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Revision TKR Revision TKR 2nd time Lucky

lisabl

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A long post I know, but here is my history. If you have RA beware of PKR.

In May last year I had medial partial knee replacement. Initially recovery seemed good but with all the swelling and meds I had no idea what problems would lie ahead. Physio progressed well and within 8 weeks I was at 5° extension and 120° flexion but swelling still bad.

I had spent 10 weeks with my leg raised and iced using a Cryocuff for most of every day and all PT could say is give it time. At 6 months I still needed walking stick and still iced 3-4 times a day and twice during night. I had good muscle tone and strength in the knee and could even slowly walk leg over leg upstairs.

However at 9 months, as swelling started to go down, full pain started when I tried to get out of chair, more night pain (back to continuous icing) and sticks. The only relief from pain was in the swimming pool. So at 10 months I went back to consultant who did xray and said he couldn't find anything wrong, but was prepared to do an arthroscopy to see what might be amiss.

Three days later I got a second opinion from a consultant who showed me an info sheet on the prosthesis which clearly said not suitable for patients with inflammatory arthritis. I have RA and the original surgeon knew that. The other half of the knee joint had started to rapidly deteriorate but due to swelling I was unaware of the problem.

I am currently walking with 2 sticks and a knee brace, and can't wait for my full revision next week. Will need lots of support on 2nd time round recovery.
 

JAS20

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You have my deepest sympathy, I had a partial knee replacement last July, I have been in constant pain since. I have had to have my knee aspirated, the end of October I had to go back in for surgery, the bearing displaced, pain still continued, sent for a second opinion. I go for my pre-op next week, like you I can’t wait for the TKR, good luck hope it goes well
 
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lisabl

lisabl

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Lets hope the TKRs solve all our problems. I will post my progress on my thread, last year I was just a lurker on the forum, but learned so much.
 

Cjackso21

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Good for you getting a second opinion. I spent about as much time in pain especially standing. Felt like something was pinching anterior tissue. Many visits to my OS with no idea what was wrong. Finally got a “super” specialist who figured out in 20 mins that my prosthetic kneecap had come loose. Ends up all components were loose. Good Luck!
 

Jockette

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I’m another unhappy partial recipient, mine is a Patellofemoral. It’s been 2 years of discomfort. I’ve had 2 second opinions and my X-rays look fine, end of story.

With your revision next week I will leave you our Recovery Guidelines now. Each article is short but very informative. Following these guidelines will help you have a less painful recovery.

Knee Recovery: The Guidelines
1. Don’t worry: Your body will heal all by itself. Relax, let it, don't try and hurry it, don’t worry about any symptoms now, they are almost certainly temporary
2. Control discomfort:
rest
elevate
ice
take your pain meds by prescription schedule (not when pain starts!)
don't overwork.
3. Do what you want to do BUT
a. If it hurts, don't do it and don't allow anyone - especially a physical therapist - to do it to you
b. If your leg swells more or gets stiffer in the 24 hours after doing it, don't do it again.​
4. PT or exercise can be useful BUT take note of these
5. At week 4 and after you should follow this
6. Access to these pages on the website

The Recovery articles:
The importance of managing pain after a TKR and the pain chart
Swollen and stiff knee: what causes it?

Energy drain for TKRs

Elevation is the key

Ice to control pain and swelling

Heel slides and how to do them properly

Chart representation of TKR recovery

Healing: how long does it take?

Post op blues is a reality - be prepared for it
Sleep deprivation is pretty much inevitable - but what causes it?

There are also some cautionary articles here
Myth busting: no pain, no gain
Myth busting: the "window of opportunity" in TKR
Myth busting: on getting addicted to pain meds

We try to keep the forum a positive and safe place for our members to talk about their questions or concerns and to report successes with their joint replacement surgery.

While members may create as many threads as they like in the majority of BoneSmart’s forums, we ask that each member have only One Recovery Thread. This policy makes it easier to go back and review the member’s history before providing advice, so please post any updates or questions you have right here in this thread.
 
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lisabl

lisabl

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Thankyou @Jockette. I have been reading the notes and some threads for most of today as I sit with leg elevated and an ice pack in the brace (its to stop the side to side wobble and minimises the valgus). Not very mobile at the moment.
 

Jockette

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I got a second opinion from a consultant who showed me an info sheet on the prosthetic which clearly said NOT SUITABLE FOR PATIENTS WITH INFLAMATORY ARTHRITIS. I have RA and the original surgeon knew that.
@Josephine Is it the materials the implant is made of that would affect RA?
The other half of the knee joint had started to rapidly deteriorate but due to swelling I was unaware of the problem.
This is often the case with partials.

I hope your revision goes really well.

My experience with knee replacement has certainly been an eye opener.
 

Celle

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Unfortunately, it's not at all uncommon for a PKR to need to be revised to a TKR because arthritis has spread to another of the knee compartments.
You have my sympathy.

I was fortunate because my PKR lasted for 11 years before it failed. Even so, when my other knee needed replacing, I chose to go straight to TKR.

My revision from a PKR to a TKR was no worse than the original surgery and recovery had been.
 
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lisabl

lisabl

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Starting to get nervous about tomorrow's op, as hubby reminded how badly I reacted to anaesthetic last year with 6hrs of constant nausea and vomiting after I woke up from op.
 

Jockette

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:console2:

Wishing you the very best!
 

Celle

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Starting to get nervous about tomorrow's op, as hubby reminded how badly I reacted to anaesthetic last year with 6hrs of constant nausea and vomiting after I woke up from op.
Don't forget to tell you surgeon and anaesthetist this - and ask to be charted anti-emetic drugs, so you can take them to prevent the nausea and vomiting. I always have to do that.
 

sistersinhim

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Can you use sedation and a spinal instead of GA? I always throw up for a couple of days after a GA. Not so with the sedation and spinal. My prayers are with you.
 
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lisabl

lisabl

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Back out of surgery. Spinal given (although took 3 attempts!). 2nd pot of tea and no vomiting or nausea. Woke up in recovery really bright and chatty.... not groggy at all. So different from last year. Making most of pain meds to sleep, no food as not hungry. Sure I will be at breakfast tomorrow.
 
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lisabl

lisabl

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@Celle could one of the forum advisors change my thread heading to Revision TKR 2nd time Lucky

Thanks
 

alexthecat

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I've changed your thread title, as you requested. I also changed your thread prefix to Revision TKR. Is all that correct now?

Sent from my SM-S327VL using Tapatalk
 

kneeper

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Good to hear it went well and you're feeling ok!
 
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lisabl

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End of Day 1 and pain under control. Physio turned up at 10am and I managed to stand using a walking frame and sit in chair for half an hr. Low blood pressure for most of the day curbed my PT, and was back up at 4pm so took a walk around the room with frame. Tomorrow I will be promoted to walking to toilet, so thankfully going slow.
Even managed a 3hr sleep after my evening meal.
 

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