TKR Post op swelling and stiffness<<

[Celle]

Josephine is away at the moment. She'll answer you when she gets back.

Yes I had a totally new knee cap.
It was too bad to be resurfaced.

I didn’t find this out until my day of discharge.

I have never heard of that being done. Maybe part of your kneecap was removed and part left in place, but there is no surgical device that replaces a kneecap.
It may be possible to remove part of a patella and leave part of it in place.
If the entire kneecap is unsalvageable, then it would be removed, but that is truly major surgery and I think you would have had a much more difficult recovery.

I'm going to ask @Josephine to address that, too.

Sometimes surgeons will say "I replaced the kneecap" but they really mean they resurfaced it.

 

[Josh1303]

@Celle

I have the paperwork that says patella.
My Gp also said the letter from the surgeon Aldo says complete removal of patella and replacement prosthesis.

I cannot feel anything remotely like my own knee cap ( bobbly)
It’s also very flat when standing up with no sign of my knee cap

 

[Jockette]

Do you have X-rays you could post for us? I would like to see your replacementin the X-ray.

 

[Josephine]

Yes I had a totally new knee cap. It was too bad to be resurfaced. On my list of parts it does say Patella. I am confused. My GP said the letter read that I had a new patella as my own one was knackered

To the best of my knowledge, there is no such thing as a replacement patella and this is because it wouldn't make any sense to even try to use it. This is because the patella is a unique bone that develops within the tendon and is called a sesamoid bone. One side of it articulates on the femur but even that is not essential. So the usual method, if the patellar button cannot be used, is to simply remove the bone completely and repair the patellar tendon in its place. But this would complicate your recovery extra-ordinarily.

My GP also said the letter from the surgeon Aldo says complete removal of patella and replacement prosthesis.

I don't understand that at all and I tend to think that either the secretary and/or your GP have completely misunderstood the surgeon's dictated notes.

The ultrasound has shown that I have a torn quadriceps muscle. The radiographer thinks it’s been caused by the stair lunges

I've never like those exercises as you can see in this article BoneSmart philosophy for sensible post op therapy

I am worried now as to if it can be fixed and how?

If it was a really severe tear then it could be repaired (sutured) but mostly such tears are just allowed to heal on their own.

Did you see my post about ultrasound results?

Yes I did.

 

[Josh1303]

@Jockette

Hi
Sorry, I don’t have access to my post op x rays.

I saw an x ray when I went back for my post op consultation though.

I remember clearly seeing something that looked like it was a knee cap though.

When I feel where my knee cap was it feels totally flat.... no shape at all.

I’m beginning to wonder if the x ray I saw was actually mine!!!

 

[Jockette]

I’m disappointed you don’t have an X-ray, I’d really like to see what’s inside your knee!

My surgeon was always happy to let me take a picture of my X-ray at my check ups. I used my phone’s camera.

How are you feeling these days?

 

[maryo52]

If you cannot feel your knee cap, and I don't know all the details of your status right now, it's possible that it's buried in swelling or effusion (excess joint fluid). I had no discernible knee cap after my original TKR because I had a sizable effusion that never went away. I had to push a finger fairly deeply around where I thought my kneecap was to feel its borders.

 

[Josh1303]

@maryo52

I had my own knee cap totally removed

 

[Josh1303]

@Jockette

Hi again

Unfortunately I didn’t take a photo of the screened x ray when I saw my consultant.

I had a check up at 7 weeks and signed off so I won’t be seeing him again

 

[maryo52]

AIn Josephine's response she thought maybe there was an error in how the surgeon's notes were recorded. No one here has heard of a patella being removed. When you find out more, do enlighten us.

 

[Josh1303]

@maryo52

As you can see from this photo it clearly states Vanguard Serena Patelka

 

[maryo52]

I looked this up and it's the Vanguard Series A Patella -- not a patella per se but a patellar prosthesis. They shave off the underside of the patella and apply something that works with the other total knee components.

 

[sistersinhim]

When I looked this up it looks like something that is added to your own kneecap. I wish I could see xrays, too.

 

[Josh1303]

@maryo52
@sistersinhim

I have had my own knee cap totally removed.
It was no good at all and not repairable.
The consultant said it was far worse than what he originally thought and couldn’t save it.

 

[sistersinhim]

When you go back take a photo of your xrays and post them here. We would love to see them. We're never too old to learn.

 

[Josh1303]

@sistersinhim

I’m not going back. Surgeon discharged me at 7 weeks

 

[Josephine]

I have had my own knee cap totally removed.

Josh, once again I will say - there is no such thing as a 'total' patellar replacement. This is what comes with your total knee and it's a patellar button as per usual.

 

[Josh1303]

@Josephine

I am getting totally confused because my surgeon said the knee cap had been totally removed as it was too bad to repair.
When I feel where my knee cap was, there is no shape or anything to feel.
It feels totally flat and goes inwards

 

[sistersinhim]

I am getting totally confused because my surgeon said the knee cap had been totally removed as it was too bad to repair. When I feel where my knee cap was, there is no shape or anything to feel. It feels totally flat and goes inwards

I have no kneecaps at all and that's what my knees do. There are dents where the kneecap would be. I had these removed in the early 90s and they were not replacing them then. It is possible that he didn't put anything in place of the patella. If that's true then he would have had to shortened the patella tendon. Having your kneecap removed would add to your recovery time.

 

[Josephine]

When I feel where my knee cap was, there is no shape or anything to feel. It feels totally flat and goes inwards

So does mine - in both knees. And only the left has a patellar button!