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TKR to have revision, or not to have revision

PaulF

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HI I am new to this thread. I had LTKR two years ago. The first year was OK not wonderful, still took NSAID everyday, but could play tennis and do what I wanted. However knee was trembly and would throb in the shin if I was sitting too long.

However that all changed at the beginning of this year when, after bending the knee with a little too much pressure on it, it became very painful to walk. I also began experiencing back pain, specifically sciatica, which has become chronic but manageable.

I relate it to the surgery and the fact that my left leg is longer that my fight by 0.6 inches. The leg has always felt too long especially on the lateral side (outside). I was on the couch for three days. Slowly after 9 months, I can walk again and manage some tennis, but it hurts everyday. I am considering a revision, but two surgeons said it is stable, can not find anything wrong, and not to do revision except as last resort.

Another surgeon recently told me I am a candidate and is ready to schedule me. I still have pain everyday, mostly throbbing when at rest, but functional with weight bearing etc. But walking is problematic for longer spans like over a mile. Any advice or can anyone share real experiences with Revision.
Thanks
 

lovetocookandsew

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Welcome! While no one can make the decision for you, I can offer a little insight. First off, my OS, and others, recommend only doubles tennis after a TKR.

I had a revision 2 1/2 years ago due to allergies to the metal, and a lot of non-stop pain, and really had no other option. The recovery from it, for me, was easier than my original TKR, but sometimes that's not the case. Every surgery and recovery is different, but one thing that's basically the same is that recovery is not a cake walk.

I think what I'd do first is make sure all three surgeons are revision specialists, and do many revisions each year. Then, after finding out who are actual revision specialists, I'd weigh all my options, assess my quality of life and then begin to make my decision. I'd maybe even go back to talk to any who are revision specialists for more info. If none of them are specialists, I'd definitely keep looking for one. What makes me hesitate somewhat is that two surgeons said no and your third opinion said ok. I'd wonder a bit when it's two vs one, but you can delve a bit deeper first by looking into their specialty. You really should visit a revision specialist, unless you already have, as a regular OS may not have the experience of a specialist. He may be perfectly qualified to do a TKR, but revisions are different.
As for the pain, it's a good idea to ice it when it's painful; ice is a good pain reliever, even two years down the line.
I would also ask them about the leg length and back pain; if related to your knee, it's another reason to consider the surgery, although maybe not a deciding factor.

In the meantime, I'd lay off the tennis for a bit and allow my leg to rest for a while. Ice it, don't do anything too strenuous, and see what it feels like in a week or two.

Would you please give us the date of your TKR, and any other knee surgeries, so we may make a signature for you?
 

newlybionic

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Hi @PaulF. I’ve had a complete revision on my left knee and am planning a revision on my right knee. I actually did much better after the revision surgery than the original TKR. My right knee has become painful and losing range of motion. No loosening or problems with poor bone growth. Nothing concrete to fix, but it just isn’t working very well for me. My OS is a revision specialist and he feels he can help me by doing a full revision and checking the underside of the knee cap for problems there. I’m going for it. I want to be able to do everything I used to do before the surgeries.
 
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PaulF

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Love to cook and Sew,

MY LTKR was performed on October 1, 2018. It was a Conformis Knee. Is there somewhere in my profile I should add this information as well as previous history?
 

Celle

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@PaulF I have added your surgery and its date to your signature.
Thank you for telling us the full date.
 
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PaulF

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Hi @PaulF. I’ve had a complete revision on my left knee and am planning a revision on my right knee. I actually did much better after the revision surgery than the original TKR. My right knee has become painful and losing range of motion. No loosening or problems with poor bone growth. Nothing concrete to fix, but it just isn’t working very well for me. My OS is a revision specialist and he feels he can help me by doing a full revision and checking the underside of the knee cap for problems there. I’m going for it. I want to be able to do everything I used to do before the surgeries.
newlybionic,

Thank you for sharing your experiences. I am wondering how the revision feels now that you have had it for over 4 years, especially after experiencing the original TKR. I am not afraid of going through the surgery and rehab again, but I am worried that it will be worse not better. Right now, this knee is functional but uncomfortable everyday. It keeps me from moving about as much as I used to before the surgery and my ability to walk longer distances is less also. So I guess there are just no guarantees but it is encouraging to hear your story and your desire to have the right knee done. Best of luck on the upcoming procedure.
 
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PaulF

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Welcome! While no one can make the decision for you, I can offer a little insight. First off, my OS, and others, recommend only doubles tennis after a TKR.

I had a revision 2 1/2 years ago due to allergies to the metal, and a lot of non-stop pain, and really had no other option. The recovery from it, for me, was easier than my original TKR, but sometimes that's not the case. Every surgery and recovery is different, but one thing that's basically the same is that recovery is not a cake walk.

I think what I'd do first is make sure all three surgeons are revision specialists, and do many revisions each year. Then, after finding out who are actual revision specialists, I'd weigh all my options, assess my quality of life and then begin to make my decision. I'd maybe even go back to talk to any who are revision specialists for more info. If none of them are specialists, I'd definitely keep looking for one. What makes me hesitate somewhat is that two surgeons said no and your third opinion said ok. I'd wonder a bit when it's two vs one, but you can delve a bit deeper first by looking into their specialty. You really should visit a revision specialist, unless you already have, as a regular OS may not have the experience of a specialist. He may be perfectly qualified to do a TKR, but revisions are different.
As for the pain, it's a good idea to ice it when it's painful; ice is a good pain reliever, even two years down the line.
I would also ask them about the leg length and back pain; if related to your knee, it's another reason to consider the surgery, although maybe not a deciding factor.

In the meantime, I'd lay off the tennis for a bit and allow my leg to rest for a while. Ice it, don't do anything too strenuous, and see what it feels like in a week or two.

Would you please give us the date of your TKR, and any other knee surgeries, so we may make a signature for you?
lovetocookand sew,
Thank you for sharing your experiences. I do believe the surgeon who is ready to do the revision does a considerable amount of revision, but how does one assess or find a revision "specialist" versus one who just does them less routinely.
 

lovetocookandsew

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We have a surgeon locater area here at BoneSmart. It's at the top of the page, in the tool bar. That's a good place to start. I'd also ask any surgeon you've spoken to how many revisions they do per year, and for how many years. I'll also tag @Jamie as she may have more knowledge in this area.
 

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