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PKR with Problems

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Thank you all so much, and Josephine that really explains alot!!!!!!!!! I am not crazy about the mini-crowbar thing but at least I would be asleep(thank god).I am still learning all that I can and this information is invaluable. I have been wondering why in the world this could come loose after such a short period of time but that explanation makes perfect sense, it also eases my mind. I will not worry so much now about this thing coming completely undone while I go about my routines AND find the special OS I nee. Again, thank you all!
 
Deb--
I'm so sorry that you're having such a difficult time. You'll be in my thoughts and prayers. I'm sure you'll find an OS you can trust who can get this straightened out and get you better.

Blessings,
Irene
 
Dear Deb,

What a bummer---and what an incompetent os---I hope his malpractice is paid up!!!

Can't those general surgeons you work for find a revision specialist for you? although you seem to have done a good job on your own. It will be a pain to drive to NYC, but, possibly, the surgeon there might recommend someone closer to you as well.

My surgery was a quad sparring MIS (minimally invasive surgery). I was very worried about the scar and appearing "damaged". Yesterday, I was at the pool (I do a daily "run" in the pool while wearing a bouancy belt) and talking to three women who had had tkrs. I mentioned that I had had one too----remember, we are in the dressing room after swimming!! and the three of them said that they had looked at my knee when I went in the water and did not see any scars---and they asked me which knee I had Had done!!! When I showed them the scar that I had been so worried about, they all said, where and moved closer. It is there--but, since it is three inches long, it does not stand out!!!

I had my tkr on May 13 and I just went on a nine mile hike in Glacier National Park on last Wed. Thursday, I rode 12 miles on my bike to have lunch with friends. I am biking to my OS appt on 8/31---the OS office is 8 miles from my house. I think you are taking control of your own health care which makes all the difference---I still have bouts of "was this all worth it" myself. But, if we want to be active, we have to push, push, push. I am 65, am a ski instructor in the winter--I have just stepped up my gym workouts to make sure I am strong enough in December.

good luck and keep us posted!! Kelly
 
DebR said:
Thank you all so much, and Josephine that really explains alot!!!!!!!!! I am not crazy about the mini-crowbar thing but at least I would be asleep(thank god).I am still learning all that I can and this information is invaluable. I have been wondering why in the world this could come loose after such a short period of time but that explanation makes perfect sense, it also eases my mind. I will not worry so much now about this thing coming completely undone while I go about my routines AND find the special OS I nee. Again, thank you all!
Click to expand...

Actually, I was just trying to emphasis that the implant may well be fairly firmly fixed in the bone even though it's 'micro-moving! And most of our orthopaedic instruments look like a workman's tool box anyway! :wink:

I wouldn't stress out about finding a revision specialist as converting a partial to a total is not that technically demanding. Any good knee surgeon will be more than able to do it. But the key word is GOOD!!


 
I was just recommended to an OS at Mt. Sinai by the name of Ronald Grelsamer. He is chief of orthopedic surgery. There is an OS that used to practice here where I live, and one of the surgeons I used to work for is a personal friend of the OS. This man actually did my husband's arthroscopy many years ago and treated a stress fracture on my son. He made a call to Dr. Grelsamer and when I called this afternoon I got an appointment for next Thursday, 9/1/09. Unbelievable how fast I got an appointment. I am very comfortable with that I have read and heard about this doctor so we will see. I am taking the list of questions that Josephine posted just to be sure I don't forget anything, so we will see. Again thank you so much for the input and the prayers!!!!
 
Cool beans! Sometimes it's nice to have contacts!
 
Deb
I just read through your whole post. I'm glad you are seeing a new OS soon. That is great news.
I have a wonderful hip/knee surgeon. He replaced my hip and has done surgery on my knee. I asked him about a partial knee replacement and he said no way for me ever. He said I am too active, if they work at all it would be for a very sedentary person with the correct amount of damage. I only have damage in the pattello-femoral section. He still thought it woud become loose very quickly and then I would need a TKR. Sound familiar.

So far the scope/microfracture/cleaning out the scar tissue has worked so I'm good. Just thought I would add what I know.

You are on the right path now. We are all here for you too.
judy
 
sounds very familiar, the only difference is my OS did not say those things!! He knows what I do for a living (managing a surgical practice) and that I am very active. His one questions was, are you a runner? To which my answer was no, I walk when I can. He said then the partial should be my first choice, perfect candidate, etc, etc. So funny to hear about other people's experiences. He never mentioned it coming loose, just that it should be good for 15-20 years before possibly needing a TKR. I have learned so much through this website. Every person that contributes or tells their story helps so many people, even if you are not aware that you are doing it. I too ran a low grade fever in the late afternoon and evening for a while. The swelling was exactly where your's is. Outside of knee and the top. In fact after 5 months, the outside of my knee is still numb. Shaving still gives me the chills when I go over that area. Wierd huh?
 
I use the electric razor of my husband still no cuts..lol.......Mine is still numb to wonder how long that lasts............Hope you feeling better......)
 
Nerves can take a year to repair themselves. Sometimes they never do.
 
Hi Everyone, went to see the doctor at Mt. Sinai. He was great! Has me on crutches for 10 days, god, my arms are killing me!! Wants to see if this could possibly still be post-surgical pain. He is also doing an Indium scan? THe hospital near me only does white blood cell scans so I am waiting to see if that is comparable, if not will have to go elsewhere. He also wants to do another diagnostic arthroscopy to completely rule out infection. If none, then up to me as far as comfort. He did say the bone scan I had,will read abnormal for up to 1 1/2 years due to the joint replacement so the additional scan will help. If they indicate underlying infection will have to have TKR in either 1 or 2 step procedure but said to premature to think about that yet, so we will see......
The 2 step procedure sounds pretty awful but I think I have read notes on here from some that have had that done. Go in, remove the knee, home for 6 weeks of antibiotics and then back for the TKR? Anyway, just checking in and trying to adjust to the crutches. It is much harder than I thought (ha-ha)
 
Indium Scanning
"A scanning procedure in which a patient's white blood cells are first labeled with the radioactive substance indium, and then the patient's body is scanned as a way of tracking the white blood cells at the site of possible infection."
Link
 
Hi Deb. Sorry to hear about all your problems. I've been down the 2 step replacement route following infection in the knee joint. It's not much fun so I really hope you don't have to go there.

Hang in there with the crutches. I was on them for 11 weeks having had the old joint taken out and before the new one could be put in. I never thought I'd get used to them and to start with my arms and my breast bone were really painful. But eventually I got the hang of them, became quite speedy on them, and actually became quite attached to them. I felt quite bereft when I finally had to give them back and go on to two sticks instead!

Hope you have some good news soon. Linda x
 
Thanks Linda,
I was reading your posts, and you went through a rather rough time of it yourself!! How long after the PKR did this all happen? I am 6 months post-op, and just now trying to rule out infection. The crutches are getting better but I need to do the rest to rule out any infection. Scan and arthroscopy next. The doctor at Mt. Sinai did say I may have to donate blood for the indium scan? Not sure why that would be and of course I thought of that question after leaving the office!! Linda I am glad you are doing better, you are incredibly strong
 
Well, Deb - I can see you never read the link I left you! You really should, it's a good, clear explanation of the procedure.

"A nuclear medicine technologist withdraws about 50 ml. of blood. White blood cells are collected, exposed to indium, and reinjected by IV back into the patient."

(Ain't it amazing what you can find on Google!)
 
Mine's a long story Deb. I had bilateral PKRs in August 2005. In April 2008 the left one came loose so I had it changed to a TKR. This was ok until November 2008 when it once more started being painful and so the lower section was again replaced. It was 10 weeks after this, in February 2009, that the infection first appeared. The knee joint was washed out and I was on strong IV and then oral antibiotics for 6 weeks. 2 weeks after coming off them the infection reappeared and so my surgeon made the decision to remove the whole knee joint. That was on 1 May this year. I was then back on anti-biotics, in a leg brace and on crutches or in a wheelchair for 11 weeks while the infection cleared. The new knee was put in on 20 July and so far all seems to be well.

PLEASE don't let my horror story scare you. As you'll know if you've been reading the posts on the forum, people who get an infection are the exception rather than the rule and the majority of people sail through their knee replacement with hardly a backward look. However, if it turns out that you do have an infection, you'll cope because you have to!

Do you know when your scan and arthroscopy will be? Keep posting so we can keep you in our thoughts and prayers. Linda x
 
Sorry Josephine, I read your post and completely overlooked the word "link"
Duh!! Thanks for that explanation, now I get it.
Linda, I don't know yet when the scan will be, still waiting to see if I can have the white blood cell scan close to home or go elsewhere for the Indium scan.I am calling the OS office today. You are one incredibly brave woman, I can't believe what you had to go through!!!!!!!! I so hope all is still well and this one will be a charm. You are right, there really is no choice but to do what's needed and thank god I have an incredible family and wonderful friends. I am definitely feeling a huge difference in the pain while on the crutches, less swelling etc. Not sure what to do after the 10 days, except rest it more often than I was before. Will keep you posted as to the test and arthroscopy, but as far as I am concerned the sooner the better. I just need to know if there is an infection. My sister and I were walking back to the car in Manhattan after the doctors visit when the question hit " are they taking out the whole knee if needed for 6 weeks, how do I get around? Should have asked the MD, but you answered that. If the 2 step procedure is needed, do they fill that knee space and then cast it? I am just trying to play out all the possible scenarios due to work. Lot's going on, and I cannot carry over vacation time. My new time will start the beginning of the year. What kind of time frame are we realistically talking about as far as being completely out of work? I am on my feet alot and work an average of 10 hours a day. us some thoughts?????
Thanks again as always for being there, Deb
 
They make 'spacers' out of bone cement impregnated with antibiotics to keep the space out to length and stop the ligaments from contracting. You'll find it quite difficult to get around in this phase, needing to use crutches, and work will be out of the question. No cast though. I think you'll also be on oral and/or IV antibiotics as well which can make you feel pretty rough. It's good to take those probiotics yoghurt drinks during that treatment as it restored your gut bacteria which is what makes you feel so grotty. There will also be regular blood tests to see the state of play in the infection and they won't proceed with the second stage until you've been clear for a couple or more weeks. That's not a very predictable time period.

Sorry to be the harbinger of bad news, but I always believe in truth where these things are concerned. But who knows - it may not come to that. Let's pray it doesn't.
 
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