Well I feel surprisingly light and happy today after meeting with my OS. I was there to reconnect with him after receiving two second opinions about a 19 month old knee that is slightly unstable and has an effusion that won't quit, plus my quad is somewhat small. The 2nd opinions did not find anything horribly wrong except some valgus and laxity, which in turn apparently causes the effusion. The quad problem is due to the feedback loop between the knee and the brain which is telling the body to protect the knee.
What a process this has been! It is so important that we with artificial joints have a supportive ortho. The 2nd opinions were helpful except they were limited, and those orthos don't become your allies unless you go back. So, again, the ortho as ally is essential.
Mine proved his mettle today by neither defending or accusing but with professionalism responded to the points raised in the office notes of my second opinions. He ultimately said he did not disagree with the 2nd opinion of Dr. Parks at Hospital for Special Surgery.
So we are going to proceed with a brace and see how this affects (a) my effusion and (b) my quad wasting. If the brace improves things, he said, then I'll know whether revision would solve things.
We also talked about my MCL which seems to be lax.
My ortho explained the compromise involved in spacer sizing, saying that a large spacer might not have allowed me to fully extend. I know from his OR notes that he first put in a 9mm and then a 11mm and noted that the 11mm was acceptable. He did not try a 13mm. The 13mm might've been perfect but we don't know and there's no point discussing it now. What I needed today was to move forward and make the best of what I have.
So where does this leave me? My knee is no better for all the appointments I've had in the last few months for it. But I've got it settled in my mind that the brace is my best bet.
As a side note, it's interesting when I read my ortho's notes done in a little rural hospital, and the notes from Hospital for Special Surgery, which is one of the world's leading artificial knee centers. Yet Dr. Park's transcribed notes were hard to read because of the numerous errors, as if the typist was unfamiliar with orthopedic terms.
Time will tell!
United States
Of course the cement was gone also so that didn't help matters any! When I wore the custom fitted brace it worked for awhile. The I started losing more weight and I kept adding pads to it so it would fit. After a few weeks, the brace just slid own and my stability was gone! So my advice to you is make sure you include plenty of chocolate in your diet so your brace will continue to work! 
