Knee Infection* Revision #3 Journey

[Pumpkin]

Congratulations on the weight loss!

pes anserine bursitis

Your OS should be able to do a steroid injection or lidocaine into the bursa, or you could use a topical such as Voltaren Jel.
Go easy with the exercise.

 

[celynda]

After losing 20+ pounds, I am no longer pre-diabetic, which is the good news. I've also started walking more and have even signed up for my first 5K in December.

Unfortunately, the R knee is still not doing well. It hurts no matter what I do. After walking two miles or walking 1/2 block or even just sitting and getting up. Any twisting is painful.

I'm having a WBC (white blood cell) scan next week to see if there's something wrong. Since it's been 25 months since the TKA, I sure hope it's not an infection.

The current discomfort is occasional stabbing pain, a feeling of fullness, and stiffness. Applying Pennsaid after activity seems to help but nothing takes the pain away completely.

This is so frustrating. I mean I can DO more now than I could do pre surgery but the pain is really aggravating.

ok - vent/rant over.

 

[Pumpkin]

Have you sought a second opinion?

If not suggest you seek a second opinion for your TKR, from a surgeon specializing in 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.

Sorry to hear you are having troubles with your knee.

 

[celynda]

According to the OS, the bone scans were normal. He suggested it might be a soft tissue injury which makes sense since the pain started when I started moving more. He didn’t have any suggestions other than let’s give it another month and see. GRr.

Going to look for another OS specializing in revisions or soft tissue injuries. Maybe I should try Mayo Clinic in Jacksonville.

 

[celynda]

I am officially fed up with the knee pain. I signed up to walk my first 5K in early December as a motivating factor for getting more exercise. I’ve over 20 pounds in the last six months and lowered by A1C so I am no longer pre-diabetic. The new pain started about 6 monthes as I started to get more active. I’ve been walking, water walking and walking on the treadmill and using the recumbent bike. I also started strength training. Currently, the pain is constant with practically any movement.

This pain is different from the pain pre surgery and different from the pain post op. The knee feels “full” and stiff. ROM is decreased and when I walk the aching increased. The level ranges from 4 - 8. There are periods when I feel unstable but fortunately I’ve not fallen.

I looked for an OS in my area with expertise in revisions and there are none. I’m on a wait list for an appt with Mayo Clinic in Jacksonville. It will probably be Feb before I am seen.

Sometimes after a couple of hours of activity, I need to take a 5mg Oxy and just veg. My current meds include 1350 mg Tylenol Arthritis 1 - 2/day and 800 Ibruprofin 1 - 2/day. I also rub Pennsaid on my knee 1 - 2/day. I am going to up the meds to the max. The OS isn’t offering any options, saying Physio won’t help with a soft tissue injury.

Thanks for reading this rant.

 

[Celle]

I’ve been walking, water walking and walking on the treadmill and using the recumbent bike. I also started strength training. Currently, the pain is constant with practically any movement.

Since those activities are causing you pain, I think it would be a good idea to stop doing them.
If it hurts, at the time or later, don't do it.

 

[celynda]

Celle, you are so right. I guess I was thinking, “if it hurts no matter what I do or don’t do, then why not keep moving in an attempt to stay/keep in shape.” Guess I need to rethink the plan a bit. Maybe there’s a happy medium somewhere.

 

[Jockette]

I think there will be a happy medium in the future, but right now the knee is in charge. I read on here a long time ago, if you push the knee, the knee will push back, and the knee will always win!

 

[celynda]

I read the same things on here as I was going through post op recovery TWO years ago. I figured I could be in charge NOW. I guess not. There is one Revision OS in Orlando who I might try to get in to see. Problem is he has a “target” max BMI of 40 for surgery and mine is currently 45. My BMI was 50ish when I had the TKA.

I hope to continue losing weight and getting in shape. I think my current work out routine is what 1) reduced the BMI and 2) caused the pain and aggravation I am currently suffering. GRR. Can’t win.

I wonder if anyone has any experience with the Hospital for Special Surgery in NYC?

 

[BusterBeans]

Celynda, sorry to hear about your pain but you and I are in the same boat in Orlando. I had a BTKR 2 years ago and the right one continues to give me pain whenever I try to walk, do water aerobics, etc. The left was painful until I had a THR but the right hip is fine. I just moved to the Orlando area and looked for a great knee specialist as my old OS just kept ignoring my pain. The new OS has ruled out other causes and the only thing left is my upcoming bone scan to check for loosening or infection. My husband and I are celebrating our 25th anniversary with a 2-week trip to Europe in early May which is already paid off so I’m freaking out. Please share how things go for you.
BusterBeans

 

[celynda]

@BusterBeans, welcome to the Orlando area. I hope you’re having better luck with your OS than I. My current OS is blowing me off in not taking the new knee pain seriously. I tried to see another OS at Florida Hospital South who does a lot of revisions. After reviewing my records, “he doesn’t have anything to offer me.” I think my BMI of 45 might have something to do with the lack of interest.

Considering I’m trying to get in better shape and do more to REDUCE the BMI, you’d like the docs would be interested in helping me stay pain free and find out what’s wrong. Even the nuclear bone and WBC scans were inconclusive. The more I do, the more it hurts. I am still going to do the 5K on 3 Dec though.

I am on a waitlist to see an OS at Mayo Clinic in Jacksonville. I hope to have an appointment in Feb as they only schedule 5 revision patients a month.

I’ll PM you my contact details so we can compare notes and doctors IRL, if you’re interested.

 

[celynda]

Today was an educational day...

TL;DR - have Depuy Attune which has probably loosened so looking at revision.

I saw a new OS at Mayo Clinic in Jacksonville for evaluation of my R knee pain. Even though he is a baby doctor (in practice 7 years), I am very impressed. He reviewed the WBC scans and immediately pointed out how "hot" the two pieces were. This, of course, indicates either an infection or loosening. GRR.

When he learns I have a Depuy Attune, he is almost certain the device has loosened. Of course, the first thing is to determine if there is an infection. So, he aspirates some fluid from the knee (this hurts, even with the numbing spray and anesthetic). The fluid along with blood work is sent to the lab and I hear about the results mid to next week.

For DX purposes, he injects some Lidocaine in the joint. If after 10 minutes or so, there is significant reduction in pain, it's a strong signal that the pain is due to loosening. If there is no or minimal pain reduction, it's more likely, the nerves in the pes anserine are "angry" and some neromas have developed.

My pain reduction was significant so I am planning on a revision in late Feb or March. Of course, may need to deal with the infection first.

I know the revision surgery will be tougher than the first but I am in better shape now which is a good thing and I shall endeavor to continue to lose weight in the next few months. I'm cleared to exercise "using common sense."

I did complete my 1st 5K in December and it was a great thing. Took me three days and several oxy to recover so it will be a while before I think about doing another.

I do have a question for the larger group - I'm registered for an industry conference the first week of May. If I have surgery in early March, how realistic would it be to fly cross country and participate in workshops, an expo, networking, etc. Never mind. As I wrote the last sentence, it sunk in that I would be in no shape to travel EIGHT weeks after a revision. What am I thinking. GRRR.

Thanks for reading.

 

[kneeper]

Sometimes it's helpful to "think aloud" isn't it? I'm sorry you have to have a revision but it sounds like you have confidence in your new OS.

 

[celynda]

Thanks to electronic medical records, I have the following bits of information:

CRP Quant: 13.8 High
MCHC: 32.4 Low
Fluid Color: Yellow. (Still waiting on results of culture results)

According to Dr Google, an infection is likely. Since we know how qualified Doc Google is, I am trying not to let this information ruin my weekend. If this is correct, it means TWO surgeries to fix.

 

[celynda]

I heard from Mayo clinic this morning and the revision surgery is scheduled for March 15. The good news is there is NO Infection.

Q: Should I start a new Pre-Op thread for questions, etc. on the Revision surgery or post everything here?
Q: Would someone change my title to [Revision] Christa's Florida Revision Journey?

I know the recovery for a revision is more complicated than the original. Is there anything special I should know or do to be better prepared for the revision.

Differences from Original Recovery

• Not going to rehab
• New home has right height toilet, walk in shower, very low tub with grab bar, fenced yard to let dogs out
• Adjustable bed

 

[Jockette]

Best wishes on your next phase. I’m sorry you have to go through it.

You’ve got some really good features in your new home.

I have an adjustable bed also, but I still use my elevating wedge in bed. I raise the head part up just a little to take the pressure off my lower back, (which I’ve had problems with for years). and keep the foot area of the bed flat. This combination works great for me.

 

[sistersinhim]

It sounds like things will be much easier this time around. Revision surgery seems to be the same as a tkr. Being is better shape will be a huge help! You'll do just fine!

 

[SherrieT]

Best wishes on your revision. I hope this fixes everything for you and your recover is smooth as silk

 

[Celle]

Would someone change my title to [Revision] Christa's Florida Revision Journey?

I've changed your thread title, but I'll alter the prefix to "Revision" in March, closer to the date.

I think it's best if you keep posting in this thread, so that we have a continuous history.

I know the recovery for a revision is more complicated than the original. Is there anything special I should know or do to be better prepared for the revision.

I had a revision from a PKR to a TKR.
My recovery wasn't much different. Some people find it a little harder, but I didn't.

I didn't have to do anything special and I think what helped me was that with the revision I knew what to do and what not to do.

 

[celynda]

I had a bit of an insurance scare today. My revision OS is in my network but the claims for the initial visit and testing in January came back as out of network. Turns out there are conflicting provider numbers in the various systems used by the insurance company. Panic over.

I am in daily pain and really limited in my activities now. I'm back to icing on a regular basis and taking pain medications on a regular basis. It is no fun and I am counting the days until surgery. I have two work trips (one in Feb and one right before SX in March) and I am not looking forward to them. I am tempted to arrange for wheelchairs in the airports as the long walks are not fun.

I work from home which makes dealing with this a bit easier. The challenge, for me, will be NOT thinking about work in the weeks after surgery.