TKR Second TKR - First had Arthrofibrosis

[hhilltop]

Guess I should update my status. I wrote in late July that my other leg had been throwing me for loops. It has continued. As you can see, the week of vacation wasn't very fun with lots of pain and it ended by seeing if it wasn't blood clot related. Throwing me for loops kind of describes a lot of the summer. I'd do something that challenged it and then I'd need to recover. Trying to figure out what was challenging and what was acceptable use became sort of a game. It's the other leg that hurts - carrying too much load for the TKR leg and the weaker other knee.

I realized today as I dug up nearly 50 pounds of potatoes from my little garden plot, that I really have made hefty gains. Though my leg didn't like me moving the electrical netting on the steep slope, it did bounce back much quicker.

I set things in motion for questioning the need for the other knee to have TKR. I've seen one surgeon and I will see an osteopathic in a couple of weeks. The xrays show some wear, but my PT said it's not that bad. If I could have my way - I'd hold off on the second knee for a good 5 years if possible. I don't want to repeat this past year's aggressive scar tissue issues anytime too soon. Thinking about using synovish (sp?) injections.

Bright note - the new OS said he's done bilateral TKR's where only one leg had aggressive scar tissue issues. Anyone else know stories of one knee having aggressive scar tissue issues and the other not? Dhare63, Josephine, skigirl, maryo52, medan2012,

 

[Josephine]

The xrays show some wear, but my PT said it's not that bad. If I could have my way - I'd hold off on the second knee for a good 5 years if possible.

I've seen xrays that were "oh gor blimey" and yet the patient said she was not experiencing much pain or disability. On the other had, someone whose xray showed only moderate damage was in considerable pain and frequently resorted to a wheelchair. It all depends where the damage is and how much debris there is floating around in the joint.

Bright note - the new OS said he's done bilateral TKR's where only one leg had aggressive scar tissue issues.

Absolutely! It's quite usual for arthrofibrosis to affect a single joint.

 

[maryo52]

Martha, my ortho said more than once that there can be arthrofibrosis in one knee and not the other.

I had the same problem, and I have the same strategy: preserve what I've got. My native knee is not bad, and TKR is fine, am trying to keep it that way. If I ever need TKR again, though, I'm heading to Chicago to this ortho who was an engineer before he was a doctor and he designs his own surgical instruments so that he can do minimally invasive and then sends his patients home the same day of surgery. The more "stirred up" the tissues are, the more likely for arthrofibrosis to occur.

 

[Tweet25]

Martha I just talked to someone here in WI who's mother went to Dr. Rush and I guess he takes Cash. Not sure how much a TKR really costs but I would assume it's outrageous. I woud love to go to him too but I don't think he would take my insurance here in Milwaukee.

 

[hhilltop]

Thanks. ladies, for the encouragement. It is especially helpful to hear from others that don't need to expect another round of arthrofibrosis if and when I have a second TKR.

 

[hhilltop]

The picture below was taken 4 days ago on my way home from work. I don't have to go on vacation to take in great scenery.

 

[hhilltop]

I went to an osteopathic for a second opinion. He feels my other knee is a good candidate for his treatments. I had explored having Synvisc injections with an orthopedic, but wanted to wait until I'd seen him. Turns out my insurance didn't want to cover the Synvisc, though the OS was able to pull strings and get it approved. The osteopathic suggested something similar, though less expensive that the insurance would cover. I had 2cc of hyaluronic acid gel and 20 mg PF triamcinolone acetonide. He said it would take 3 days for any noticeable changes, but I was noticing improvement today - 1 day later. Like Synvisc I'll have 2 more injections spaced a week or two apart and then I should be good for 6 months or so. I like this routine better than the cortisone injections I had in my right knee the year before my TKR. That I had to wean myself from because eventually the cortisone would wear down the cartilage.

He also recommended glucosamine and tumeric. I told him what I'd heard from an orthopedic about glucosamine being a protein and the body would likely digest it like other proteins breaking it apart. He said that there have been studies with radioactive isotopes attached to the glucosamine that showed it congregating in the knee and did help repair cartilage. I'd heard about tumeric before, too, but from street sources. He said he always uses the transducer to guide his injections - only 4 doctors in our state do. He claims studies show that injections without transducer guidance have a high percentage of missing the mark.

Anyone else have comments about injections to prolong an existing real knee?

 

[Tweet25]

Martha I had orthovisc in June of this year. It's a another brand. It took more than 6 weeks to see any results which I did find relief. I then in August got another cortizone that gave me even more relief. My OS didn't do the guidance with it but my Aunt went to a place and had it done th way you are and with the same brand. She is finally feeling some relief. He also put her on Celebrex. You won't find the relief instant though so give it some time. I have not had TKR done yet. I am hopeing to do the shots again after my meniscus surgery to see if it helps the pain even more.

 

[hhilltop]

I'm really surprised. I was told it would be at least 3 days before I noticed any change, but last night and this morning I went downstairs normally using the handrail just for balance. I have confidence in my left leg. It's like it needed lubrication so it wouldn't hurt and now I can freely use it. This is WONDERFUL!

I went exploring Dr. Fenton's website to find answers for Ramblin' Knee. I found all kinds of things of interest - especially this, though. He did his studies at U of M, so it is a link to their educational resources. It shows how they use the ultrasound and positioning of the transducer to get the images they use to detect various issues in the joints. I can't seem to link you right to the knee section. You will have to choose examples and then knee before you'll get images of knee issues. broken link removed: https://www.med.umich.edu/rad/muscskel/mskus/ I was fascinated, but then his examination report was full of detailed information about my knee that I wondered how he had obtained so rapidly. If any of you have questions, I see him again next week and I'll gladly take your questions with me.

 

[hhilltop]

I think I'll flag a few of you to see if any of you have questions about what I've posted on using ultrasound for diagnostics and injections. I head back to this doctor next week. Send me questions if you have any.

Nanners, Dhare63, maryo52, skigirl, Tweet25,

 

[skigirl]

My husband goes to a pain clinic and they use ultrasound diagnostics for all injections. I think it is a great idea, I also think you are smart to save the "good" knee. I used injections for three years---the first ones were the best, I also took and take Tumeric---and I had good results using Glucosamine DS which I bought at Costco. When I would run out, I would wonder whether i should spend the money for more--it was $66 for three month supply---but, my knee would begin to ache and that made the decision to get them easier.

 

[Dhare63]

Where do you buy tumeric? I never heard of it outside cooking circles...

Martha, where is the osteopath located that you are seeing? Just curious since we live so close to one another, in case I need to consider him in the future.

Thanks for the research!

I am heading up your way today. I have to see a client in Middlebury and go over the Bethel Mtn road to get there. Although we are past peak, it still should be a pretty drive!

Be well,

Dawn

 

[skigirl]

I buy it at the health food store---it looks like the stuff you use for cooking, but it is in little capsules. There is a section in our health food store for "joints" and it is in there. tumeric has been used for centuries to prevent Inflammation.

 

[amab]

Had two rounds of euflexxa in my right knee in an attempt to avoid a second TKR.....while the injections provided some short term relief, the damage was such that I had to do a RTKR in mid Sept. So 2 TKRs in 2013 .......recovery of my September Knee continues to go pretty well.

Fantastic photo of the fall colors!!!!!

Good luck to you!

 

[Campervan]

I took glucosamine and chrondroitin for a few years. It was my surgeon that put me on to it but he said it has to be in the right ratio to be of much benefit. Must be 5 parts glucosamine and 4 parts chrondroitin. It's hard to find in that ratio and when you find it it is expensive. I paid for it a couple of times and found it beneficial, then I tried lesser ratios and no benefit. I then found one that worked that was two-thirds:one-third.

 

[speedy2]

skigirl just read this thread and interested to know whether Turmeric is taken instead of anti-inflammatory?
Thanks speedy2

 

[skigirl]

I take Tumeric in place of anti inflammatories because the anti inflammatories make me retain water and I feel uncomfortable after a day or so. Tumeric I can take with no side effects. Not everyone is sold on the benefits, so it is a personal choice.

 

[speedy2]

Thanks for that skigirl, I will certainly look into that as there would be no long term side effects. Great information.

 

[mrs cricklewood]

very interesting... I am off now to see if I can get some tumeric capsules on ebay or else I will try my heath shop....my knee is still ( to me ) swollen abit and I have taken all my prescription of anti inflammatory tablets and run out.....probably tumeric would be alot better for my guts ! thanks for the info . I also take a good quality glucosamine and chrondition ..that won't hurt if I take the tumeric as well would it ?

 

[hhilltop]

Sorry, I haven't been checking in as often.

Here's some comments some of you might find of interest.
You can find tumeric at most coop stores along with the spices. Start adding it to an assortment of things you cook. I should ask where you know to find it in a tablet or capsule form.

Dhare63 - my osteopath is up in Burlington - Dr. Fenton. It's a bit of a hike for you, but worth consideration. I encourage all Bonesmarties to check out his website broken link removed: https://www.jfentondo.com/education.html. He states very empahtically - no one should be giving injections without guided ultrasounds, too many well trained doctors have high percentages of misses. He also thinks that antiinflamatories can impair healing and sites research to this effect, though it is only one study and more technical than I care to tackle. Here is a link I found at his site to U of M's ultrasound data broken link removed: https://www.med.umich.edu/rad/muscskel/mskus/. He is involved in cutting edge research on stem cell studies. He/they are trying to see if there isn't a way to do some rebuilding using your joints with regenerative injection treatment RIT broken link removed: https://www.jfentondo.com/rit.html . He hasn't talked with me about this, just mentioned it once and it sent me digging deeper into his website where there is quite a bit of material.

Those of you with more medical background, I hope you will check into this. I'd love to have your feedback.

@jose