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Revision TKR TKR problems/crunching

johnmces

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Had rt TKR on 12/17 at age 50. Within weeks I felt & heard a "crunching" in the knee when walking. Knee was very swollen and both PT and OS felt it was nothing & would resolve with the swelling. I went back to work at 5 weeks, still swollen, crunching and with pain, but sucked it up. OS took a wait and see approach, unconcerned about the crunching yet not happy with the swelling/effusion.

At 4 months post he drained the effusion and tested the fluid and did blood work to eliminate possibilities of infection, etc. taking 60 cc of fluid off. Implants solid, no instability found. Swelling came back with in days and I continued to have crunching when walking. At 6 months he and his partner together diagnosed the cause of my problem to be mid range instability. The joint was solid at 90 and 0 degrees, but unstable in between. This would explain the crunching sound when I pushed off from the back of my stride and why it was uncomfortable driving distances as my knee remained at an angle while driving.

The solution was determined to be a revision to upsize the polymer spacer disc in between the femur and tibia assuming nothing else was found. Prior to the revision, swelling improved some, but pain continued. The revision was done 1/19 and the spacer was increased from 5mm to 8mm, stability was checked while in surgery.

Long story, sorry, but now I am post 6 months revision and while I am not as swollen as I was, the knee remains significantly swollen, and the crunching sound is worse. It feels like something is sliding/moving within the joint and is audible to people around me. I have pain with the crunching which although bearable, becomes much worse when walking distance greater than 1/2 mile.

Worse than that I have a constant ache, and waves of bad pain(8+) that hit me 3 or 4 times a day while at rest. I have pain at night when laying and jolts of it when trying to change position, thus quality sleep has been difficult to find.

I have put very little demand on the joint as my activity level is extremely light. OS is not pleased with the outcome. Feels that structurally everything is as it should be, but functionally not so. Plan as of May was to wait 3 months and reassess with potential referral to Mayo if no improvements.

The OS is a good Dr and I do not doubt his abilities. However, I am VERY frustrated, and would be far better off having my original arthritic knee as the pain wasn't as bad and my activity level was far higher.

I am wondering if anyone has experienced or heard of anyone having similar troubles following TKR. I have a video I would like to share of my crunching/walking, but I guess I need to post more before I am allowed to so that.

Hope I did not come across as a whiner... just trying to find answers and looking for help!

https://photos.app.goo.gl/rHiU8aKGTJBjdyfb6
Here is a link to my crunching/walking.
 

lovetocookandsew

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Welcome to BoneSmart. I'm sorry you're having so many issues with your knee. I've not experienced "crunching", but will tag our forum admin, @Josephine to see if she has any information that might help.
 

Cjackso21

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Hello, so sorry about you having to go through all of that. I’ve had similar swelling and what feels the same driving and general instability if I bend slightly while standing or pushing off. But no consistent crunching. Just occasional clunking which I guess is normal. I’ve also had 4 revisions after my first TKR (listed below I believe). Doctor says everything looks fine even with a MARS (Metal Artifact Reduction Scan) MRI. He said that it could be something with the plastic spacer that the MRI wouldn’t see but doesn’t want to do any more surgeries. I have some days of severe pain and knee is always swollen but I can walk fairly well. Hope you figure something out and if you do let me know. I’ll do the same. Good luck.
 

Josephine

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At 4 months post he drained the effusion and toook out 60 cc of fluid. Swelling came back with in days.
Of course it will. The aspiration is not a treatment to cure, only to give temporary relief.

The revision was likewise. A 'try it and see' procedure. But it didn't work and you are left with the consequences. I suggest you now start looking for a good knee surgeon who does many revisions and see if you can find any answers. I'm so very sorry it has come to this.
 
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johnmces

johnmces

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Hello, so sorry about you having to go through all of that. I’ve had similar swelling and what feels the same driving and general instability if I bend slightly while standing or pushing off. But no consistent crunching. Just occasional clunking which I guess is normal. I’ve also had 4 revisions after my first TKR (listed below I believe). Doctor says everything looks fine even with a MARS (Metal Artifact Reduction Scan) MRI. He said that it could be something with the plastic spacer that the MRI wouldn’t see but doesn’t want to do any more surgeries. I have some days of severe pain and knee is always swollen but I can walk fairly well. Hope you figure something out and if you do let me know. I’ll do the same. Good luck.
 
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johnmces

johnmces

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Thanks for the kind words Cjackso - your troubles make mine seem insignificant!
 

Atlas_aus

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Hi,

So sorry to hear about this. I do hope you get it sorted.
 

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