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TKR Sailor's Recovery Thread

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Hi @Roger I have just been reading about your visit to the specialist and I am so sorry that this news for you was not as positive as should have been expected. I wonder how many times this sort of thing is happening and would not wish this on anyone. I do not personally think any of this was your fault as being a patient you should have been able to trust the surgeon to have enough knowledge of how to handle the special needs that your particular case regarding your previous history.

That is their job and they should not be doing this type of surgery unless they are totally up to snuff on the ins and outs of the elements it involves. I am so sorry that they have caused you so much stress and can fully understand why you are having a hard time understanding how it could have all happened and the shock that hearing this news has caused. I think we have always been led to believe that people in high positions are above any doubt realizing they are not always .

So much time spent after surgery trying to get back to normal, physio, cost of time lost at work and after all of this to be told that a mistake has been made and you are the one that has to make up for the mistake. I have faith in my surgeon just because think he did my surgery right but still have had many doubts even so as to why of all of the people that have this surgery I am one of those who still cannot after this amount of time achieve more then 90 degrees.

Hearing these stories makes me wonder is there something that is not right with my knee as well that has limited the bend so much compared to the bend that so many achieve. Have actually been considering whether or not the next surgery might be better waited for as what if the outcome is even less bend then this one. But then again still trusting that I was in good hands as he said not all knees turn out the same and so much damage before surgery on my knee at least I can walk without pain on that one. I would be so angry to. I think this sounds like something that your surgeon should be so accountable for neglect in the way that he should have known his method might have been lacking if he is not experienced as he should have been. I am wishing the best for you and once again so sorry that you are dealing with this stressful situation We are all here for you and wishing for someway it could all be turned around. Holly
 
Roger,
I am so sad to read your post, take some time to calm down, it won't seem so overwhelming. From the sound of your post you have a very good evaluation of you knee, and what your options are.

Following your thread, you were not available earlier to see the revision OS, you had to take care of your teeth before you could even consider anything for your knee. You were doing OK with your knee brace and it did not seem like you needed to see someone ASAP. Two years is the average time from TKR to Revision for those of us who fall into that 2%, you are a little ahead of the curve.

I was also recommended to have a stabilizing knee brace but opted for a Revision. I was sorry I did not get the brace to get me to the revision, because of scheduling I waited 3 months. I think I would have been more comfortable during that wait, and would not have sufferred with the pre op pain, had I obtained a brace.

Both @RestAssured and myself have Smith and Nephew hinged knees, I think @RunA42K has a Depuy stabilizing knee. As you know both of them are walking the Houston 1/2 Marathon in January. I am on the slow train to recovery, and am getting there slowly but surely.
@busylizzie and @Shortie , have had revisions this summer.

I have wasted a lot of time beating myself up with if I had..., try to avoid this trap. It is a waste of time. And yes I still need this advice.
We are here for you ((((HUGS)))),:console2:
 
Thank you, everyone for your thoughts. Right now, I am contemplating taking legal action against the first OS, but I don't know if I have a leg to stand on (no pun intended...lol).

@Pumpkln
Yes, the knee did feel fairly good. But for the last few months it has been getting worse. And it has always been loose. The revisionist said that it will only get worse, because the tendonitis and synovitis is like a viscous cycle.
 
I read your post with some dismay---but then, I thought how lucky you were to get someone this good to give you this report. I have seen so many on BoneSmart who need a revision but cannot find a revisionist.

It is not worth it to blame yourself for anything---I think the first OS should stop doing knees as he obviously does not have the expertise---but we both know how important my opinion will be to him!! Instead, take some time. Yes the brace is a good idea. It will buy you some time which is what you need right now.

A year will make a difference with work and the process of making a decision. I don't think you will have as much pain or discomfort from the revision , your quads will not be cut (I really have trouble believing that he did that!!!) and you will not have as much cutting---and you will be in the hands of a skillful surgeon. However, I can tell you that I resented having to rehab that knee twice!! I complained and complained---and frankly, I never worked up any enthusiasm for it. But . . . I did it and I am glad. My knee is more stable and less problematic.

I empathize with the shock---I had the same problem, took me at least a week to get over it. Then I wasted a month being mad---don't bother with that one! Finally, I made a decision and scheduled the surgery is the least problematic time of the year for me. I am glad that it is over---glad that I was able to be successful. I relate to your confusion and anger right now!!
 
@skigirl
Thanks. It's going to take me a while to get over this. As I said, I am considering taking legal action against the first OS, and I do mean that. My wife doesn't want me to, though, as she says it will only prolong the agony. But I think he should be held accountable.

I hope that I have one year. The revisionist said that the plastic post could fracture at any time. Also, I wish the odds of a successful revision were a little better than 85%.

I'm trying to stay positive, but right now it is very difficult. Tomorrow, I will have to tell my boss about this, so they are forewarned that I will eventually need to take another 2 months off from work.
 
BTW, I forgot to mention that the first OS was the one who I had seen for 10 years before my TKR, and who treated me for arthritis, and who did a very good job of that. When it came time for the TKR, I put all my trust in him. Big mistake. I should have researched the doctors more.
 
Hi @SFBaySailor I'm so sorry that you are going through this I have been in a similar situation in that I had my original TKR in March 2013 which long story short continued to have +++++++pain and reduced ROM. Although my X-rays / tests did not show anything definite my new OS says that from my pre TKR bone scan he believes that I should have never had the TKR in the first place and that something like a osteotomy would have been more appropriate, so although not the same I know how frustrating it is to know that someone did something wrong and that it has wasted nearly 2 years of my life! I too have considered complaints and still think about it but in my case my original OS has now retired and it was done in the hospital I work for (in a different department) so I think it will just cause me more stress than I need!

The OS I went to for a second opinion (this is second opinion not from the OS who's team I was put into when my original OS retired as I got nowhere with him!) to an OS I chose from reputation and recommendation. He was honest and up front and gave me the similar options you have been given by the sounds of it. These were the safest thing was to do nothing and stay as I was (not an option in my mind) and the other was to do a revision however he did tell me that there was a chance that it would make it worse, a chance there would be no change but a much much bigger chance that it would improve things, so I looked forward to the future bit the bullet and went for it and I am so glad I did. I don't think I would have ever been happy accepting how it was especially as there is the thought that I should never have had the TKR in the first place!

Anyway on to the good news I am now just over 2 weeks post revision and I know every knee is different so just the fact that it feels different isn't any guarantee that it is better BUT I have a really good feeling about it it does feel so different in a good way. And I am VERY VERY happy that I made the right decision and am now looking forward to a good future rather than looking back to a rubbish past!

Oh and the other fantastic thing is that I've had the fantastic BoneSmart crowd to help me along the way.

Shortie xx

p.s. Yes I too should have researched OS's more too for the original TKR but that is a whole other story as I think I was passed around 3 OS's before original TKR and by the point of being told / offered a TKR I just wanted my knee better and didn't want to wait any longer - if I had who knows I probably would have been through all I have BUT personally my brain / emotions can't cope with what if so onwards and upwards I look to the future! x
 
SFBaySailor said:
I got plenty of answers from the revisionist. Very definitive answers.
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Hi Roger, When I read your post I could feel my emotions going from angry, to sad, to fear. But surprisingly I ended up feeling something akin to relief for you. Its bad when things don't work out as they should, but the not knowing what is wrong is frightening and can result in chronic depression. At least you now know what is wrong, and the OS you are currently seeing sounds amazingly good.

Yours in one of the most thorough diagnostic reports I have read. I would be very interested to hear what tests he put you through to enable him to give you such a thorough diagnosis. When I went for my second opinion it all felt a bit vague. He said previous Xrays reveal AN APPARENTLY well fixed and well positioned cemented Vanguard TKR with resurfaced patella. The conclusion was that I should.................give it more time. I'm due to see him again in December.

I know you would have preferred better odds than 85% with the revision surgery. But this OS sounds like he really knows his stuff.

Roger, the R word (Revision) is the last thing we TKR folk want to hear. You can't `dress it up' pretending its no big deal and `you'll be fine' just doesn't cut it. You also have to deal with work issues. All I can say to you my friend is that from your previous posts its clear you are a fighter. And better than that, you are a fighter with a sense of humour. In my book that increases the odds of an excellent recovery to 100%.
 
Hi @Roger hope you are feeling better with all of this so much to take in all at once. Going back over your thread and re reading your posts. So much as happened over that time. Your need for implants for your teeth was also a major hurdle and you handled it all so patiently. I was noticing that you are also allergic to wasp stings and so am I am very allergic need to go to hospital if stung. Looking back at your picture of little Annie who reminds me of the little Dashshund that we meet in our park Jasper he is short haired though unlike your Annie with her beautiful long hair. He is now looking to catch squirrels it is driving our park friend crazy stronger then he looks. Are you thinking of having the surgery right away can you manage with work .Hoping you have had time in your boat to give you some peace away from all of the rough stuff.

So many factors and reading your post it sound like the revision may help with problems you have been having surgeon sounds like he knows what he is doing and hopefully you will be in very good hands. Wishing to have your stress level calmed and hoping that all works out for you with whatever you decided. One time should be enough and very unfortunate you have to deal with this on top of the other stuff. Wishing you the best Holly
 
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patient 99 said:
I would be very interested to hear what tests he put you through to enable him to give you such a thorough diagnosis.
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Carol,
The revisionist is obviously very good. He is on the list of doctors here on Bonesmart. He was also recommended by my PT, who sees a lot of his cases and said that they almost always have good outcomes. He does more revisions than he does first time TKRs.
All he did was take some X-Rays, then manipulate my leg to determine the amount and directions of the laxity, and ask me a few questions about my history. From the X-Rays, he was able to determine that the knee components were sound, and what type of knee I have. A physical exam of my knee showed some slight swelling and fluid, and also, based on my symptoms, he was able to tell that I had recurring tendonitis & synovitis. The key information was when he asked if the knee ligaments were loose prior to surgery. I know they were, since back when I was a teen, right after I injured it, I had to give up playing golf because my knee would buckle on the follow-through. I've also had many Drs over the years tell me the knee had loose ligaments.
He has seen these cases before, so it was easy for him to pinpoint the diagnosis. Kind of like an auto mechanic who has seen the same problem over & over...lol.
Interesting. He mentioned that OS's on the East Coast USA are more attuned to balancing ligaments and looking for those types of red flags when they perform TKRs. Here on the West coast, not so much. The revisionist was educated on the East coast, so that is how he is aware of the differences.

I've calmed down a bit. I'm going to listen to my wife, and not consider taking legal action against the first OS. It will be counter-productive, will induce unneeded stress, and I likely would not prevail, since he did the procedure correctly to the limits of his knowledge.

@skigirl
Thanks. But I would think that with having to remove all the old components and the cement, and resurfacing all the bone, that the revision recovery will not be significantly easier than the first. I can hope, though. I will prepare myself for the worst, and hope for the best.

@lavender
Thanks, Holly, for all the kind words. I feel a sense of relief now that I have the answers.

@Shortie
It sounds like your revision is progressing well, and I wish you all the best. I hope mine goes as smoothly when the time comes. I spent more time researching the procedure than researching the doctor. That was a huge mistake, but life goes on.

The key lesson here is that any TKR that is performed on someone who has loose ligaments due to an injury should be treated as a special case. The revisionist said that the knee is a standard knee, and would be fine for someone who has osteoarthritis but normal, well balanced ligaments. He said that because of my ligament looseness, it would have been advisable for me to seek the advice of a sub-specialist from the start.

Last night I got so angry over all this, I slammed a door open so hard that the door handle put a hole in the bedroom wall! So now I have a repair job to do. But it will wait. This weekend is a long Holiday weekend for us (Labor Day), so I'm going to try to relax, and get out on the boat at least once, and enjoy the weekend. Thank you all for your support.
 
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Sorry I said the wrong thing. I seem to do that a lot. I'm gone from this board. Take care and I hope you get the help you need and things work out.


Sent from my iPad using BoneSmart Forum
 
Sailor--I did not mean that the revision would be easy---just that with this surgeon who seems to be so much more knowledgeable about tkrs, your recovery will be smoother---without the lingering pain and stiffness you have had since your first TKR/

We all understand your anger----I used to ice skate and let lightening bolts come off my fingers onto the ice!! I am glad you made the decision to enjoy yourself this weekend. Once you begin to move forward again with your life, I think things will even out. I am so sorry that you have to go through all this again---I have to tell you that I was filled with resentment after my revision--- which was the removal of adhesions and a spacer exchange. I was so nasty to my pt, that I had to apologize and bring him a pie.
 
Lauramacky said:
By the way, I thought cutting the quads was old school these days....I am surprised it was done that way. :(
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Laura, You said nothing wrong! Sorry, I forgot to reply about your friend with the ALS. It's true that other people are worse off than I am. BTW, I still need to take the ALS ice bucket challenge...lol.
How is your knee doing?

Roger
 
Roger.....just catching up on your thread and see that you have a detailed diagnosis from the latest surgeon you've seen. It definitely sounds like you've connected with a doctor who is experienced in the problems you have. This would give me a lot of confidence in going ahead with the revision as soon as you can. As you know, issues never really improve....they only have a chance of worsening. You are young and healthy and deserve to have a functioning knee!

I am glad to hear that you are probably going to give up on legal action against the first surgeon. Your wife is one smart cookie!!! The worst part of pursuing something like that is, because any legal action is a lengthy process, it takes over your life for an extended period of time and makes you miserable. My friend, life is way too short for that!!! Better that you move forward and look toward happy things in life. If you really wanted to do something to officially record the problems you had with that first doctor, check into filing an official report with your state's medical board.

I wish you the best going forward. Keep in mind how many successful revisions are done. Your surgeon sounds good and I think you are right to place yourself in his competent hands.
 
@Jamie
Thanks. I still need to finish up my dental implant work, which I have appointments in Oct & Nov, and I need to travel for that. So I'm thinking about having the revision done next year, although I'm not sure what time of the year. Hopefully, the knee brace will buy me some time. I can function pretty well right now. There has only been some minor pain in the MCL area, and on the kneecap, and some slight swelling by the end of the day. And some stiffness.
 
Jamie said:
I am glad to hear that you are probably going to give up on legal action against the first surgeon.
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My feeling is that the first OS was probably aware of the looseness in my ligaments, but he used a posterior stabilized knee in the belief (or hope) that it would be enough to alleviate the looseness. The revision specialist also suggested this may have been the case, and that is when he mentioned the differences between the East Coast/West Coast ways of going about this. I may look into filing a complaint with the state medical board.
 
@Lauramacky
Laura,
Glad to hear you finished your home PT, and you're doing better. I understand about the meds.
Redoing the PT is not one of the things I'm looking forward to on this revision. I think I'm leaning towards getting the rigid knee brace, and putting off the revision as long as I can, hopefully towards the end of next year. Take care.
 
Roger, thanks for the thorough outline of how your OS came to his diagnosis. I found it very useful.

SFBaySailor said:
so angry over all this, I slammed a door open so hard that the door handle put a hole in the bedroom wall!
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Tell me to mind my own business , but with all you have to cope with its easy to get real grumpy. The ones in the firing line are usually our nearest and dearest. You might want to do something real nice for the Mrs.
 
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