MUA UPDATE - MUA determined today...ugh!

[RadioGal]

"...excellent information on tibial tray overhand impinging on soft tissue, especially the IT band."

Wow, @Knees4Me, I think I might just have found the reason for the biggest issue I'm facing with my knee! I have never heard of this, but as soon as I read your thread my mind went, bingo!! I'm not trying to analyze my own condition, I mean, what do I know? BUT the pain you describe sounds exactly like what I'm experiencing on the lower outside of my TKR knee. I move, it grinds (best way to describe it) and produces extreme pain. I try to walk normal, bending the knee in my gait just to have it grind again, extreme pain. Pretty much every movement involving bending, standing, sitting or lying on my back, produces this pain in just this one area. And it feels like something in there is hitting/rubbing against soft tissue. It's excruciating!

I have thought this might be swelling related at first, that in time it would get better, but now you got me thinking. BTW, it's only gotten worse, as you said.

@Josephine I need to know where is this excellent info on "tibial tray overhang?" I think I need to read up on this. Thank you.

 

[RadioGal]

@Celle My apologies, I'm still learning here. And before seeing your message I actually asked a question on Kayow11's post. Forgive me, I will be more aware of this in the future, so sorry.

@Josephine, my mistake, +5 is what I meant. I should seriously proofread my posts! But yes, currently @ +6 (as of today) and still around 115 on extension. Not bad now that I step back and look at it.

Easy answer as to why I'm worried, because I, like most here, am a total layperson. When you have a renowned OS, the OS's PA, Physical Therapist and all his assistants, even your Chiropractor saying they are "alarmed" it cuts deep into the vulnerable psyche of someone who is just experiencing this kind of traumatic surgery/recovery for the first time. I don't think I'm alone here. I've even seen posts where I'm like "calm down, let it heal" and then I read my own posts and laugh @ what a hypocrite I am.

I will take some deep breaths, relax and continue to ice, elevate. I'm already giving up the Dynosplint brace, not renting it for another month, knowing I do not need it! I've learned.

However, I still do have real issues such as 7-8 degrees valgus, and a pain on the lower lateral part of my knee that only seems to be getting worse. I have requested info from Josephine on tibial tray overhang as I suspect that is what is causing the pain.

Please be patient with me. I'm just a mother, grandmother, radio announcer who just wants her life back! One absorbs a ton of info here, then again from my care professionals and many times they clash. Thank you.

@Jamie my zip code is 98296 - thank you as well.

 

[Celle]

I have copied your post from kayow11's thread, so it can be discussed in your own thread.

 

[Celle]

Wow, @Knees4Me, I think I might just have found the reason for the biggest issue I'm facing with my knee! I have never heard of this, but as soon as I read your thread my mind went, bingo!! I'm not trying to analyze my own condition, I mean, what do I know? BUT the pain you describe sounds exactly like what I'm experiencing on the lower outside of my TKR knee. I move, it grinds (best way to describe it) and produces extreme pain.

You know, it's not a good idea to self-diagnose by comparing someone else's symptoms.

Tibial tray overhang is diagnosed on X-Ray, not just by symptoms.

Another reason for your symptoms could be that you have a misalignment of your leg - see Josephine's post #17 and her advice to you, near the beginning of your thread.

Have you looked for a surgeon who specializes in revisions and asked for a second opinion?

 

[RadioGal]

@Celle That is the plan, looking for second opinion, or revision specialist. But I've also read not to rush into that, give your knee some time to heal first. So, I'm not in any hurry to garner that opinion. Would you agree with that? BTW, I have provided Jamie with zip code to find such a doctor.

 

[Knees4Me]

@RadioGal - It's true that you need X-rays to see tibial tray overhang. When I insisted on seeing my surgeon early this month to discuss why I'm still having so much pain, I also insisted on having new X-rays. The overhang was clearly visible and she said it might be impinging on the IT band, but 9 out of 10 patients wouldn't feel pain. Lucky me. She said it might resolve itself in the next while before my one-year review three months from now. But it isn't getting any better despite icing, stretches, gentle physio, Tylenol or Voltaren. So I will definitely get a second opinion. I'll frown (not grin!) and bear it until I get a proper diagnosis after having proper tests, such as a CT Scan or MRI of my soft tissue. I will only opt for a revision if there is no other solution to my pain, especially because I need my other replaced soonish as well.

 

[RadioGal]

@Knees4Me Thank you! Best of luck, please keep posting. I will follow your thread.

 

[Josephine]

I'm not trying to analyze my own condition

Really? You're doing a pretty good imitation of it then!

related @ first

Please don't use text-speak on here. It's a forum not a text/facebook or twitter feed

I need to know where is this excellent info on "tibial tray overhang?" I think I need to read up on this.

I think you need to stop reading up on these things. For one thing, most of the things you listed in your thread are typical of a variety of soft tissue issues. Nothing to do with implant impingement which is actually extremely rare.

my mistake, +5 is what I meant. Not bad now that I step back and look at it.

Yes it is. 5 degrees is as near normal as you can get!

 

[Jamie]

@RadioGal.....here are some revision surgeons in the Seattle area:

Dr. William Barrett
Proliance Orthopedic Associates
4011 Talbot Road S, Suite 300
Renton, WA 98055
Phone: 425-656-5060

broken link removed: https://www.swedish.org/physicians/james-crutcher?returnUrl=%2fphysicians%3fSpecialtyType%3dadult%26AdultSpecialtyID%3d2273%26PediatricSpecialtyID%3d-1%26AllSpecialtyID%3d2273%26LastName%3d%26Keyword%3d%26Address%3d%26MaxDistance%3d10%26showHide%3dshowOptions%26ClinicalInterestID%3d-1%26Gender%3d%26page%3d2
Swedish Medical Center/Cherry Hill Campus
500 - 17th Avenue
Seattle, WA 98122
Phone: 206-320-2000

Dr. Navin D. Fernando
University of Washington Medicine Hip & Knee Center
Northwest Outpatient Medical Center 10330 Meridian Ave. N
Seattle, WA 98133
Phone: 206-520-5000

Be prepared that they may not agree to talk with you until you are anywhere from 6 months to a year out from your surgery. As Jo mentioned, many of the things you're describing as problems can be attributed to soft tissues that are still healing and getting used to your new knee. You know, we do tell folks it can take up to a full year or more for recovery and it may be that your body just needs a bit more time.

But you can call and chat with the offices to see what options you have. Good luck and let me know if you need any more assistance.

 

[RadioGal]

@Jamie Thank you!

As for the inquiry, it more has to do with that my knee is now valgus. It wasn't before surgery and now it's very visible, I look knock-kneed. I'm concerned about that primarily. Whether or not a revision is in order, I'm not sure, but I'm tired of my doctor telling me over and over again that nothing is wrong. I need someone else to take a look. Thanks again.

 

[hempsteadjb]

Good Luck RadioGal!

 

[Jamie]

I understand, RadioGal. But you may find some surgeons have a blanket rule that they won't discuss even that with someone for a specified period of time following surgery. I hope that's not the case, but I just didn't want you to be surprised if you were confronted with that roadblock. Good luck and let us know how things go.

 

[RadioGal]

@Jamie Exactly why I'm in no hurry, in fact probably won't even make calls until next year sometime. I just need those names for when that time comes. Thank you again, appreciate the info and patience displayed in your responses.

 

[kayow11]

@RadioGal, as you know, I did get a revision specialist to see me last month. He did x-rays from the pelvis all the way to the ankle and the Valgus showed up much more than just doing a knee x-ray.

Didn't you say that you were having hip and back issues also? Hopefully you will find someone to see you sooner. I am not going to wait since I found someone. Probably in February or March I will get mine revised.

My surgeon didn't think my Valgus was that bad either, but the revision MD said it was 10° and definitely thinks it needs to be fixed before I have ligament damage.

Be aware that those things can be happening to you too. I will be happy when you find someone to see you, and suggest asking for pelvic to foot x-rays like I had. It shows up better that way.

 

[RadioGal]

Forgive the laymen's terms, but to the best of my recollection here's what happened a couple days ago. Saw another OS, one that came highly recommended by my physical therapist, for another opinion. He took thorough x-rays, including full length of the leg, and determined that my knee, while not technically misaligned, had too much "correction" during TKR last June. Thus, I'm now valgus by about 4-5 degrees he determined, but a revision is not in order. I did not exactly think I was there, but even if he had recommended a revision I would have said no. Once is enough, thank you!

When I asked if this will have a negative effect on my hip (since I've had a pretty good amount of hip pain since surgery) he basically said "time will tell." But he also added that he's not particularly crazy about injections. I mentioned my OS recommended this due to my pain, but he says these don't usually last and in some cases can make things worse. X-Rays showed bone spurs, some arthritis on hip (same side of TKR.)

One thing that he found, something I sort of suspected due to an unusual crunching, grinding pain on the outside of knee was that there is a bit of an overhang with the hardware at the back of my knee, tibia location. I could see it pretty clearly on the x-ray. He said if that was at the front of the knee, it might be a problem but because it's at the back, it's something I could live with. He thinks the severe pain I've been experiencing is a build up of scar tissue and recommended intense massage. I'm already getting Graston on my knee from the chiropractor and as painful as it is, it does seem to help.

Bottom line, just over 6 months post TKR now and everyday gets a little better. There are setbacks, pain worse on some days than others, but for the most part I'm actually beginning to feel good about having this surgery. Would never have said that first few weeks after.

 

[jboles]

Both my knees are valgus 15+ degrees each. My left knee was corrected to around 4 degrees. I inquired why it wasn’t corrected to 0 degree? My surgeon said he never corrects to 0, he says around 4 degrees is what he goes for? I don’t know if that’s just an answer for my benefit or not. He even measured my husbands and they are around 3 degrees. Who knows? He’s getting ready to do my right knee in 2 days, I just hope I wake up with a straight leg! With yours measuring 4 degrees, is that why your second OS said a revision wasn’t necessary?