TKR both knees

[AbbyGirl2010]

AbbyGirl, wondering if what is wrong with your foot is the same thing I have. Mine is called posterior tibial tendon dysfunction. All of a sudden one day my foot hurt like crazy and my arch went flat and even bulged out. Had an MRI and said there was a torn tendon and I could have surgery to repair it. Well, I would have been off my foot for 2 months then months of rehab. So decided to go the orthotics route and a brace too for when I work out, or am on my feet for a long period of time. Guess I just didn't hurt enough to go through that. Doc said if it ever ruptured the rest of the way I would be ready. For now, orthotics for me. Sorry about your foot.

Thanks Debbie, I wish I had heard of a brace, but it was never mentioned to me. I am so sorry you too are going though foot pain. I was a avid jogger, practically lived at a gym and walked constantly. Since my foot surgery I am unable to go for walks unless I want to deal with extreme pain, which I did not have prior to this "unnecessary" foot surgery. If you are able to, avoid the surgery at all cost. I have known people who have had the surgery and are still no right. One of them a avid jogger has had to stop jogging. I have met people in places I have gone, like a grocery store, out shopping and even one at my veterinarian's office who have had the surgery and are still rehabilitating from it after almost a year. All of them and I have one thing in common, the same surgeon. So, if you live in the Albany, NY area avoid Dr. Dixon! I would not tell my worst enemy to go to him for anything! Besides that, he has no bedside manners, and no sense of humor. He is cold and distant. Good luck with the brace and keep your spirits up....avoid surgery if you can!

 

[KayeKaye]

To suggest you wait another ten years at your age is unconscionable. These guys were obviously NOT proper knee surgeons as a proper knee surgeon would know a) that 50 is a prime age for doing knee replacements and b) would not be suggesting this "This operations is wrought with problems and is not what you want to do until you have exhausted all the other options" rubbish. Anyone who thinks this is not even a poor knee surgeon! Are you sure they weren't rheumatologists or something? It's the kind of thing those guys come up with all the time. Did I suggest you read this Choosing a surgeon and a prosthesis

Yes they were both knee surgeons and not Rheumatologists. I did read the link posted above, before I chose them. This is really difficult. Maybe they want to bill for all kinds of treatments before they do the surgery. The both said the same thing, that "at 60 the knees last maybe 25 years and you don't want to have to redo knees at 85". They want me to wait 10 more years so the redo would be at 95 and hopefully (for them) I would be dead. However, I say, my mother lived to 97 and my aunt to 105. They don't care and act as if I am lying :~o Oddly enough my Mother in law IS 85 and heading for her first TKR so, so much for that theory.

I just can't imagine sitting for 10 years crying in pan and doing nothing at all. I did drag myself down to the beach yesterday and it wan't easy. I paid for it by sleeping really really late and got nothing done today -again.

 

[KayeKaye]

Another Doctor tomorrow. This one is a knees only doctor as well and seems(?) to be a good one. A friend of mine and her mother both had their TKN by him. My friend really wants me to see him as she thinks he is great. We will see...
But afterwards I am dragging this body down to the beach again, with a couple grand nieces.

 

[KayeKaye]

this seems very odd. Can you get ahold of the radiologist's report? We have a "mychart" feature with my insurance, so I always can see the writeup from the reading radiologist when I get xrays. I would imagine you could request them. I would think the radiologist has no stake in your knee one way or the other and you'd get an accurate report.

but I think telling you that you have to wait 10 years is nonsense. iirc you are 60ish?

I don't have the xray in writing but I have the MRI report written out, not that it makes ANY sense to me... and one of the doctors said you can't diagnose knee injuries with MRI's. But it does say that the meniscus tear was there.
Josephine; I don't know if any of this report makes any sense to you, or anyone else, but I would appreciate any clues.

"MRI EXAMINATION OF THE RIGHT KNEE

CLINICAL INFORMATION: Knee pain. Rule out medial collateral ligament tear.

TECHNICAL INFORMATION: The MRI examination was performed with a localizing surface. Thin section 4 mm thick sagittal proton density and T2-weighted spin echo dequencs were obtained, followed by coronal STIR images were acquired, followed by 4 mm thick axial T2-wieghted images.

INTERPRETATION: There is a small knee joint effusion. There is no evidence of popliteal cyst.

Osseous Structures: The bone marrow signal of the distal femur and proximal tibia is preserved without evidence of bone marrow contusion or occult ossesous injury.

Ligaments: The fibular collateral ligament is intact. There is mild thickening and signal change involving the proximal medial collateral ligment fibers in keeping with residua of mild incomplete-appearing medial collateral ligament sprain. The anterior and posterior cruciate ligaments are intact.

Posterolateral corner: The direct fibular and indirect tibial attachments of the biceps femoris complex appear preserved. The remaining posterolateral corner soft tissues appear normal.

Posteromedial corner: The posteromedial corner soft tissues, including the pes anserine and semimembranosus tendons are intact.

Extensor mechanism: The extensor mechanism is intact The quadriceps infrapatellar tendons are normal.

Medial compartment: There is Grade II/III chondromalacia of the medial joint space compartmetn including brad-based areas of near full-thickness chondral loss involvng the central and posterior weight-bearing portion of the medial femoral condyle as well as the medial-most portion of the medial tibial plateau. A localized area of horizontal cleavage tearing of the infra-articular surface of the anterior one-third aspect is noted. Intrasubstance myxoid degenrative-type signal change of th posterior one-third of the medial meiscus is noted.

Lateral compartment: The articular cartilage of the lateral joint space compartment appears preserved. There is no evidence of discrete lateral meniscal tear.

Patellofemoral compartment: Grade III/IV chondromalacia of the patellofemoral compartment is noted.

CONCLUSION:
1. Residua of mild proximal medial collateral ligament sprain.
2. Grade III/IV chondromalacia of the patellofemoral compartment.
3. Grade II/III chondromalacia of the medial join space compartment. A localized area of cleavage tearing of the infra-articular surface of the anterior one-third of the medial meniscus near the junction between the middle and anterior one-third of the medial meniscus is noted. "

 

[KayeKaye]

Same song second verse with the doctor today. He too wants to wait and do cortisone shots. He too warned me that it's an unpredictable operation at best fraught with problems and infections run rampant. He said I was "red flagged" because of my two others operations that became infected. He said knee infections leave with the mechanism being taken out and no knee until it heals and then it even more difficult to do the operation.

I will say he was at least personable and let me ask questions. When I told him I am doing nothing but sitting and being in pain he said to try some cortisone and maybe by November look at the operation.

His take on the situation was:
Yes to Osteoarthritis and
Yes to meniscus tears,
but not to the degree of causing pain.
So the pain is the arthritis which could be controlled by Cortisone shots.

(However the Synvistic One did nothing for my pain so why would a cortisone.)

On to the Mayo clinic next month.

 

[RestAssured]

I would head to the Mayo clinic with the x-rays, and then they like to do their own for comparison. Mayo will know how to handle infections, because they work as a team! Much like Dr. Maale surrounds himself with each doctor in Dallas. They do the same at Mayo

 

[KayeKaye]

Yes I hope they can give me some sound answers. If I get the same answers at Mayo as I got I will just give up. I am so shot. I am in so much pain right now I can barely type or read. I got to take care of two grand nieces today which was so fun, except for the pain. Will see them again tomorrow, hopefully I will have a better day tomorrow so we can have some fun.

I hope you are well today RestAssured!

 

[kneeper]

To my understanding the synvisc and cortisone work in different ways. Synvisc is to help with lubricating the joint. cortisone would bring down the inflammation.

 

[KayeKaye]

Kneeper, no one told me that. I knew that the synvistic was cushioning but thought it was for pain as well, I think that is what I was told though I'm sure of nothing at this point. All the doctors have asked me if the synvistic alleviated any pain and agreed it didn't. I do take a LOT of ibuprofen for inflammation.

 

[kneeper]

The cushioning effect would help with the pain b/c you would be less bone on bone, but it wouldn't be a direct pain reliever.

 

[Josephine]

chondromalacia is cartilage damage, aka arthritis

He said I was "red flagged" because of my two others operations that became infected.

What infected operations? I don't remember you mentioning them before.

He said knee infections leave with the mechanism being taken out and no knee until it heals and then it even more difficult to do the operation.

What he is referring to is a two stage revision. They are quite a common protocol Infection: peri-prosthetic infection - also known as late onset infection. As to whether it's difficult to do anything afterwards is questionable and probably depends upon the skill of the surgeon.

Synvistic One did nothing for my pain so why would a cortisone.

Synvisc is also called "broken link removed: https://www.synviscone.com/what-is-synvisc-one.aspx" and is a thick substance that both cushions the joint and lubricates it. That's all it does for pain. Cortisone is a type of steroid that is produced naturally by a gland in your body called the adrenal gland. When extracted and used in injections for various inflammatory conditions, it is a powerful anti-inflammmatory and thereby reduces pain. It's always worth a 'shot'!

 

[KayeKaye]

Thanks Josephine.
I've had two infections from operations:
1990 Staph infection in Caesarean, took 3 months to close
2004 Infection, unknown kind, foot operation, took 6 months to heal the incision.

So now I'm going to ask if I can Both, Synvistic and cortisone if that's the case. No one has suggested that yet.

 

[Josephine]

I've had two infections from operations:
1990 Staph infection in Caesarean, took 3 months to close, 2004 Infection, unknown kind, foot operation, took 6 months to heal the incision.

8 years since the last one? I can't figure that as being a red flag now. I've known many patients with previous histories of infections who have had joint replacements. They just got intensive prophylactic antibiotic coverage was all and did fine.

So now I'm going to ask if I can Both, Synvistic and cortisone if that's the case. No one has suggested that yet.

They don't as a rule. They don't mix well as one is oil based and the other is water based. and you know the old saying that "oil and water don't mix"!

 

[KayeKaye]

Ahh, thanks again Josephine. No one told me that they didn't mix. interesting the lack of explanations I have gotten. If it wasn't for this forum I would truly be in the dark!

 

[Nyland]

Hi KayeKaye!
I feel so bad that you are in so much pain with no answers. Try the cortisone first. I found that the first few treatments helped some. Maybe you have lots of painful inflammation? Maybe the cortisone or a round of prednisone burst would help?
I know this sounds crazy, but if I eat cherries at night, it helps the stiffness.
Good luck!!!!

 

[BJ Mac]

They don't as a rule. They don't mix well as one is oil based and the other is water based. and you know the old saying that "oil and water don't mix"!

Are you Serious??? Whoa!!! I think at one point my other OS gave me Cortisone when he gave me Supartz, to help alleviate the pain until the supartz could take affect... HMMMM!!!!!

 

[Nyland]

How are you doing, BJ? I think about you often. I love your posts.

 

[BJ Mac]

Thanks for asking Nyland. I am feeling tired, hurting and weak, and I am frustrated that I am this far out and feeling this way. But honestly as I was just posting the things that I did today, "taking it easy", I look at it and say, "Seriously? That is you taking it easy?" I realize that I do not know how to take it easy. I am also dealing with a humongous change in my life, going through divorce, at this time and learning that that alone is reason to feel as weak and exhausted as I am without trying to recover from knee surgery as well. So, A bit down today... and I really like that you asked about me, I feel cared for.

 

[Nyland]

Take care, my friend. You need to heal physically and emotionally. It's not fair that you have so much dumped on you, but know that you have friends that care and think you're absolutely awesome!

 

[BJ Mac]

Thanks friend!!! It sure helps to know that I have friends that care and think very highly of me. I know very well that life is not fair and that it could be even worse. (I used to tell my kids when they complained that life wasn't fair, that if it was fair we would all have had a stroke - my second son had a stroke as an infant) I for one do not want life to be fair, I want grace and mercy... I know that I am blessed and that I will come through all of this and be better for it. There is something to that saying, "What doesn't kill us makes us stronger." I also know that I would not be able to appreciate the mountain tops in my life without first walking through the valleys...

So, here is to the victories that are yet to come!