Revision TKR Revision: Second Time Is the Charm

[spinfanatic]

Hi Bonesmart community. This is my first post after a RTKR on 9/22/12. My recovery has been relatively routine and I am lucky to have both great ROM and pain control. But as I have learned following Bonesmart, there always seems to be something and my problem is a paralyzed vocal cord which I woke up with after surgery. After lots of crazy tests, my Doctors are saying its cause is idiopathic and there is no statistical evidence to point to surgery particularly since my anesthesia was via spinal epidural. My ENT who specializes in voice disorders is researching for me as this paralysis is not a disease but a symptom and I am scheduled for second knee as soon as I get up the courage. I wondering if anyone in this community has or heard of a similar complication. Thank you all!

 

[bottomshollow]

Spinfanatic, so pleased to have you join us here on the forum. I have moved your thread from "How to Use This Xenforo Forum" to the Knee Replacement Recovery Area where you will be able to receive responses from other forum members.

In the time I have been on the forum, I have never heard of anyone having this happen to them. However, I, personally have no medical expertise. I am going to tag Josephine, our forum mother hen and resident medical expert to address this with you.

We have an excellent Library filled with very informative articles. Please feel free to browse there. And, of course, there are members' threads to read and glean info and insights from.

Take care and keep us posted. We care.

 

[Jamie]

Welcome to BoneSmart. Boy, that is something I've not heard of before. Maybe Josephine will have additional information for you.

It sounds like you are actively working to get the problem resolved. GREAT!!! I wish you the best and let us know how things go.

 

[Josephine]

this paralysis is not a disease but a symptom

I have heard of it but that's about all. However, I would disagree with you in this conclusion. Here the paralysis appears to be an outcome rather than a symptom. And idiopathic actually means "arising from an unknown cause" so in that respect, your doctors have told you as it is. Any number of conditions, diseases and ailments are idiopathic. Doctors are only human after all and by definition therefore cannot know everything. It's also entirely possible that this may not be connected with the surgery or anaesthetic whatsoever despite its coincidental appearance.

However, in the obvious admission that I don't know everything either - perhaps Orthodoc might like to offer his 2c as well!

 

[Pumpkin]

My Mother had vocal cord paralysis last year after her 4th GA, she is fine now. She had some voice therapy, it took a few months. Different situation than yours, but I wanted to let you know she has her voice back.

 

[Orthodoc]

I have seen a couple of patients develop hoarseness after an intubation. One of my patients needed to be referred to an ENT for this condition. It spontaneously resolved over time.

This situation is a bit perplexing given that the anesthesia was via a spinal. I wish I had more to contribute to this. I wish you the best of luck on your other knee.

Orthodoc

 

[jerseychick]

My mom also had vocal cord paralysis. She got hoarse rather frequently and was under the care of an ENT. Nothing could really be done, she lived with it, at times the hoarseness was worse than others.

 

[spinfanatic]

Hi Bonesmarties. At 20 weeks post TRKR I have hit a major setback. After a very routine and almost ideal recovery, two weeks ago my knee started to snap/klunk/stick every time I extended from 90 degrees, walked up stairs and got out of chair. Prior to this I had a pain controlled recovery with ROM of 148. PT was a breeze and with OS approval I was back to spin and yoga at 15 weeks at a modified pace. Met with OS this week who was shocked and believes I have a large scar band along inside of knee. OS believes that ultimately this will need to be scoped but wants to wait and see given how early I am in recovery. In the interim, I have been sidelined from ALL physical activities, avoid anything that triggers knee to snap, apply heat as often as possible, wrap with ace bandage and take 1200 mg of Ibuprofen/day. Follow up with OS in 30 days. I am curious if other Bonesmarties have had similar experience? If scope is needed will it resolve problem? Will I loose my ROM (not doing heels slides to maintain)? Any advice/thoughts/recommendations would be really appreciated. I have followed this community for months! Such a gift!

 

[jerseychick]

So sorry that you are going through this. skigirl has had surgery for scar tissue removal. I tagged her for you so she can comment on your post.

 

[Pumpkin]

Dhare63 also had a similar problem, and will be able to comment on your post.

 

[spinfanatic]

Thank you pumpkin and jersey chick!

 

[Josephine]

Will I lose my ROM (not doing heels slides to maintain)?

It's never been my experience that lack of exercising affects ROM this far out. Most people tend to forget all about them after a few months. I know I did. But normal everyday activities will usually keep things going and even improve them over time.

If scope is needed will it resolve problem?

Might do, might not. No-one can really say for sure. But I think the odds are on your side!

 

[spinfanatic]

Thank oh Josephine. Your confidence means a lot! Trying to stay positive!!

 

[skigirl]

I found that at about 5 months, I noticed a noise like velcro ripping when I bent my knee. This got worse over time and after two years, my knee cap was comprimised and I could not ride my bike without pain. I had an open lysis of adhesions---which is opening my scar and removing the scar tissue from my knee. I have a thread under "Open Lysis of Adhesions". I had the surgery last spring, am skiing this winter and now have my rom of 145 back on that knee. Don't loose hope, this is just a blip. Kelly

 

[Dhare63]

Ditto what Kelly said....if you need to have the adhesions removed, it isn't as bad as you might think, but as Kelly and I both were cautioned, go very slow with that recovery. The mantra of ice, elevate, control pain and reduce swelling are of utmost importance.

I'm sure you feel deflated and worried. When I had my quasi revision to remove the adhesions/capsular release, I planned for the worst. For 4 days it was extremely painful, then suddenly got a lot better. I am now 5 months post op and the knee is really pretty good.

You were really fortunate to have great rom before this happened. Hopefully you will get back to it, but please be patient. It may take time and persistence...just keep at it.

Let us know what questions/concerns you have. We will help to the extent possible!

Best,

Dawn

 

[spinfanatic]

Thank you Kelly and Dawn. I have gone back and read your historical posts. Lots of good info! Spent the last week following OS instructions and catching/klunking is actually worse. I am back to OS in 3 weeks and worry he will want to give knee some additional time to correct itself before scheduling scope. He mentioned June. Timing is a big issue for me.Big spring/summer for my kids...2 graduations and a wedding! I also need to have vocal chord repair. Wondering if I should push OS on date? If I don't have repair next month I believe I will have to wait until fall. As an aside, I have been a very active person my whole life and can't imagine not being able to cycle or power walk for another 9 months. What do you bone smarties think? Xo

 

[skigirl]

I think that you are in charge---if you want surgery early, just tell him you want surgery now. If he suggests waiting, simply say, no that will not work with my schedule, it will have to be now. Don't worry, he will agree. Kelly

 

[Dhare63]

Ditto what Kelly said....you have to live with it!

Let us know how it goes, we are here for support!

Be well,

Dawn

 

[spinfanatic]

Hi Bonesmarties. I am 6 mths post op and over the last 10 weeks have had problem with stairs and extending my leg due to what my surgeon believes is scar tissue. Lots of catching, clunking, aching and inflammation. I posted two months ago about this problem but can't seem to update that thread. Back then my OS sidelined me from all activities in hopes that the knee would heal on its own. He put me on max dose of NSAIDS daily for first month and vitamin regimen for second month. Heat and leg elevation as often as possible. Met with OS today and he believes the scar tissue will need to be scoped and is sending me for MRI to confirm. Have appointment in two weeks to discuss MRI and plan of action. In his practice this happens in roughly one out of every 100 replacements and has great success with scope to bring full recovery. Any member thoughts would be appreciated. Thanks!

 

[Pumpkin]

Hi Spinfanatic,
I will tag, skigirl, and Dhare63, both have had a similar experience.
All the best,