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[TKR] Questions about spacer replacement

Discussion in 'Knee Replacement Recovery Area' started by Luluk, Sep 14, 2018.

  1. Irish471

    Irish471 senior

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    Hi @Luluk , you made me smile. I used to play that little game, too, pretending that my knee was normal . I had lots of good days, so I wasn't 100% sure it was time yet. I decided I would do all the things I wanted to do and I got stopped in my tracks pretty fast and would pay for it for days after. Truth be tokd, my good days were good because I wasn't being active. But that's not living my best life possible. It actually really helped me to make the decision to do the surgery. You're making the right choice :)
    In the meantime, I would try to get to the bottom of why your other knee still gives you trouble. Maybe a second opinion is needed. You will need to depend on that knee for your recovery. Keep us posted!
     
  2. Luluk

    Luluk junior member
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    That is funny,another member who likes to play the game of pretending to be normal! In an effort to try to survive til scheduled tkr date in july, i had a a corticosteroid injection last week. It feels so much better! Its really easy to pretend im normal, except when i walk too much or go downhill, or try to put on shoes and socks. If my knee goes slightly sideways it locks up. How many times can a person goes through this? the knee locks up, and you have to force it to unlock, and the knees go snap. Before those bones cant take it anymore and just break?

    Anyway, i got a visit scheduled with the knee surgeon to comtinue to complain anout the bewildering perplexing pain in the three year old right tkr.
    Wondering if any members who have one or more total knee replacements, and or total shoulders, also have had a complete spinal fusion .?? Im wondering if because of a total spinal fusion my knee joints have taken a whole lot more abuse that they werent suppose to....
     
  3. Irish471

    Irish471 senior

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    That’s great that you got that steroid shot! Hope it helps with the pain while you wait :)
     
  4. Luluk

    Luluk junior member
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    dear knee friends,
    Finally! I got a second opinion on right knee today, which had tkr 2016. I took the complaint of knee pain to the surgeon at Least five times in the last three years. In may of 2019 he finally said i dont know whats wrong. The left knee qualifies for a tkr right now. But how could i plan for a second one, especially with the same surgeon, when the one he did still hurts so much?

    The second-opinion surgeon thinks the first surgeon put in a plastic spacer that is too small. Which accounts for the knee feeling loose, noisy and painful.
    I am so relieved to discover that there is a cause for this pain and that there is a fix. New surgeon says the metal implants are good, only the spacer would be replaced.

    Who has had this kind of surgery before? What is the recovery like? Was there a good outcome?
    And should i ask original surgeon to do the fix..even though he last said he doesnt know what's wrong? Is it really inappropriate to go back to the original surgeon after you got a 2nd opinion, and say here's what the other doctor says?
    Is this a frequent occurrence, that the spacer size is wrong?
    The second doc said take care of this before i get a tkr on the other one.
    The knee with the tkr hurts so much more than the severly arthritic totally messed up other knee.
    Thank you for all your helpful feedback!!
     
  5. Celle

    Celle FORUM ADVISOR Forum Advisor

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    Hello @Luluk ,
    Since this is really a continuation of the story about your right knee, I'm going to merge it into that thread. I'm also going to merge all the updates you've written about that knee into the thread, so that we have one continuous story about what's happening.

    Personally, I feel that you've given your original surgeon enough chances to diagnose your knee's problem and now you've found a surgeon who knows what's wrong I'd stick with him, rather than go back to your original surgeon.

    Changing the spacer will require your knee to be opened up again, but it's not as serious a surgery as having all the hardware replaced.
    Initially, you will have to go back to resting, icing and elevating your knee, and taking your pain medications on a regular schedule, but your recovery shouldn't take nearly as long as your original recovery.

    Knowing what size of spacer to insert during the original surgery is a matter of judgement. If too thick a spacer is used, than there are often problems with straightening the knee. If a smaller spacer is used, the knee may feel loose until the ligaments tighten up, and then it is just right. But sometimes the ligaments don't tighten up quite as much as expected and then you're left with a too-loose knee - which is what seems to have happened to you.
     
    • Informative Informative x 2
  6. Celle

    Celle FORUM ADVISOR Forum Advisor

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    @Luluk - I've merged three threads, so we have some sort of a continuous story about your knees. Some of the discussion is about your left knee, but that's now part of your decision about how to proceed with sorting out your right knee, so I think it's OK here.
     
  7. Luluk

    Luluk junior member
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    Im curious about traveling by plane after surgery. Do you need to wait 2-4 weeks before taking a 3 hour flight back home after a Tkr? If you have it done only 45 minutes away by plane, can you go home quicker?
     
  8. Celle

    Celle FORUM ADVISOR Forum Advisor

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    I think you should talk to your surgeon about flying after your surgery and see what he/she advises. The biggest danger is that you could develop a deep vein thrombosis (DVT).

    Obviously, a shorter flight presents less risk of a DVT than a longer flight does and your surgeon may allow you to fly home after your surgery.

    My surgeon allowed me to take a 50-minute flight one month after surgery, but he advised me not to take longer flights for at least 3 months, preferably even later than that.

    Here is an article about Flying soon after surgery
     
  9. Luluk

    Luluk junior member
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    Thank you so much.
    I was so surprised when the 2nd surgeon said if he replaced a spacer in anchorage, a 45 minute flight, i could go home day of discharge. If i went to seattle, a 3 hour flight, for same procedure, it would be a 4 week wait.hotel bills really add up!
    The two surgeons that did the tkr and tsr, in seattle, three hour flight distance,both had me wait only two weeks. So, the difference between a two week delay and a four week delay i guess is a difference of opinion.
     
  10. Luluk

    Luluk junior member
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    Well, a new twist to this saga....after pondering a lot about this, i contacted the original surgeon who did my tkr in 2016 and told him what the second opinion was. (Original surgeon had said, after a few visits complaining about knee pain, i dont know whats wrong with your knee) The surgeon i saw for 2nd opinion believes the original plastic spacer is too small.
    The original surgeon messaged back that he thought that the plastic spacer was causing the problems and please call his office to schedule a visit to discuss this in person.
    Wha!
    So what now?
    Why couldnt he come up with this idea on his own?
    Should i trust him to fix it?
    Should i except him to fix it since he did the original tkr?
     
  11. sistersinhim

    sistersinhim FORUM ADVISOR Forum Advisor

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    I wouldn't go back to the original OS. He had his chance and wasn't willing to research your complaints further.
     
  12. Luluk

    Luluk junior member
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    can i ask questions here about spacer replacement surgery? Do you generally get replacements done by the original surgeon who put the replacement in in the first place, or is it better to go somewhere else? and is there a reason a spacer may become too small after its been installed, such as too much exercise or running or tendons stretching? In other words, was it that a bad judgement on the correct spacer size was made in the first place or could something happen after installation that makes a spacer no longer be a good fit? Wondering if anyone had a spacer replaced only to discover it was not a good decision and knee feels even worse!
     
  13. Celle

    Celle FORUM ADVISOR Forum Advisor

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    @Luluk
    You'll notice that, once again, I have merged your newest thread with your original recovery thread.
    Please don't keep starting new threads. You need to have just one thread for your recovery.

    For several reasons, we prefer that you only have one recovery thread:
    • That way, we have all your information in one place. This makes it easier to go back and review your history before providing advice.
    • If you keep starting new threads, you miss the posts and advice others have left for you in the old threads, and some information may be unnecessarily repeated
    • Having only one thread will act as a diary of your progress that you can look back on.
    So please post any updates, questions or concerns about your recovery here.
    Don't worry that we won't see your question because, between us, the staff read all new posts every day.
    If you need an urgent response to a question, just tag a member of staff.
    How to tag another member; how to answer when someone tags you

    If you prefer a different thread title, just post what you want and we'll get it changed for you.

    Here are the instructions on finding your thread, How can I find my threads and posts? . Many members bookmark their thread, so they can find it when they log on. Please do that, so you can add to this thread, rather than starting anew thread each time.
     
  14. Celle

    Celle FORUM ADVISOR Forum Advisor

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    Now, to answer your question.
    We've already advised you that your original surgeon has had enough chances to sort your knee out and he hasn't diagnosed what is wrong. Therefore, don't have your spacer replaced by him.
    A spacer can be the right size when inserted and it can wear thinner over time. THat's not necessarily due to over-activity.
    Or the spacer could appear to be the right size at the time, but your tendons don't tighten up as much as expected during your recovery, which then makes the spacer loose. That's not bad judgment by the surgeon, just something that happens occasionally.
    Usually, replacement with a spacer of a different size fixes the problem. If done by an experienced surgeon, there is little chance of making the knee worse.
     
  15. Luluk

    Luluk junior member
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    Hoping this is the right place to ask another question?
    What happens if there is a delay in replacing an undersized plastic spacer? Greater risk of falls or deterioration of components? Or anything else?
    Thank you very much.
     
  16. kleo

    kleo junior member

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    I had continuous pain and giving out of my knee after knee replacement. I went back to the surgeon several times but he kept saying it was fine. After two second opinions, I had my spacer replaced by a different doctor about a year and a half ago. The recovery was faster - about three months - but it was just as painful as the original surgery for those three months. My knee was great for six months or so - I could do stairs and go up and down hills with ease. However, it has been steadily becoming less stable and more painful. I went back to see the doc this spring and he said it’s loose and needs a bigger spacer again. Evidently the tendons have continued to stretch. He gave me another hinged brace, so I use it if I have to walk a lot. I moved to a house with no stairs and plan to keep going until it gets worse. It’s less painful for the most part but it’s been less than perfect. A bigger spacer wasn't the total answer for me but I know it’s worked for others. I don't regret giving it a try. Good luck!
     
  17. Luluk

    Luluk junior member
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    Wow- i was not aware that tendon stretching was an issue with tkrs, or with plastic spacer sizes. Part of my enormous frustration with my life is the other knee is way past needing a total, and my shoulder replacement is also very painful snd the other shoulder needs a replacement, and since they removed the hardware from my spine, the back pain is sometimes debilitating! Sometimes i just cant stand all this.

    Your good attitude is very inspiring - that you are glad you gave it a try. I'm going to try and remember that.
    I wish you the best and i thank you tor your helpful information.
     
  18. kleo

    kleo junior member

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    I understand how you feel - It’s hard when you feel like everything’s falling apart! I’ve had rotator cuff repair on both shoulders and one isn’t doing well. I broke my ankle years ago and it’s now causing trouble and the joints in my feet are a disaster. Have you been to a rheumatologist? They may be able to help...they’ve helped me. Some days are better than others...I guess we just have to keep plugging along and hope for the best!
     

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