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Hinged Joint Revision Complete, recovery continues

@lavender
My revision was a complete removal of the old hardware, and new hardware was installed, with stems in my femur and tibia, and my leg was re aligned. The re alignment overshot the correct alignment by 5 degrees and that is why I am having such a difficult recovery. It looks like the surgeon did not take into consideration my mal union fracture which is 4 to 5 degrees off.
Some revisions are just the additon of a patella button, a spacer exchange, scar tissue removal, or just replacing the tibial or femoral portion. @Nana moon 27 is having a patella button for her revision, and @Dhare63 had scar tissue removed.
Since TKR's that were done 20 years ago are still doing well, I would think the ones done today will last even longer.
 
@lavender

Revisions are done for a variety of reasons, and what happens often depends on that reason.

If it is just the spacer that is wrong, it is possible to do a much simpler revision, involving only changing the spacer.
Sometimes it is necessary for adjustments to be made to the tendons, which would be a more extensive job, and sometimes the entire artificial knee has to be replaced .

I had my PKR for 11 years before it failed. The plastic spacer broke suddenly, without any prior symptoms. (That's unusual.) I was left with the metal components rubbing against each other. By the time my revision was done, I had some damage to the internal knee tissues, due to tiny metal fragments rubbing off the main pieces.

I'm not sure what Pumpkln's revision involved, but when I had my revision from a partial (PKR) to a total (TKR), all the hardware was removed and replaced - the metal bits in both the femur and the tibia, and the plastic spacer between them. I don't know if the plastic button behind the kneecap was redone, or if it was inserted for the first time (I must ask my OS next time I see him).

My knee was washed out, to remove any remaining metal fragments and the broken pieces of spacer were removed, except for one, which the OS could not reach, as it was at the back of the knee, in the area where Josephine says it is not advisable for the surgeon to go.

Both my femur and my tibia were re-cut, to make them the correct shape for the new metal components, which were hammered and cemented into place. Then I was all stitched together again.

I originally had an incision about 5 inches long. My OS followed the line of the old incision, but had to extend it further, so that I now have a scar about 8 inches long.

That all sounds horrible, but actually my recovery seemed to be easier than it was for my initial surgery. My muscles and tendons were in better shape before the revision and I think the protocols for pain relief had improved. Also, I had found BoneSmart by then and I followed the BS recovery method.

I guess I was lucky, in that I did not experience the problems that Pumpkln has! I had a different reason for the revision, too, and I think that has some bearing on the recovery.
 
Thanks @Pumpkln for explaining how revisions are done. Did not realize they removed the entire replacement in some cases . So much for you to have to have gone through. It is really unfortunate that the surgeon did not take your case into consideration when doing your revision as reading your posts can see how much more difficult this has made your recovery time. I appreciate you taking time to make it easier to understand and hope that they can find ways to make it all go smoother for you.Wishing you pain free days and that things will sort out for all of this that you have had to go through. Holly
 
Thanking you also @Celle. you have been through a lot as well with your revision. Did not know that a spacer could break don't really know much about so much of the things that make up replacements but can't imagine going through this twice. I thought that they automatically replaced the knee cap part too but feeling mine it does not seem to feel or look different then my left knee. Something I am going to ask my surgeon when I go for my shot. So much is involved to this surgery learning more as I ask questions and read but neer realized how much they actually have to do to replace our knees. This must have been very painful when the spacer must have scared you wondering why you were feeling what you were. Miracle that they can do this surgery but how careful they have to be to make sure that you do not have any complications after if something is overlooked. Hope it is working out better now for you. My scar is now much smaller then it was after surgery. People who had their surgery around the time I did did not have as many staples I had 43 and did not understand why. My incision measured at 11 inches wondered why but told they make it the way they need to to give them room to get everything in there right now maybe only 8 inches. Well thanks again for explaining what is involved not anticipating this for hopefully many years but wondering when people posted that they had a revision why they needed it and what was involved. Thanks so much and hope you are having lots of pain free days. Holly
 
@bottomshollow, Thanks! for starting a new thread for Nanny49, we must have crossed threads at the same time.

Saw the pain specialist today, he is also my back doctor who I have known for 6 to 7 years. Told him my story, he adjusted my pain meds, and gave me some lattitude on how many times a day for break through pain.
He took me off Tramadol because it does not sit well with me, and added one more Norco a day if I need it.
Relieved I will have the pain relief I need now, and someone to assist with weaning off if I need help.

On the knee side, I have been steadily improving since the weekend, using my crutches much less in my house, pain levels sometimes down to a 1 (Whew), no pain spikes, and no pay back if I walk too much.
I saw my foot prints when I got out of the pool today and noticed my left foot print is contacting the ground so much more.
Between 1 am and 3 am seem to be the worst time, I think my knee does not like to be in one position for that long. Sounds like a good time for that extra pain pill.

Everyone have a good evening and a good nights sleep,
 
[Bonesmart.org] Revision Complete, recovery continues
update, @Pumpkln. I'm so glad that you're getting the pain meds straightened out and the your knee is improving. Boy, these things do take a lot of time and wear our patience thin.

We did cross paths there with Nanny49---but we got her fixed up and on her way.

Take care---we care. [Bonesmart.org] Revision Complete, recovery continues
 
I hope you get some decent pain relief now. :console2:
 
Thanks @bottomshollow and @kneeper for stopping by to wish me well. Good wishes go along way to help with healing.
I am glad to be feeling better and to know I will have adequate pain medications. It was so stressful and painful to be cut off suddenly a few weeks ago.
 
Thanks for stopping by @Nana moon 27 ,
Doing better than I was a week ago, I think my knee is healing, and my foot is getting on the ground on the TKR side. My left foot was rolling me over and contributing to the muscles on the outside of my lower legs firing too much when I was walking.
Hopeful given time I will recover from this revison.
How are you doing today? I hope OK.
 
Not too bad felt a bit iff today after the headache this morning. Just overtired I think. Lovely to hear from you. Glad you are starting to improve Chris, you deserve it xxxx

Love Ann xxx
 
I overdid it yesterday. Woke up around 2, and have not been able to go back to sleep. Tried ice, tried pain med nothing nada not relief. Just figured out I should try heat, ahhhh, relief at last.
And trying to get used the new pain medication schedule, not quite there yet.
High fire danger here today, glad the kids are back in school, they frequently are the culprits. Not on purpose just not being careful.
Thanks @patient 99 , for stopping by, I should post the photographs of my foot a month ago and now. Going to the pool today, just have to remember to take a camera.
@Nana moon 27 I hope your headache has cleared and you were able to get some rest.
 
Now our built in smoke detector is chirping, it is on a high ceiling, ARGH! So much for taking a naps.
I think we are going to need to call an electrician and have a new one installed. This one is over 20 years old.
I like birds chirping but not smoke alarms.
 
Hi @Pumpkln Nice to hear you are getting time in the pool and hopefully they have your pain medications sorted out so hard to be feeling all the stuff caused from the surgery and then no way to get relief. I know what you mean about the relief from the heat. When I went to the massage guy the first thing he did was put a large pillow like heated blanket over my knee and he massaged with it at first. Made the whole thing feel so much better it was my favorite part and it did not hurt. Know that ice is needed for the swelling but loved the heat massage moments so much. It is nice to hear that you are getting around with your crutch easier and that someone has listened and trying to get your pain medications on track.

I think if they can manage the pain level that is the biggest part of the managing the rest of all of the other stuff. It must feel nice to see the improvement in the way your foot is touching the ground better everything the seems to be improving makes you feel like things will get better. You have been very patient and have handled the challenges your knee revision has made more difficult in your recovery. I wish for you a wonderful pain free and think it is time that pain finds somewhere else to go. Thanks so much to for all of the support show to myself and all of us as you are handling so much and still take time to show you care. :friends: Holly
 
Hi @Pumpkln Just reading about your smoke alarm. I know how you feel ours is very sensitive and for a while there it seemed to go off even if you boiled the kettle and it is a whole room away. It drove my husband crazy and for some reason rather then ringing when we were cooking it would start after we started to eat. Kind of made us wonder when it stopped doing this for a few days thought it was broken but after checking the battery found it worked fine. Great to have never know when it will be there and possibly save your life but sometimes a pain when it seems to ring for no reason. Well wishing you a great day Holly
 
Hi @Pumpkln It is true sometimes our knees feel like they are managing and with not a lot of pain once and a while not often I remember thinking maybe it would be ok to just go a little further when I was walking out from on our sidewalk then remembering my knee told me it did not like the extra pushing and let me know it did not like it hard to find a happy medium sometimes. Hi @Nana moon 27 I hope you are no longer having your headache still they can be so uncomfortable and sometimes last so much longer then wanted. Hope you are both feeling better now. Hope your knee gets better soon you been very patient @Pumpkln and that your surgery comes soon for you @Nana moon 27 Holly
 
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