Bilateral TKR Slow recovery

[PVCT]

Thank you sistersinhim.
I omitted to mention in my earlier post that I had MUA 5 months ago and it was unsuccessful. Part of me says that perhaps I should wait a while to allow the knees to recover from the MUA and the other part of me says get it done now without delay so that I can recover sooner. A head scratcher for me.

 

[sistersinhim]

Waiting a while is a good idea. Maybe your knees will improve on their own without spacer replacements.

 

[PVCT]

Just got the bad news from my surgeon. Tomorrow is my one year anniversary after BTKR and my ROM is still limited to 90 with constant pain and tightness in both knees. He now says that normally he would replace the spacers with smaller spacers to give me more ROM and pain relief but my existing spacers are only 2 degrees greater than the minimum spacer thickness and that gaining only 2 degrees is unlikely to resolve the problem. He suggests cutting 10mm off the bottom (calf?) bone and replacing the bottom prosthesis, which will create more room and flexibility in the spacer area. He suggests doing one knee first and then, if successful, the other knee. My major concern is whether the bottom prosthesis can be safely removed given the fact that it is cemented into the bone. I am also curious to know how successful such procedures normally are.

Has anyone had a similar successful procedure? Any advice or pointers concerning the surgical risks and the recovery will be highly appreciated.

 

[EalingGran]

I think I would be looking at getting a second opinion from a revision specialist as to why your ROM is still limited and what remedy they would advise- before I would agree to further surgery. But that is just my thoughts.

 

[benne68]

I agree with EalingGran. A second opinion from a different surgeon -- ideally someone who specializes in TKR revisions -- would be my next step as well.

 

[Ghostpipe]

Having had bilateral tkr in one surgery 3 years ago, I would seriously consider what it is that is bothering you before you undertake more major surgery with more risk than the the primaries.
If it is your rom, then you must ask yourself if 90 is really too little for your lifestyle. Many people live successfully with that, either naturally or more often after knee surgery.
If it is pain and swelling, then wait a while. Your body is healing two major surgeries. At 13 months, mine were still swelling after activity, even just normal daily ones, and significantly after exercise. There was major improvement during the second year, and I would say that it took nearly three to get as good as it gets.

 

[sistersinhim]

He suggests cutting 10mm off the bottom (calf?) bone and replacing the bottom prosthesis,

I have never heard of this before and strongly suggest you seek another opinion.

 

[PVCT]

It is now 2 years after my BTKR. Never managed to get more than 90 degree bend in either knee despite constant physiotherapy, exercise and MUA. Doc did revision surgery to right knee 8 months ago and still no improvement in bend beyond 90 degrees. During revision he discovered large amount of scar tissue and suggested that I had artho fibrosis and that I must now learn to live with it. Pain levels are manageable most of the time without medication, but very uncomfortable in weight-bearing mode, limiting the distance that I can walk reasonably comfortably. Anti inflam meds do not help at all.

I’m going for a second opinion later in the week but I am wondering if any other members have had similar experiences and might possibly have had some relief or success with treatment after being diagnosed with arthro fibrosis. Perhaps radiation or arthroscopic surgery?

 

[benne68]

Sorry you are dealing with arthofibrosis, @PVCT.

I do recall several other members who have been through this, but they may no longer be active on the forum. You can search for their threads using the Search button at the far right end of the blue tool bar above.