ORIF TKR and Hardware Removal? Advice welcome

[Jamie]

I'm glad you were able to find someone to help you with knowledge and experience. That's half the battle! Although you'll have a bunch of surgeries in a short period of time, others have been through this and have done just fine. Here's hoping things go well for you. Please keep us up to date on how you're doing. We're here for support if you need us.

 

[Ayse]

I'm glad you were able to find someone to help you with knowledge and experience. That's half the battle! Although you'll have a bunch of surgeries in a short period of time, others have been through this and have done just fine. Here's hoping things go well for you. Please keep us up to date on how you're doing. We're here for support if you need us.

Thanks so much Jamie. It's great to find so much encouragement here. Xx

 

[Ayse]

Does anyone know when the meniscus is removed for TKR does that mean the patellomeniscal ligament is also removed? And what happens to the other ligaments around the kneecap, like patellofemerol and patellotibial?

Many thanks

 

[Jamie]

When a person has a total knee replacement, the tibia and femur are cut as shown in the illustration below. The tibia is cut in such a way that the entire tibial plate including the meniscus is removed. If a patellar button is to be placed (when there is arthritis in the patella area), it is shaved to accept the plastic button.

The entire meniscus is removed during surgery. Depending on the condition of the anterior and posterior cruciate ligaments, they may also be removed. If this is the case, a special knee prosthesis will be used to compensate for their loss. The other ligaments in the knee joint are retained and the surgeon must ensure a careful balancing of those ligaments to ensure a well-functioning knee. This is where the surgeon's expertise comes in and it's the reason we advise our BoneSmarties to find a surgeon who does at least 150 knee replacements (not just "knee surgeries") in a year.

A new tibial plate and a plastic spacer are inserted as part of the knee replacement that completely replaces the function of the meniscus to cushion the joint.

I hope this explains the knee replacement process for you in a way that helps. If you have any specific questions, please don't hesitate to ask. You may also want to discuss this with your surgeon to see what his typical surgical procedures are.

 

[Ayse]

When a person has a total knee replacement, the tibia and femur are cut as shown in the illustration below. The tibia is cut in such a way that the entire tibial plate including the meniscus is removed. If a patellar button is to be placed (when there is arthritis in the patella area), it is shaved to accept the plastic button.

View attachment 86620 View attachment 86621

The entire meniscus is removed during surgery. Depending on the condition of the anterior and posterior cruciate ligaments, they may also be removed. If this is the case, a special knee prosthesis will be used to compensate for their loss. The other ligaments in the knee joint are retained and the surgeon must ensure a careful balancing of those ligaments to ensure a well-functioning knee. This is where the surgeon's expertise comes in and it's the reason we advise our BoneSmarties to find a surgeon who does at least 150 knee replacements (not just "knee surgeries") in a year.

A new tibial plate and a plastic spacer are inserted as part of the knee replacement that completely replaces the function of the meniscus to cushion the joint.

View attachment 86622 View attachment 86623​

I hope this explains the knee replacement process for you in a way that helps. If you have any specific questions, please don't hesitate to ask. You may also want to discuss this with your surgeon to see what his typical surgical procedures are.

Thanks so much! The picture of what thwy remove is very helpful.

 

[Jamie]

Good.....I'm glad this helps you understand what the surgery involves. Don't hesitate to ask any other questions if they pop up.

 

[Ayse]

I've been trying to find articles about exactly how surgeon's actually balance ligaments during TKR but can't find anything. Really interested in anything if anyone can point me in the right direction. Many thanks

 

[InkedMarie]

I hope you get answers because I don’t even know what you’re talking about LOL!

Marie

 

[Jamie]

You can view a wide variety of information available on the internet by Googling "Ligament balancing in a TKR."

Here is a link to one YouTube that may help you understand what the process involves. It is a very complex part of knee replacement surgery and the most critical for success with your new knee.

 

[Ayse]

You can view a wide variety of information available on the internet by Googling "Ligament balancing in a TKR."

Here is a link to one YouTube that may help you understand what the process involves. It is a very complex part of knee replacement surgery and the most critical for success with your new knee.

Oooh, thanks so much! Really helpful! xx

 

[Ayse]

Feel like I'm falling apart now while waiting for my TKR on left knee. I haven't been able to hardly walk for a year which is now taking serious toll on my right knee too. And I've been doing the same few exercises for 11 months to try and keep at least some muscle but now I have severe muscle strains in both legs, tendonitis, sore ligaments, etc, pretty much my whole of both legs. Left leg shakes when standing or walking from posteriorlateral corner like something is torn and can hardly support me, even with a brace and cane. Right knee has chondomalacia patella and arthritis too but it's been the one supporting me for most of the year and has taken a pounding.
I've stopped doing the weights, just been trying very gentle exercises every other day with no improvement to severe muscle knots/constant burning pain in muscles/tendonitis. I have practically no medial quads left and other muscles also severely atrophied. For some reason I haven't been able to really build much muscle in a year. Now I'm so worried that even with TKR, unless I can get the muscles/tendons/ligaments better that my leg still won't work. I know the bonesmart approach is more rest less PT but I feel like I'm in a catch 22.

 

[Jockette]

@Ayse I have combined all your threads/questions into one thread, so your history is all in one place. I’ve also moved it to the Recovery Forum, since you did have ORIF surgery.

Please keep all your questions and updates in this Recovery Thread from now on. We can change your thread title any time, to reflect a new question or topic, just let us know what you want it to be.

Best wishes as you seek answers.

but now I have severe muscle strains in both legs, tendonitis, sore ligaments, etc, pretty much my whole of both legs

These issues need to heal, before you can continue to try to strengthen your legs. I’m sorry you have such pain.

 

[Ayse]

@Ayse I have combined all your threads/questions into one thread, so your history is all in one place. I’ve also moved it to the Recovery Forum, since you did have ORIF surgery.

Please keep all your questions and updates in this Recovery Thread from now on. We can change your thread title any time, to reflect a new question or topic, just let us know what you want it to be.

Best wishes as you seek answers.

but now I have severe muscle strains in both legs, tendonitis, sore ligaments, etc, pretty much my whole of both legs

These issues need to heal, before you can continue to try to strengthen your legs. I’m sorry you have such pain.

Thank you so much. I'm going to try some TENS/NMES and see if that helps any. xx

 

[Jamie]

@Ayse….I can certainly understand your concerns. Do you know how much longer you will have to wait for your knee replacement?

 

[Ayse]

Thanks so much Jamie. I'm hoping January. I spoke to the surgeon and had some more scans and he's going to have a multiteam meeting about the best type of implant, possibly a hinged. As I'm sure many can appreciate, the longer it goes on not being to walk the more it plays havoc with the rest of your body. Looking at the CT scan is freaky! There is such a big depression on lateral side! xx

 

[Ayse]

For people who had a lot of muscle atrophy before their TKR, did you manage to rehab successfully with just the bonesmart approach of ADL?

 

[Jaycey]

@Ayse I think you will find that nearly all our members were able to rebuild strength and stamina using our approach. Slow and steady means the body has time to recover from the trauma. Trying to push through only results in setbacks and disappointment.

You will notice that I merged your newest post with your original recovery thread. For several reasons, we prefer that you only have one recovery thread:

• That way, we have all your information in one place. This makes it easier to go back and review your history before providing advice.
• If you keep starting new threads, you miss the posts and advice others have left for you in the old threads, and some information may be unnecessarily repeated
• Having only one thread will act as a diary of your progress that you can look back on.

Please post any updates, questions or concerns about your recovery here. If you prefer a different thread title, just post what you want and we will get it changed for you.

If you need an urgent response to a question, just tag a member of staff.

Many members bookmark their thread in their computer browser, so they can find it when they log on.

 

[Ayse]

@Ayse I think you will find that nearly all our members were able to rebuild strength and stamina using our approach. Slow and steady means the body has time to recover from the trauma. Trying to push through only results in setbacks and disappointment.

You will notice that I merged your newest post with your original recovery thread. For several reasons, we prefer that you only have one recovery thread:

• That way, we have all your information in one place. This makes it easier to go back and review your history before providing advice.
• If you keep starting new threads, you miss the posts and advice others have left for you in the old threads, and some information may be unnecessarily repeated
• Having only one thread will act as a diary of your progress that you can look back on.

Please post any updates, questions or concerns about your recovery here. If you prefer a different thread title, just post what you want and we will get it changed for you.

If you need an urgent response to a question, just tag a member of staff.

Many members bookmark their thread in their computer browser, so they can find it when they log on.

Thank you Jaycey xx

 

[Ayse]

So...I have my date in early Feb for TKR. I wish I could say it will fix all my problems but I'm still unsure what the end outcome will be as the injury caused a lot of bone deformity where the femur pushed the tibia inside itself in a depression that kind of mushroomed out the bone. This area is lower than where the joint ends will be replaced, so at the moment the ligaments, tendons, muscles are not in the right place, rubbing on the bone, very painful and causing functional problems. There are also a lot of adhesions around the whole area, despite soft tissue release treatment. After discussing things with the surgeon I'm sure it's going to be more functional and less painful than it is now, but he can't guarantee all the problems will be fixed. So I'm pretty apprehensive, scared of another surgery and recovery, and keeping my fingers crossed! It's been a long road as I haven't been able to walk properly for 14 months and have been in constant pain.As I'm sure most of you have experienced, when you can't walk properly it puts everything out, back, feet, legs, hips, etc. Just trying to get through each day has been a challenge, mentally and physically. I'm lucky I have a very supportive husband who has literally had to do everything around the house as I've been unable to. It's taken it's toll on both of us so hopefully this will be a new beginning!

 

[Jaycey]

After discussing things with the surgeon I'm sure it's going to be more functional and less painful than it is now, but he can't guarantee all the problems will be fixed.

Well this is the case for literally every procedure. There is always a risk that something can't be fixed. But in most cases our members come away from surgery delighted with the outcome.

I haven't been able to walk properly for 14 months and have been in constant pain.

So your biggest challenge post op will be patience! You already know the impact that results from not being able to move around correctly. It can take awhile to correct your gait. Slow and steady does it.

What is your surgery date? We will put the information in your signature for you!