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TKR Suggestions needed for “tight band” feeling

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@Jamie: clarification: the results of my c-reactive test and bone scan mentioned above are the results (within the past week) of what my new OS ordered; the last time I had a bone scan was May 2020. I’ve had several blood tests in the past 2 years so I will have to check my notes from when those “previous” numbers came from.
 

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Okay.....thanks! I'll be interested to hear the result of your appointment this coming Tuesday.
 
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@Jamie: Had a good appointment. We talked abt scar tissue removal and putting in the “button” in the replaced LEFT l knee. Sadly the scan showed moderate to severe arthritis in the RIGHT knee :sad:

(re the bone scan, he said it showed no loosening/infection, looked unchanged compared to the one in May 2020, and didn’t show any “degradation of the bone.”) I think his nurse confused me with another patient…

He could do arthroscopic surgery for the scar clean up… if it helps, great!; if not, then he’d open me up to put in the button and I assume clean up more scar tissue. Taking a conservative approach, which I appreciate. In your opinion, can the small incisions of arthroscopic surgery provide enough “room” to see and remove scar tissue? I’m trying to avoid the big incision and the difficult recovery.

We briefly talked abt a cortisone shot in my replaced knee (is this a good idea?) and how my high C-reactive protein shows inflammation but not exactly where in my knee.
 

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Arthroscopic surgery is the way this procedure is done. It can work well for some people, but isn't a guarantee that it will take care of all your tightness. I think your surgeon's approach to what he'd like to try makes sense, though. You might want to consider doing as he suggests.

I'm glad to hear there was no sign of loosening and no degradation of the bone. Boy, that's irritating that you would be given incorrect information, isn't it!
 
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@Jamie: yes, I was a bit irritated (but mostly relieved!) that I was told I had “degradation” of the bone when I didnt.

Probably will do the arthroscopic in early January or February.

What about a cortisone shot in my replaced knee… good idea?

THANKS, as always!
 

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Trying the cortisone shot really depends on how much pain you are in between now and the first of the year. There is no guarantee it will help or if it does, how long pain relief would last. There are some risks associated with injecting a replaced knee.

This is strictly my personal opinion, but since you are planning to have a procedure after the first of the year that does have a higher probability of helping, I would skip the injection.
 
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@Jamie: Hope you are doing well. I’m sorry to bring up this same issue but here goes: I’m no better and cannot stand for any length of time. I went to my high school reunion a few weeks ago and could barely move my knee after standing (occasionally, briefly, sitting, too) for so long.

I went to my new surgeon yesterday with the SOLE objective of getting a date on the January 2022 calendar for a procedure.

He said it’s up to me…arthroscopic vs opening me up and putting the button in. A part of me wants to start with a conservative procedure first. (I am frankly terrified of going through another horrific recuperation like I did with my replacement.)

He doesn’t think he can get enough scar tissue out arthroscopically and thinks that it will not help very much. Do you/Bonesmart have any idea about how much scar removal can be done arthroscopically (20%, 50 %, etc)?

I am agonizing over this decision…but SOMETHING needs to be done. I suppose I could get a cortisone shot first (perhaps THE most conservative thing to do)… and then go the arthroscopic procedure and, if not better, the cut me open and put the button in procedure.

I’d be grateful for any thoughts you have… thanks.
 

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I don't think anyone - even your surgeon who has seen you personally - could predict how much removal of scar tissue could be done via arthroscopy versus open surgery. I understand how agonizing it is to have to make this type of decision yourself, but it really is up to you to decide which route to take now that you have your surgeon's input.

Whichever procedure you opt for, it will be important to keep inflammation down in the first couple of months following surgery. This may mean taking pain medication to keep pain levels low and not overdoing the exercises or activity.

Inflammation causes heat and that tends to dry out your tissues. Then they are more likely to stick together and reform adhesions. This could happen no matter which procedure is performed. But....please know that the removal of the adhesions can improve your knee's function. Add in the change of the plastic insert and the potential is there to make your life much better.

My thought (and it's strictly my personal opinion) would be to go with your surgeon's recommendation to do the procedure that offers the greatest potential to remove all the constricting tissue from your knee and insert the plastic button. I wouldn't want to risk going through 3 procedures (shot, arthroscopic surgery, maybe followed by an open surgery) in a short period of time. That's a lot of potential recovery time. At some point a person has to trust the surgeon you've chosen and take a leap of faith.

Sure, there is a risk that your recovery could be uncomfortable. But there is an equal or greater chance that it could go very well. No two recoveries are ever the same.

I'm sorry you have to make such a difficult decision. Please don't hesitate to hash out your feelings here until you know what is going to be the right choice for you. We're here to listen and discuss any thoughts you have with you.
 
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@Jamie: Thanks, again, for your thoughts! It sounds so much more reasonable when you lay it all out. Will ask husband to come to yet another appt so HE can ask questions and feel better about it all. That will help me then, too. :)
 

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Sounds like a plan. All the best to you and your sweet hubby. It's so nice that you have his interest and support for all you've been through.
 

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