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TKR Questions about spacer replacement

Jockette

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I’ve had 3 opinions total, my original surgeon and 2 second opinions, and no help for my issues. I’m 2.5 years post op. What I have is far from perfect but it is manageable, so I’m just making do.

Well! So what do i do now! Has anyone gone for a third opinion????
Yes, sometimes you have to keep looking for a surgeon that you will have confidence in.
 
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Luluk

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Wish i could say, its manageable. Its more like,miserable. Enjoyment of life and function are compromised.
Im wondering who has taken the step and had a spacer replaced and ended up worse off?
And one of the local transplant surgeons who could provide another opinion is a DO. Is it better to just go with an MD or does it matter?
 

Jockette

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And one of the local transplant surgeons who could provide another opinion is a DO. Is it better to just go with an MD or does it matter?
It matters a lot who you see for a second opinion. Personally I would never take my knee issues to a DO or regular MD, or anyone who didn’t specialize in TKR.

My second opinions were with surgeons who do Revisions, they have the education and background to determine what is happening with troubled knees.

Look for a surgeon specializing in complex joint reconstruction or revisions. They should have no relationship with your present OS, not even golf buddies.

Both my second opinions looked at my supposedly perfect X-ray and said they didn’t know what’s causing my issues, as nothing wrong showed in the X-ray. Neither would do any further tests. So, I’m searching for my third opinion. This seems to be what those of us who don’t have good outcomes go through. Sometimes it seems no one wants our case. :bawl:
 
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Luluk

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Am i reading between the lines too much? Or Should one give more weight to the opinion of a surgeon who does a lot of revisions; or to the opinion of a surgeon who does a lot of transplants (and is now medical director of the hospital)? Thank you.
 

sistersinhim

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Transplants and joint replacements are two different things. I think a medical director is more admin work than actual hands on.

I agree with the others, that you need to travel away from your area, find a doctor that specializes in revisions of problem knees and does not have any affiliation with your previous doctor.
 
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Luluk

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Oh i made a mistake using the word transplants. I meant to refer to the surgeons as surgeons who do joint replacements.
The original surgeon, who did the total replacement 3 years ago practices in another state. The person who gave me the 2nd opinion lives in my state, different city than where i live. These two docs know of each other. The surgeon, from whom i am seeking a third opinion lives in my city, and has a great reputation amongst many of his patients whom i know.

Part of my anguish is my other knee desparately needs to have a tkr, but it is difficult to put my trust and confidence in someone who keeps saying i dont know whats wrong- with the knee that he already did! (Despite testing for infection, and having a bone scan 2 years ago.)

I also had a total shoulder 2 years ago, that always hurts. I wonder if there are some bodies that for some reason are always going to hurt.
Thank you very much for having replied to my post.
 

Celle

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Should one give more weight to the opinion of a surgeon who does a lot of revisions; or to the opinion of a surgeon who does a lot of transplants (and is now medical director of the hospital)? Thank you.
Listen to the surgeon who specialises in doing revisions. He has the practical experience, whereas a transplant surgeon and a medical director have different areas of expertise.

Would you go to an orthopedic surgeon for a transplant? No. You'd go to a surgeon who specialises in doing transplants. Those areas of expertise and experience are completely different.

So, give most weight to a surgeon whose expertise and practical experience are in doing revisions. He/she sees problem knees every working day.
 
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Luluk

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I used the word “transplant” in error. Imam talking about joint “replacement.”

What i think i am alluding to is a difference between a surgeon specializing in “replacements” and a surgeon specializing in “revisions.”
 

Celle

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OK. I see you've re-phrased the question.

I'd still give more weight to the surgeon who specialises in doing revisions, because he/she will have seen more problem knees. A surgeon who does knee replacements will not have as much practical experience in dealing with problem knees as a revision surgeon who sees them every day.

The other thing is that you need to seek an opinion from a surgeon who has no connection at all, either social or professional with your current surgeon. That's so you get a completely independent opinion, uninfluenced by the opinion of your current surgeon.

And no, I wouldn't have a second knee replaced by the surgeon who did your first replacement and now says he doesn't know what's wrong with it.

Word of mouth recommendations are good, but they only go so far. You need to see a surgeon whose expertise is with problem knees.
 
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Luluk

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Today i got the fourth opinion on the continual knee pain from 3 year old tkr. Well apparently, 80 percent of tkr patients like the results, 5 percent have really bad outcomes, and 15 percent are disatisfied. So he concurs with three of the four opinions, that there is nothing surgical that can help me, and i am in the 15 percent group. His only suggestion regards treating the pain.

But heres what i want to know: who has had great outcome with the Conformis custom made implant? (This new surgeon does that.) who has had good outcome with robotic surgery and which is better? Laying aside my frustration with the already done knee,i have-to plan for the other tkr.
 

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