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Revision PKR to TKR

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davrunner

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Well I'm back at the start. After 20 months on my RPKR I am headed for a revision on Oct 11. I can't say the PKR was a total failure because I did have reduced pain but my knee stayed swollen and the none metal side became more and more painful. I am not back to the pain I had before the surgery but want to get the operation before I get there. The other reason to get it done now is I need a 3 level fusion in my neck c4/c5 to c6/c7 and I don't want to mess that surgery if I have to be on crutches for my knee.
Both my rhuematoligist and OS believe the issue is RA which had it been diagnosed before I had the PKR they would have performed the TKR from the beginning.
 

Janet2012

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I wouldn't be surprised if pkr's are eventually phased out completely in the future. It's a heck of a thing to go through to postpone an inevitable tkr that would last much longer to begin with. Sorry you are having to do this so soon.
 
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davrunner

davrunner

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Thanks.
When I went in to the surgery I knew I need an open synovectomy to clear up Lipoma Arboresence (a fatty tumor that came back after an arthoscopic synovectomy). At the time I was seeing a Rhuematologist but he didn't think I had RA, so I authorized the OS to perform the synovectomy and if needed either a partial or full replacement. He took the conservative route as the cartlidge loss on the other side was isolated to non weight bearing surface. He even sought opinions from two other surgeons during the surgery, so I was okay with what he did.
What I believe needs to be done is maybe narrow the protocol for partials, only use them where there is certainty that you won't be back in trying to get a revision.
 
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Thing is that if arthritis has damaged one section of the knee, it is almost a certainty that down the line arthritis is going to move to the other parts of the knee. The idea behind replacements seemed a good one, but the reality for most partials is that they will eventually need to become totals. And we also now know that recovery for both partials and totals are just about the same. So all things being equal, I would always go with the total. JMHO.
 

Josephine

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Oh Dave, I am so sorry. You took a punt and it didn't come off, what more can be said.


Janet, sadly that won't happen as there are so many 'enthusiast' PKR surgeons out there but they are so practised, they do get really good results overall. But it does seem that many surgeons who are fairly neutral in their feelings are no longer doing them.
 

partsman805

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I had a PKR done Dec 22, 2007, I agree with bottomshollo. I am getting a TKR done then end of Oct. I was not educated enough to know which was better way to go. My doctor at the time did not really give me any options. i was only 49 and kinda in shock hearing i needed a PKR. Fast forward with more knowledge and this site, i am looking forward to a TKR and being pain free.
 
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davrunner

davrunner

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I am with you Partsman, I was 49 when I had my PKR as well. While I got full range of movement I never was pain free and only a handful of days over the last 20 months that it wasn't swollen to one degree or another.
One of the reasons that the Rhuematoligist didn't think it was RA was that it was affecting mainly just one knee, didn't realize that some of the hand pain that I thought was normal aging and due to computer work really was RA. I realize I will probably have to have the left knee replaced at some point but it is no where near as bad as the right one.
 

RestAssured

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Well Dave and Partsman, know that you have people who will be praying for you, cheering for you, and listening to you! As you already know Dave we are like a big family, and Partsman, I hope you you feel like you are a part of the family also! :happydance:
 

Jamie

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I'm always sad to hear that someone has to revise to a TKR shortly after having a PKR done. I know there are cases where a PKR lasts for an extended period of time, but it just doesn't seem to be a large majority of the cases. My prayers are with your both for excellent outcomes in your surgeries. You know you have our support to get through this challenge.
 

KathyH

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Sorry to hear your news, Dave. But your TKR will see a new you with a painless and non-swollen knee :thumb:
 

Josephine

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partsman, I was in just the same situation when I was first diagnosed. The surgeon took one look at the xray and said "unicondylar" and that was it! No discussion or anything and I was uninformed at the time so never challenged him. Then we got a new knee surgeon who, when I talked to him, told me he never did unis any more because of the unacceptably high rate of conversion and that, given my age and size, in his opinion I wasn't really a candidate anyway. Then he said the clincher which was "Do you really want to risk ending up having two major surgeries within 1-3 years?
 
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davrunner

davrunner

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Had my precert with my primary care Dr last thursday. Just waiting for the Blood work to come back from the lab. Won't have to do the joint replacement class as I've been there done that. Received the ice machine yesterday. Planted all the fall beds that I'm going to be able to get to this past weekend. Next two weekends will be straightening the house and doing the cook ahead meals and putting the nets over the fish pond to keep the leaves out.
16 days to go....
 

BJ Mac

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Oh Gosh Dave, that stinks that the partial didn't seem to do the trick. I just went back to the doc for my 5 month check up from my partial and I am never without swelling and find that after standing for 10 minutes the swelling and pain begin to be extreme, definitely not where I thought that I would be at this point... I thought that I would be out snowboarding this coming winter and I find myself just wishing that I could stand around and talk to friends without pain and ride my bike, which I could before surgery, but cannot do without pain and swelling now. I find that some things are better, some are the same and some are worse. I am not happy that I have had this done and very sad to hear my surgeon say that if he does not see marked improvement in the next 7 months that he will be recommending a full knee replacement.

I do hope that this goes very well for you and that you are in a much improved place in the very near future.
 

Rosegurl3

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@BJMac- did you have your partial done with Makoplasty? I am hoping that mine will last me 10 years at least! My OS and I discussed at length the pros and cons of PKR vs TKR - especially as I needed 2 compartments replaced. I do feel I took a gamble- but am hoping with the better placement of the Makoplasty it will last. I'm active like you and like the bone sparring part of the partial. I'm small boned and already have osteopenia and was worried if I had A TKR at 53 I would not have good bone stock for revision at 70. I hope your swelling gets better. I'm still very swollen - but only 9 weeks out. I would think you'd be feeling better by 7 months. Sorry!
 

RestAssured

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Dave,

I wish you well in your upcoming surgery! You have always been so supportive especially when I hit the rough spots, and I just wanted to let you know I will be praying for you! :angel:
 

RestAssured

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I was discussing PKR's with my PT today, and she said that the doctors around here have gone almost exclusively to TKR's because of the longevity of the new advancements that have been made. She said they fully expect at least 30 or more years now, (unless you join a roller derby, or fly off ski jumps!). She said that if I chose to do that, I would start over again! LOL :happydance:
 

Rosegurl3

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Eeekkk!!! Hope I haven't made a mistake! My PT told me she thought mine could last me 15+ years! Time will tell!
 

BJ Mac

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@BJMac- did you have your partial done with Makoplasty? I am hoping that mine will last me 10 years at least! My OS and I discussed at length the pros and cons of PKR vs TKR - especially as I needed 2 compartments replaced. I do feel I took a gamble- but am hoping with the better placement of the Makoplasty it will last. I'm active like you and like the bone sparring part of the partial. I'm small boned and already have osteopenia and was worried if I had A TKR at 53 I would not have good bone stock for revision at 70. I hope your swelling gets better. I'm still very swollen - but only 9 weeks out. I would think you'd be feeling better by 7 months. Sorry!
No, I did not have it done with Makoplasty. I was also hoping for 10 years, and I am not done hoping! I still have 7 months for it to heal and improve and am seriously hoping that that will happen. I hope that yours does well and lasts long. Thanks for the good wishes! My OS told me that my hopes of returning as a snowboard instructor would only be possible with the partial. Remember that 9 weeks is very early on in your recovery. :)
 
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davrunner

davrunner

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Thanks BJ and Sonja. Believe my issues with the partial are all due to rhuematoid arthritis. Rosegirl believe you made the right decision for you. Praying that your partial will last a very long time.
I got the precert back and good to go. Have preadmission 2 days before. 12days to go have started turning some of my responsibilities over at work. Thank goodness I have great co workers.
 

Rosegurl3

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Thanks davrunner! The best of luck to you - I'm going to start adding all us Bonesmarties to my prayer list at night! Knees are so on my mind all the time!
 
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