Smith&Nephew Journey Issues

[DaveW]

Hi new to the forum, concerned about issues with Smith&Nephew Journey replacements. Had bi-lateral April2, 2008 Left knee has been fine with a range up-to 125 derees.

Right knee is a major problem. Does not fully extend, somewhere around 10 degrees less than full extension. Other extension with help from Therapist is 105-110.

Surgeons uncooperative and have said I need no further visits. Suggest Dyna-Splint but according to Dyna-SPlint if not used within 2/3 weeks of surgery little change of fully straightening knee.

Second opion states knee replacement needs to be redone. Have done extensive P/T for 12 weeks 3x per week. No imporvment in right knee.

Has anyone had problems like mine or have stiffness in the new knee. It seems either it was no installed straught or not enough room was left between femur and tibia to allow for range of movement.

Still have swelling and intense pain, especially when trying to sleep.

Any help will be greatly appreciate.

Thank you

 

[Josephine]

That sounds a singularly unhelpful surgeon, Dave. But at 4½ months (or thereabouts) I think there's still plenty of time for things to improve.

Flexion seems good - it's just the extension. So have you tried the old trick of putting your heel on the coffee table maybe with a small weight hanging on it. Sit like that while you chill out and watch TV. Some here have said they found it helps to get back those extra degrees of extension.

 

[schoust]

Hmm Dave tell me something what was there reasoning for telling you that it needed to come out and be replaced with a new one?. I'm no expert but if it were me I would want a real good reason other than the fact that it is not on even par with your other knee.I am going in four day's for this same knee and from what I have seen and read it is as good as any knee out there and probably better. Keep Us posted on your progress and give it heck! I will stay in touch and let you know how I am doing with mine! Don't give up on it yet BUd!!

 

[DaveW]

That sounds a singularly unhelpful surgeon, Dave. But at 4½ months (or thereabouts) I think there's still plenty of time for things to improve.

Flexion seems good - it's just the extension. So have you tried the old trick of putting your heel on the coffee table maybe with a small weight hanging on it. Sit like that while you chill out and watch TV. Some here have said they found it helps to get back those extra degrees of extension.

Josephine

Thank you for your response. Yes we have tried weight on the leg up to 10 pounds for 6 minutes at a time with no improvement. Have tried it as you suggested and also lying on stomach on bed with leg extended past bed edge with no improvement. Tried it both ways for 4 weeks.

Concern is that it has shown absolutely no extension improvement since the operation of over 4 months ago.

Also one of original surgeons told me the Smith & Nephew Journey sometimes is stiff and causes problems. In this case I have had two very unhelpful and seemingly uncaring surgeons.

Dave

 

[DaveW]

Hmm Dave tell me something what was there reasoning for telling you that it needed to come out and be replaced with a new one?. I'm no expert but if it were me I would want a real good reason other than the fact that it is not on even par with your other knee.I am going in four day's for this same knee and from what I have seen and read it is as good as any knee out there and probably better. Keep Us posted on your progress and give it heck! I will stay in touch and let you know how I am doing with mine! Don't give up on it yet BUd!!

Schoust

Thank you for your reply and concern.

Not only is the knee substantially bent it is visibly swollen. As a result the right leg is 1 -2 inches functionally shorter than the left leg. This causes difficulty in walking and places excess stress on my back, right, hip, etc.

X-rays taken at NYC Hospital for Special Surgery indicate that the prothesis in the right knee is interferring with the right knee cap causing the swelling, pain in the knee itself (especially when trying to sleep which has been impossible) as well as a burining pain down the outside of the right calf into the right ankle/foot. On the good old 0-10 scale of pain the burning pain is a 12 and the pain at night when trying to sleep is a 15. That is why the Orthpod I saw last week feels there is a need to re-do the TKR.

The lack of extension he definitely feels is caused by the prothesis not being placed properly and the two pieces are too close to each other thus restricting motion in both directions. This is some thing one of the original surgeons also thought was the cause of my lack of extension & flexion but offered no solution or potential courses of action.

The only good news I got is that there is no foreign object infection, something the original surgeons refused to check for.

Dave

 

[Josephine]

Ah! Well, that changes the picture somewhat. There is someone else in here with that - suprapatellar fat pad impingement. But where his problem is a tibial insert too small, yours would seem to be too thick.

If this be the case, then the insert needs to be replaced.

 

[DaveW]

Ah! Well, that changes the picture somewhat. There is someone else in here with that - suprapatellar fat pad impingement. But where his problem is a tibial insert too small, yours would seem to be too thick.

If this be the case, then the insert needs to be replaced.

Josephine

I don't know if its too fat or if they did not grind the tibia/femur enough to allow for the thickness of the pad. The OS stated that the pads were too close.

The Hospital for Special Surgery Doc said he needs to grind more off to allow for proper spacing and not impinge on the patella.

What fun this has been and I just can't wait to do the re-hab again and risk DVT, infection, etc., etc.

Dave