Posterior Stabilizing Revision

[alvsas]

Hi
Anyone out there w/o a patella (knee cap) who went for a tkr experiencing need for revision due to instability? I have posterior/anterior (front/back) movement, pain, swelling and instability and am considering a revision. My total knee replacement was just prior to Katrina (July '05) and have experienced severe instability since. Looking for others who may have similar type prothesis or revisions. Thanks.

 

[Josephine]

An interesting situation there. The presence of the patella is an integral part of the stabilizing structure of the knee joint at any time but especially so in a TKR. It acts as a kind of buttress that keeps the tendon tensioned over the end of the femur and also keeps it tracking between to two bony eminences. The loss of the patella means that the tendon can slip and the tensions are all wrong, a bit like having the guy ropes on a tent in the wrong place!

I expect that when he performs the revision, the surgeon will be making some adjustments to the tension on the quads/patellar tendon in order to overcome this. Your rehab afterwards shouldn't be that much different from having a primary replacement.

Mind, you've done well to cope this long with it, so my hat off to you!