Revision TKR Third and final surgery all done
- Thread starter kayow11
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@RadioGal ... I'd be happy to do the same with surgeons if you'll provide your zip code. Please do this in your recovery thread and tag me on the post. It would be a good idea to also post a photo of your legs there as well. Try to take it in shorts, standing, straight on with your weight evenly on both feet. Tag Josephine on the image and she will do the calculation for you.
@kayow11 .... if you are wearing orthotics, please be aware that you must get new ones after a joint replacement. That could be contributing to some of your pain. You also need to purchase new shoes because your old ones have wear patterns that were from before your surgery. If possible, purchase some shoes with good support...like good quality walking shoes.
@kayow11 .... if you are wearing orthotics, please be aware that you must get new ones after a joint replacement. That could be contributing to some of your pain. You also need to purchase new shoes because your old ones have wear patterns that were from before your surgery. If possible, purchase some shoes with good support...like good quality walking shoes.
Josephine
NURSE DIRECTOR EMERITA
IN what capacity? I ask because this can tell me a lot about how you view and understand all that he has told you. I'm sure you are very good at your job but what it is is actually quite important.
I read all your description with interest and have only this to say - nothing of what he said is any different to a bog standard knee replacement or what any knee surgeon would do in almost every case. But I'm still not encouraged for the simple reason that he managed to leave you with 10 degrees of valgus which is actually outrageous.
Well as the saying goes 'he would, wouldn't he!'?
As it happens, you can change the number on a goniometer by just changing the point on the knee where the hinge rests. Which I why I ask for a full length photo so I can use the lines from the hip and ankle joints to get the correct spot on the knee.
Celle is right. If you watch the video in the article she gave you a link to, a very experienced professor explains how the brain won't make a problem if you have genuine pain. She makes a very compelling argument about it.
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kayow11
senior
Josephine and Jamie, thank you both of you ladies for your input on my last several posts.
Yes, I agree the shoes and orthotic issue is real important to update but yet new orthotics taken with the angle that it is now would again have to be replaced when my knee was revised. So expense wise Orthotics are about $300 a pair so I kind of want to wait but again don't want extra pain.
I had the pain in the foot at times before the surgery but it seemed under control most of the time. But now with the crooked angle, I am pronating a lot more on that left foot. When I wear the orthotics which is all the time with my shoes on, it helps correct that but still puts extra strain on that area. I do have new shoes though. With good support.
I am a physical therapist assistant and have been for 24 years. I understand the PT mindset so it has been hard for me to change that.
I have been working in a speciality clinic of strengthening necks and backs for the past 20 years, and it is very successful. But I have not been working with other joints much at all Like I did before I worked in the speciality clinic.
Since I wrote that post about my surgeon, I am having different feelings about even considering him doing it. Jamie's post gave me a lot to think about so I am definitely reconsidering that and I am looking at revision specialists even this week and plan to make some calls. And I do have an appointment with one in two weeks.
Despite what the surgeon says about 5°, it looks like more to me and I don't like how it looks or feels. My leg doesn't feel like it is put together right and has not from the start. The angle that is off feels weird when I am weight-bearing. It is not natural and normal and can Likely cause hip issues and foot issues in my future.
I am also not as worried about the narcotic issue any more after Celle's and Josephine's post and the article info. I figure after two more weeks I should be able to get off due to the healing process.
Yes, I agree the shoes and orthotic issue is real important to update but yet new orthotics taken with the angle that it is now would again have to be replaced when my knee was revised. So expense wise Orthotics are about $300 a pair so I kind of want to wait but again don't want extra pain.
I had the pain in the foot at times before the surgery but it seemed under control most of the time. But now with the crooked angle, I am pronating a lot more on that left foot. When I wear the orthotics which is all the time with my shoes on, it helps correct that but still puts extra strain on that area. I do have new shoes though. With good support.
I am a physical therapist assistant and have been for 24 years. I understand the PT mindset so it has been hard for me to change that.
I have been working in a speciality clinic of strengthening necks and backs for the past 20 years, and it is very successful. But I have not been working with other joints much at all Like I did before I worked in the speciality clinic.
Since I wrote that post about my surgeon, I am having different feelings about even considering him doing it. Jamie's post gave me a lot to think about so I am definitely reconsidering that and I am looking at revision specialists even this week and plan to make some calls. And I do have an appointment with one in two weeks.
Despite what the surgeon says about 5°, it looks like more to me and I don't like how it looks or feels. My leg doesn't feel like it is put together right and has not from the start. The angle that is off feels weird when I am weight-bearing. It is not natural and normal and can Likely cause hip issues and foot issues in my future.
I am also not as worried about the narcotic issue any more after Celle's and Josephine's post and the article info. I figure after two more weeks I should be able to get off due to the healing process.
I'm so glad you're getting away from that first OS. No wonder your knee feels off, it is! That knock-knee is very visible and should never have happened! I pray you are led to the right revisionist!
You don't have to tag me unless you have a question or comment particularly for me. I read your thread every day anyway.
Normally, at least a couple of us are reading new posts everyday. We try hard to help everyone.
@kayow11 - Although you and I are likely headed for revisions for different reasons, I am going through the same process of looking for a second opinion (and maybe a third) and seriously examining whether I want my original surgeon to do a revision. I'm seeing her for my one-year review on Jan. 24. I expect I will sign up for revision surgery after that, quite possibly with a different surgeon.
You asked why I am facing a revision. I'm still in a lot of pain nearly 10 months after my LTKR. I have not had one day without pain since my surgery. For 10 weeks post-op, I went to physio at the rehab facility in the specialty hospital (they only do joints) where I had my operation on Jan. 3. This was after the surgeon told me I had "a challenging knee to operate on." Apparently my femur and tibia were different sizes. She said I was "bigger on top," and she chose the larger of two tibial trays because a smaller one would supposedly pose a risk of fracture. I thought she knew what she was doing. But I had a very difficult time trying to recover. Twice a week for two hours I went to rehab and although I told the physiotherapists that I had extreme pain on the lateral side of my knee, the told me to "ignore the pain" and pushed my leg repeatedly under the tabke to the point of agony. (Some other patients actually screamed or cried when this was done to them!) and they said if I didn't cooperate, they'd call my surgeon! They also told me that more, intensive exercise - including at home - would help my pain. It didn't. It hurt so much. I ended going to physio for several weeks longer than most other patients, before I "graduated." (They actually gave out certificates!) The sole goal in that rehab was to crank everyone's knees under the table to at least 120 degrees flexion. I never got past 110, and that's when they finally released me.
I went to follow-up appointments with my surgeon at six, 12 and 18 weeks and was told I was making progress, although I was "a little behind," and that I could still "expect pain at five months." The surgeon said my expectations were too high...and to exercise more. I tried to stay optimistic. However, I suspected things were really amiss when nearly everyone else was more recovered by about five months. Going for walks and stationary cycling hurt so much that I had to stop. When I went to my GP for my annual checkup in July, she confirmed that I was not having a normal recovery and advised me to keep going to physio and "working through it" while my muscles, tendons, ligaments, etc. got used to my new knee. (My leg was also straightened during surgery.) But as time went on, the swelling went down and my pain was concentrated in my joint on my lateral side. I described it as feeling as if an alien is living in my knee. I cannot walk more than a few yards, bicycle, get up from sitting or go down stairs without extreme pain. The only time it doesn't hurt is when I'm sleeping. I haven't had a pain-free day since Jan. 2. This is so much worse than my pre-op arthritic pain. And I was more mobile then, using a cane. Tylenol doesn't work, nor does Voltaren. Icing helps a bit, as does wearing a neoprene brace when I go out. I still use a cane, except for when I'm home in my condo, which is most of the time now. I can't do the things I want to do, like travel. It wasn't supposed to be like this. I really regret having knee surgery and already wasting a year of my life at my advancing age. I fear I will be out of commission for at least a couple more, if my knees become functional again at all.
Long story short: after a long look at my surgeon's clinical notes and my post-op X-rays, combined with what she told me post-op, I searched BoneSmart and other websites and found excellent information on tibial tray overhand impinging on soft tissue, especially the IT band. There's an excellent explanation by @Josephine here and I also read some academic medical papers. All say a revision (seems drastic!) is the only solution for eliminating this pain, but there's no guarantee, as with most things medical. Armed with this information, I made an appointment with my surgeon for Oct. 4 and insisted on new X-rays to make sure my new knee wasn't failing. After examining me and looking at my fresh X-rays, the surgeon and her resident actually agreed with what I suspected: there's tibial tray overhang (which I can clearly see) that's likely impinging on my soft tissue. The doc said that out of 10 identical X-rays, only one patient would have pain. Lucky me! She said to continue physio and exercising for the months until my one-year review. She said, "If it gets better, fine. If it gets worse, we'll have to discuss a revision." That was four weeks ago and my pain is no better. In fact, it feels a bit worse. It's definitely chronic and debilitating. I'm disappointed, frustrated, angry and depressed. I had a difficult time for months after this surgery and I'm terrified to go through another one (or two!)
I've been given the name of the surgeon who's supposed to be "the best knee guy in the city." He's at another hospital and is also a top revision specialist. I am about to call his office so I can get a second opinion - and maybe even a revision, with him. (I also badly need my painful, arthritic right knee replaced.)
I apologize for this long post! I sincerely did not mean to hijack your recovery thread, but you asked why I needed a revision and I got excessively wordy. (I'm a writer for a living and got carried away!) I promise I'll keep any future posts very short.
But I wanted you to know that there are others of us whose TKRs did not go as planned, unfortunately. I can't believe that so many of them go so smoothly that most patients have great outcomes and pain-free, fully functional new knees just months after these operations. Poor us!!
All best wishes to you!!
Judy
You asked why I am facing a revision. I'm still in a lot of pain nearly 10 months after my LTKR. I have not had one day without pain since my surgery. For 10 weeks post-op, I went to physio at the rehab facility in the specialty hospital (they only do joints) where I had my operation on Jan. 3. This was after the surgeon told me I had "a challenging knee to operate on." Apparently my femur and tibia were different sizes. She said I was "bigger on top," and she chose the larger of two tibial trays because a smaller one would supposedly pose a risk of fracture. I thought she knew what she was doing. But I had a very difficult time trying to recover. Twice a week for two hours I went to rehab and although I told the physiotherapists that I had extreme pain on the lateral side of my knee, the told me to "ignore the pain" and pushed my leg repeatedly under the tabke to the point of agony. (Some other patients actually screamed or cried when this was done to them!) and they said if I didn't cooperate, they'd call my surgeon! They also told me that more, intensive exercise - including at home - would help my pain. It didn't. It hurt so much. I ended going to physio for several weeks longer than most other patients, before I "graduated." (They actually gave out certificates!) The sole goal in that rehab was to crank everyone's knees under the table to at least 120 degrees flexion. I never got past 110, and that's when they finally released me.
I went to follow-up appointments with my surgeon at six, 12 and 18 weeks and was told I was making progress, although I was "a little behind," and that I could still "expect pain at five months." The surgeon said my expectations were too high...and to exercise more. I tried to stay optimistic. However, I suspected things were really amiss when nearly everyone else was more recovered by about five months. Going for walks and stationary cycling hurt so much that I had to stop. When I went to my GP for my annual checkup in July, she confirmed that I was not having a normal recovery and advised me to keep going to physio and "working through it" while my muscles, tendons, ligaments, etc. got used to my new knee. (My leg was also straightened during surgery.) But as time went on, the swelling went down and my pain was concentrated in my joint on my lateral side. I described it as feeling as if an alien is living in my knee. I cannot walk more than a few yards, bicycle, get up from sitting or go down stairs without extreme pain. The only time it doesn't hurt is when I'm sleeping. I haven't had a pain-free day since Jan. 2. This is so much worse than my pre-op arthritic pain. And I was more mobile then, using a cane. Tylenol doesn't work, nor does Voltaren. Icing helps a bit, as does wearing a neoprene brace when I go out. I still use a cane, except for when I'm home in my condo, which is most of the time now. I can't do the things I want to do, like travel. It wasn't supposed to be like this. I really regret having knee surgery and already wasting a year of my life at my advancing age. I fear I will be out of commission for at least a couple more, if my knees become functional again at all.
Long story short: after a long look at my surgeon's clinical notes and my post-op X-rays, combined with what she told me post-op, I searched BoneSmart and other websites and found excellent information on tibial tray overhand impinging on soft tissue, especially the IT band. There's an excellent explanation by @Josephine here and I also read some academic medical papers. All say a revision (seems drastic!) is the only solution for eliminating this pain, but there's no guarantee, as with most things medical. Armed with this information, I made an appointment with my surgeon for Oct. 4 and insisted on new X-rays to make sure my new knee wasn't failing. After examining me and looking at my fresh X-rays, the surgeon and her resident actually agreed with what I suspected: there's tibial tray overhang (which I can clearly see) that's likely impinging on my soft tissue. The doc said that out of 10 identical X-rays, only one patient would have pain. Lucky me! She said to continue physio and exercising for the months until my one-year review. She said, "If it gets better, fine. If it gets worse, we'll have to discuss a revision." That was four weeks ago and my pain is no better. In fact, it feels a bit worse. It's definitely chronic and debilitating. I'm disappointed, frustrated, angry and depressed. I had a difficult time for months after this surgery and I'm terrified to go through another one (or two!)
I've been given the name of the surgeon who's supposed to be "the best knee guy in the city." He's at another hospital and is also a top revision specialist. I am about to call his office so I can get a second opinion - and maybe even a revision, with him. (I also badly need my painful, arthritic right knee replaced.)
I apologize for this long post! I sincerely did not mean to hijack your recovery thread, but you asked why I needed a revision and I got excessively wordy. (I'm a writer for a living and got carried away!) I promise I'll keep any future posts very short.
But I wanted you to know that there are others of us whose TKRs did not go as planned, unfortunately. I can't believe that so many of them go so smoothly that most patients have great outcomes and pain-free, fully functional new knees just months after these operations. Poor us!!
All best wishes to you!!
Judy
I have copied RadioGal's post (above) into her own thread, so it can be discussed there, without hijacking kayow11's thread.
RadioGal's thread is here:
https://bonesmart.org/forum/threads/mua-determined-today-ugh.42814/page-9#post-1083126
RadioGal's thread is here:
https://bonesmart.org/forum/threads/mua-determined-today-ugh.42814/page-9#post-1083126
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kayow11
senior
@kayow11 - Please stop inviting people to comment about their knees on your thread. Your thread should be about your recovery and your knees, not theirs.
In Post #273, just above your post, I wrote a message in red, asking you to do just that and I even left a link to RadioGal's thread, so you would talk to her on her own thread about her knee.
Yesterday, I moved 7 posts from your thread that had hijacked your thread, because they were not about your recovery. I also copied RadioGal's post into her own thread.
Please read this article and take notice of it.
Forum etiquette: being polite when posting
Every time someone's thread is hijacked, it makes work for the staff who have to fix it by moving posts. We're all volunteers and we'd rather spend time helping people than sorting out threads that have gone astray.
In Post #273, just above your post, I wrote a message in red, asking you to do just that and I even left a link to RadioGal's thread, so you would talk to her on her own thread about her knee.
Yesterday, I moved 7 posts from your thread that had hijacked your thread, because they were not about your recovery. I also copied RadioGal's post into her own thread.
Please read this article and take notice of it.
Forum etiquette: being polite when posting
Every time someone's thread is hijacked, it makes work for the staff who have to fix it by moving posts. We're all volunteers and we'd rather spend time helping people than sorting out threads that have gone astray.
OP
OP
kayow11
senior
@Celle, I am so sorry I haven't been following the rules of certain things on this forum. I did read about forum etiquette, but somehow missed, that on my thread, I was only to just talk about my issues.
So I now understand that if I have specific questions about someone else's problems, I should go to their thread, is that correct?
Thanks!
So I now understand that if I have specific questions about someone else's problems, I should go to their thread, is that correct?
Thanks!
Yes, that's right.
Each person has their own recovery thread, where we talk about their knee. It's OK to post something about your knee there, if it is to help the other person. For example, something like "When my knee swells up after doing too much, I find that . . . . . helps a lot."
Each person has their own recovery thread, where we talk about their knee. It's OK to post something about your knee there, if it is to help the other person. For example, something like "When my knee swells up after doing too much, I find that . . . . . helps a lot."
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kayow11
senior
This past week I have made some calls to the names of surgeons that do revisions, listed from Jamie.
One of them I saw originally and I don't like him. So no more of that.
But one said he would not even see me until one year from the surgery date and I was to deal with my original surgeon regarding any issues I had. I am still waiting for One or two to get back to me yet about revisions.
I sure don't want to be walking around on a crooked knee for a year before getting it fixed.
Is 0° too much to expect for alignment? Mine is 5 to 10° off depending on who I talk to.
I have had back pain and other related pain issues the past three weeks. Wonder if it is from the way I walk or it's own monster. Did see a chiropractor several times now and it seems to be improving some.
Can anyone answer why several surgeons say that women are supposed to be somewhat Valgus, and purposely make you that way during surgery? This looks bad and doesn't feel right either.
I can't believe it won't likely cause a problem with my hip or foot as time goes on, and I am weight-bearing more with functional activities or exercise.
One of them I saw originally and I don't like him. So no more of that.
But one said he would not even see me until one year from the surgery date and I was to deal with my original surgeon regarding any issues I had. I am still waiting for One or two to get back to me yet about revisions.
I sure don't want to be walking around on a crooked knee for a year before getting it fixed.
Is 0° too much to expect for alignment? Mine is 5 to 10° off depending on who I talk to.
I have had back pain and other related pain issues the past three weeks. Wonder if it is from the way I walk or it's own monster. Did see a chiropractor several times now and it seems to be improving some.
Can anyone answer why several surgeons say that women are supposed to be somewhat Valgus, and purposely make you that way during surgery? This looks bad and doesn't feel right either.
I can't believe it won't likely cause a problem with my hip or foot as time goes on, and I am weight-bearing more with functional activities or exercise.
It's not unusual for surgeons to say they wont see you until a year after your original surgery. Part of medical etiquette, I think. Keep working on your list of possible second opinions, though.
Yes, you will get aches and pains in other parts of your body as a result of your altered gait post-surgery, whether or not you have valgus.
Yes, you will get aches and pains in other parts of your body as a result of your altered gait post-surgery, whether or not you have valgus.
Josephine
NURSE DIRECTOR EMERITA
Not at all!
As it always the case.
Never heard that before. But if they genuinely think that, it could be because the female pelvis is a lot wider than the male.
But I got this xray from Google and it clearly shows a female with perfectly straight/normal legs!
RadioGal
junior member
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