of months?
Anyway, just thought I would post the question since nobody that I ask has any idea.
Thanks again,Deb

Jo, have you ever heard of this becoming an emergency?

No, not at all! This is not a situation where the implant is rattling around inside your joint. You certainly can take your time. It should be okay for even longer than that. And the reason for that is the meaning of the term "micro-loosing"

My OS says he means micro-loosening (whatever that means)

Micro loosening is when there is minute amounts of die-back around the cement. For you to understand that, let me first explain about "cement security".

When the bone is prepared for the cement, it has to be cleansed with a power washer (not unlike the one you use on your car!) which gets rid of all the blood and fatty marrow that lies within the matrix of the spongy looking area inside the bone. This is because if any of the tiny spaces are occupied by any of these materials, the cement cannot get in. And it's important because getting the cement into these crevices is what makes it secure, or hold fast onto the bone. Additionally, if this doesn't happen, the cement sits on top of the bony spicules and quite quickly the bone will die back under the loading. Bone doesn't like being unevenly loaded, you see. So when this die-back begins, the cement loses it's grip here and there until it's loose enough to start moving tiny amounts. Strangely, when the surgeon gets in there, it'll be possible that he might not find it very easy to remove the implant and might even have to apply a little force with a kind of mini-crowbar!

These illustrations demonstrates more clearly about the bony matrix and about cement security

 

[cindy88fan]

Deb,
You have been through so much! I don't know anyway that I can help you except say a prayer for you. I wish you all the best and hope you get results soon.

Love, Cindy
__________
BTKR 7/20/09