TKR Turtle still hoping to cross the finish line

[Campervan]

Hi Mary, sorry to read of your troubles. Before my TKR I was using hiking poles to relieve the weight going through my knee. They seemed to help. And using them rather than canes didn't make me feel so old.

 

[maryo52]

Josephine or skigirl, what's involved in a surgery for spacer exchange only? How does it compare to TKR?

 

[Pumpkin]

I'll tag them in a post for you.
@Josephine: @skigirl:

 

[pmonroe]

Re: a little reassurance needed

The dementia thing is tough. My husband was diagnosed with Semantic Dementia at age 53. He is still fairly high functioning, but when I had my surgery, he was so willing to help, but it was hard to explain some things to him concerning exercizes, etc. He wrote down everything the doctor said, but didn't understand much of it.

 

[RestAssured]

Mary,

I really wish you were closer to Dallas! I am feeling Pretty darned g.ood now! I have a hinged knee but I can't tell the difference between it and my left one. It has been a little less than a month and I am pulling my knee up without even thinking about it and already getting a bend of 94. Pretty good for a leg that isuposed to stay in an immobilizer brace huh! :th_heehee:

 

[PooShay]

I'm now on Day 3 of being levelled. As a result am catching up with everyone else's progress here.

Mary: silver lining. There are so many people here that need a to be heard and helped!

 

[maryo52]

Well my main problem now is psychological. I am in a rut. Every appointment I have regarding the knee which is intended to sort this out and come up with possible remedies only causes me to nosedive emotionally.

I am thinking this morning that it might be good (or might not!) to meet with my ortho. Not to berate him or get an apology, but mainly to get a prescription for a knee brace to help me achieve more stability. With the valgus I have and the instability, my collateral ligaments are taking a beating. I fear they will go downhill and only make things worse. I have s-o-o-o-o many questions still unanswered.

 

[Pumpkin]

Mary,
Hope you find a way to get the order for a knee brace, and along the way some answers about your knee.

 

[jancat]

Mary- Why not call Dr. Parks with your additional questions? It is worth the shot, and you can remind the office that he had trouble speaking when you saw him. You might have to initially speak with a PA, but I think it is worth the trouble to have the questions brought to his attention.

 

[skigirl]

Mary, I just saw the tag, as you know, I just had my spacer replaced. I did have a complication in that I had extensive adhesions which were holding my patella in one place.

so, My recovery has been longer because of the soft tissue damage(from removing scar tissue) which was painful and which I wanted to heal without causing more scar tissue.

As to the spacer itself. You do have to have an open procedure again and there the spacer has to be pried out of your knee. there is no extra bone cutting, so you do not have that additional pain. It is thus easer than a full tka, but you will have to rehab the knee again much like the rehab from a tka. I found it much easier to bend the knee and I find that my knee feels even more stable since I had a small amount of laxity in the first knee.. I know that you have many issues Mary and I am sorry that you have had to go through so much.

I also feel angry at my situation. I can't really blame my surgeon---the laxity was slight and I would not have changed the spacer, just for it. The scar tissue--is it worse because of the movement within the capsule? No one seems to know for sure. But, it does make me wonder. So, anger yes--I found that taking the bull by the horns and making a decision was helpful to me. I have had to be very slow in the recovery--I am almost six weeks out and have only done leg raises and pool stuff. I hope that the slow rehab will prevent more scar tissue from forming--but I am working in the dark on that one too. My OS did tell me that inflammation causes scar tissue and so if you are exercising an inflamed knee, there is a chance that you are making it worse.

So, I have waited until the knee is no longer "hot" to begin to exercise it---slowly, slowly. I have good rom, but my muscles look like jello right now. I feel like a blob--have finally started exercising my upper body!! I do feel for you right now. my husband is a phsychiatrist---he has had to work with me on this!!! k

 

[Josephine]

Thanks for that, Kelly. Not a lot I can add to first hand experience!

But they do have to open up the knee again through the previous scar but will only do it enough to be able to fetch the present spacer out and put a new one in. The external scar might be opened up about 90% but internally it will be more like about 50-60%. But you can't always tell how much as it depends upon how tight the tissues are and what/where else he needs to take a look.

 

[maryo52]

Well I was curious to know about insert exchange. If someone could say a simple spacer exchange would fix my problem, that I could handle that. But they can't promise that. I'm told it could range from spacer exchange to revision of all components and they couldn't say until surgery. Love it.

I'm probably living in la-la land, but I'm going to meet with my ortho, convey the results of the 2nd opinions, and ask for an Rx for a custom-fitted knee brace. I don't even need to talk to him about his screw up. I need to move forward as best I can and stop being a knee patient, at least for the foreseeable future.

 

[Morning Glory]

Mary,
I was just reading through your thread. I'm sorry you're having such a difficult time. I hate when there are no clear cut answers. Hope everything works out for you real soon.

 

[RestAssured]

Mary,

My 2nd knee surgery included a spacer replacement. Of course they had to do major debridment because of infection. That recovery was one of the most painful because of the after effects from the infection.

I am hoping that the knee brace will bring you relief. Have a custom fitted knee brace made though, because you want it to be specific to your knee.

Take care, and I will keep praying for you!

 

[skigirl]

Mary, a brace will tell you something-- if your knee becomes more stable in the knee brace and it is easier to walk, then you will know if a space change will affect your knee. I know that in my own case, the A/P movement was slight--it should have been 1-3 and instead it was 3-5--but, I could feel the shift. This time out with a spacer that is 2mm thicker, my knee is much more stable. I can feel the lack of motion.

I think that Pilot recently went in for a spacer change to get a more stabilized knee and his doc changed out the femoral component as well. He did not think the space fit will within the femoral component and he changed it.

Essentially, that is what your second opinion told you. You need a thicker spacer and he will change only that as long as the knee functions well with just it. If it does not work well, he might have to change the femoral component as well.

The arthrofibrosis is the fly in the ointment here. perhaps you need someone who is a specialist in arthrofibrosis? I think that there is a Dr. Noyes at the Steadman clinic who is working with those patients--I am not sure it is a true speciality. But, perhaps you might get some answers from someone like that.

I know that I thought really long and hard before I took on this surgery--and it has not been easy at all. I have had to basically sit still for almost 6 weeks. If the knee is hot thus inflamed, we do almost nothing at pt. Strictly e-stym and minor table stretches, massage the swelling and ice. Now, at six weeks, my knee is finally settling down. My pt told me today that he thinks we should wait for two more weeks--the possibility of adhesions forming is less after 8 weeks. For me, I am just trying to give my knee the best shot possible. If the adhesions reform, at least I know that I tried what I could to prevent them.

I understand the muddle you are in--trying to find a solution to a very complex problem. I would not give up though--I would continue to search for a doc whom you trust who offers a reasonable plan for success---or an acceptable plan for continuing along without surgery. Kelly

 

[Dhare63]

Hang in there Mary, no easy solutions in your case. I know the feeling of disappointment and being discouraged all the time; that seems to be the world I am in right now.

I agree looking forward instead of back is your best route to better days. You can't change what has happened, only what will be. Direct your energy to solution and keep the faith. We are all right behind you. (((hugs)))) Dawn

 

[maryo52]

All of you who have posted to my thread -- your words are why I hang with this forum. It's a mixed bag because the dialog is both helpful and at the same time it feels like it's another way to dwell on problems I have no control over. I remember several times Coachie saying she was going to step away, for the same reason. There are moments of such overwhelming disitress. Ultimately, this is the only place we get true understanding and that's worth gold.

Kelly, you in particular really nailed exactly where I am and the dilemmas involved. I reviewed one of the Mass Gen'l second opinion office notes last night and it was much more carefully worded than what he said to me personally. So I have to wonder if my regular doctor views my story as exaggerated in view of those office notes. I hope the notes from New York are a little more descriptive of the true situation.

Kelly I'm also impressed with your ortho. I have never heard on this forum or anywhere else an ortho who approached arthrofibrosis via the less is more philosophy. I most definitely felt as if PT made my AF worse. When I had my final procedure (arthroscopic removal of scar), I took matters into my own hands. I bought a CPM machine on Craigslist because I couldn't find one to rent, borrow or even steal. And I spent time watching TV on the CPM along with gentle stretches the first month. I wish I had your ortho! Your ROM is already great and you're going easy to preserve it. I think you are most definitely winning this battle. I'd be curious to know where your ortho learned this approach to AF. Yeah, I've heard about Dr. Noyes. My ortho actually was a fellow at the Steadman Clinic where they specialize in AF.

 

[Coachie]

Well my main problem now is psychological. I am in a rut. Every appointment I have regarding the knee which is intended to sort this out and come up with possible remedies only causes me to nosedive emotionally.

I am thinking this morning that it might be good (or might not!) to meet with my ortho. Not to berate him or get an apology, but mainly to get a prescription for a knee brace to help me achieve more stability. With the valgus I have and the instability, my collateral ligaments are taking a beating. I fear they will go downhill and only make things worse. I have s-o-o-o-o many questions still unanswered.

I am so sorry that this is tough. I know how you feel and wish I had the magic words to say to make you feel better- but I don't :/

Hang in there and hopefully soon someone will figure things out and find a way to help you!

 

[maryo52]

Thanks Coachie.

. . . as an addendum to what I wrote earlier, I could use a little less self-doubt!

 

[pmonroe]

Hang in there!