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Revision TKR Wberry knee is up<

wow @wberry , I'm just catching up on your latest. I'm glad you will get your records to this other doctor. I hope you get some good answers/results.
 
Thanks, me too. This baby is just clunking along and now it goes a little to the right and then back straight as I bring the leg forward. It is just so weird.


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I'm right with ya. As in video u could see the Pop clink. But not know. I can fill it. If your close enough to me u can hear it. And fill it.

I do hop ya get this all sorted out..: xxx


FaithMitchmommy
PKR December.1,2014
TKREV MARCH.2,2015
 
wberry said:
There seems to be a lot to consider in alignment and such with a TKR. I will have to ask Josephine to decipher the language up above.
Click to expand...
Perhaps you would tell me which terms you watn me to decipher ...
wberry said:
So how does that work, do they keep a stock of knee implants on hand in case they need to do a revision, or do they order a revision implant just in case prior to the surgery.
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That depends upon the size of the hospital. Big hospitals have a store room with shelves upon shelves of implants, the full range of all components and several different knees. Smaller hospitals will get the rep to bring in a caddy (a tall storage box on wheels) which contains about 4 each of all components, all sizes and such. Then they just pay for what's been used.
wberry said:
What are the indications of an infection?
Click to expand...
If you've got an infection, I'll eat my frilly cap!
 
Lol, @Josephine you made a nice joke line. It's that medical terminology that I don't understand. With my wife out of town I have no one to tell me what the terminology means. Makes since about the implants. I am glad there is little or no chance of an infection. One of my co-workers didn't believe me about my knee until I showed how it moves side ways and the snaps back when it comes forward. And folks turn and look when I walk because the can hear me clunking.


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I hope your knee gets better to. And or you get answers. This is a nightmare. No one understands unless there in our shoes/legs/knees/body/mind. Cause it affects it all.


Did ya see my video earlier on like lag 2-4? Did your knee do that?

Joe is right on how they do implants. But I was told at new OS to they have bunches. But who knows each place is different.

I tell you when I walk u don't hear mine. But oh can I fill it. I can't bend my knee walking. I walk stiff. And I fill pop and movement. Lord it's awful. Who knew we be having issues.

Here is a thought my mom said. Think of the hard times right know. But when after it's over it will be the best time of your life. You will be able to do what your legs took away. I love that. Cause I say oh I can't wait. And I thought I share that with you.

Kind post. Well thanks. Just return the post. We all family here. I told mom a have bunch brother/sisters that I have help get though knee journey. She said I'm crazy lol.

I been doin a lot of checking on new doc Jamie gave me. And impressed. I'm hopeful this 2nd 2nd opinion will be answers.
As I hope your apts go good and you get answers. You may not want to go though it again. But it's a decision do I want to live in pain. Or take a chance for a real life I've been waiting for... That's what I been telling my self.

U mention people walk and look at you. When that partial I had pep could see my leg was weak. And they said I had it wow so much difference. Know some one see me and they said wow mine was not like that. It's like they notice us. Which is not bad thing. Cause down here in Ky docs don't believe pep cause of all troubles. Helps when some one else notice it.


But I do hope u get the answers soon. Wife hubs alsawys there for us. Makes it harder when they away. I say me hub we like animals. But when it come to support we got them and makes the mental part of it easier. Glad u have support.

Hardest part for me. Knowing something is wrong. Trying explain to some one who has never been though it. Drives me crazy. But they see the oveious and it's like uh how do u do it. We say how u not understand. Jus never been through it.

It's a mess. But this sight makes it a bit easier. Hope your able to get answers soon. And get your life back!!! Bless you!!!




FaithMitchmommy
PKR December.1,2014
TKREV MARCH.2,2015
 
Yes, I saw it, in my case the bottom leg shifts out the turns back right at the knee cap catches and clunks. I have just tried to take it easy, keep doing my quads and wait patiently for my appointments. Not much else I can do otherwise.


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wberry said:
@RestAssured So you don't get any funny motion or anything. I thought this limited your movement? Why did the decide to do a hing on you?

Ok, just started reading your thread, wow. Haven't found the answer to my question above, but you have faced a lot.
[/Quote:]

Hello again! I had MRSA in my right knee replacement, leading to the eventual revision. That's the SHORT story.:heehee:
Click to expand...

Yes, I do get a funny motion sometimes. The only way that this hinged knee can dislocate though is if I repeat what I did earlier in recovery. I got up on our high bed belly first, and when I turned over the bottom half of the leg was still pointing towards the ground. My husband twisted it back into place.:yahoo:
 
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wberry said:
Yes, I saw it, in my case the bottom leg shifts out the turns back right at the knee cap catches and clunks. I have just tried to take it easy, keep doing my quads and wait patiently for my appointments. Not much else I can do otherwise.


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Click to expand...
Are the bones coming loose or is it patella clunk alone?
 
For sure the patella. OS said I am way beyond the 2mm I had after surgery, he thinks I loosened up to much and need a bigger spacer. On the patella, realignment or replace femoral component and realign.
He figures since they should fix both. Going for two other opinions. Will not have him do the fix, looking for a revision specialist just in case.
I have noticed my leg turns out more below the knee than it use too, thus I am getting a funny side shift as the leg comes forward.

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Stillin limbo land,waiting on medical records so I can set appointments. Did some of my exercises to keep tone. This is shear drudgery waiting for a solution.


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Can't you go to the hospital medical records and get the records from them. That is what I did to avoid argument or suspensions.


FaithMitchmommy
PKR December.1,2014
TKREV MARCH.2,2015
 
Picked up my medical records and xrays today after they called me this morning.
No PT records in there so I wonder if they ever sent them to the OS.

I have read the report from my last exam, some words i need to google to figure out.
@Josephine and @Jamie here is the results of the last exam from his notes

Physical Exam:
Right knee, medial collateral ligament is stable at 0 and 30 degrees of flexion. Lateral collateral ligament is stable at 0 and 30 degrees of flexion.The Lachman's test is stable with normal engagement of the polyethylene post on the femoral condyle.. Anterior and posterior drawer sign is negative. In the sitting position the patient does demonstrate positive engagement of the polyethylene on the femoral condyle with active quadriceps testing at 90° of flexion. There is also approximately 5-10 mm of opening of the medial collateral ligament in extension as well as in flexion. There appears to be some increase in medial opening in flexion compared to the sitting position which may be suggestive of some midrange instability. There is 1+ to 2+ effusion present in the right knee. There is some tenderness to palpation of the lateral patella retinaculum. There is also some pain that occurs with the patella lateral retinaculum with active flexion and extension especially at the terminal end of extension. Mild lateral tilt is noted on the patella clinically. There is mild joint line tenderness and no lateral joint line tenderness. The incision is well healed with expected loss of sensation on the lateral aspect of the incision. Quadriceps and Hamstring strength 5/5 bilaterally. Dorsalis Pedis and Posterior Tibial pulses are 2/4 and symmetric. There are no sensory
deficits.

Xray Study:
X-rays of the right knee taken on 6/3/2015 reveal evidence of a cemented posterior stabilized total knee arthroplasty. The femoral and tibial components appear to be in satisfactory position and alignment without any obvious signs of implant failure or loosening. There is satisfactory maintenance of the articular interval. The patella exhibits mild lateral tilt with the lateral facet close to and possibly making contact with the lateral trochlea. There does appear to be some osteolysis of the bone at this location. The patella has been resurfaced.

OS PLan:
Patient continues to have discomfort and pain 18 weeks status post right total knee arthroplasty. I believe he has 2 problems, I believe he has some midrange instability. I did review his operative note and at the time of his operation he had good flexion and extension gap with no significant instability noted in extension and flexion way left the operative room. His examination today leads me to believe that he has had some stretching of his medial collateral ligament as well as stretching out after the surgery which has resulted to mid range instability. Obliquely the femoral component and tibial component appeared to be in good position and alignment however he does have some lateralization of his patella. This may be related to tight patellar retinaculum or possibly related to asymmetric cut of the patella which is causing some mild lateral tilt. The effusion and some of his pain I believe may be related to some midrange instability as well as some patellar issues. He has tried nonsurgical management seems to not have improved very significantly with aggressive physical therapy. We was hoped that by strengthening his
quadriceps and having maximum strength of his quadriceps would help decrease some of the instability that is occurring with stair climbing as well some of the patellofemoral issues. Surgical
management options were discussed with him. He is a candidate for going in and proceeding with a revision of his patellofemoral articulation. This could be a lateral release. A more
aggressive revision would be to proceed with revision of his femoral component with increasing the external rotation of the femoral component as well as proceeding with upsizing of his
polyethylene to decrease the extension and flexion instability. All this was discussed at length with him. We discussed that he may benefit from a second opinion from a total joint reconstruction specialist. I have recommended that he see Dr. Paul Pappademus in Wichita for a second opinion. I will contact Dr. Papademus by phone to discuss the case and see if he will look at the x-rays and give us an opinion or to discuss if Dr. Pappademus would like to see the patient to clinically examine him. We will get back in touch with him once we have all this information.

I will call today to set appointments with Dr. Pappademus in Wichita, Appt set for September 3, 2015, and Dr. Scott Wingerter at Dickson-Diviley in Kansas City. Wish me luck getting these set up folks.
 
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I have one appointment scheduled, but I have to send my records to Dr. Wingerter first so he can review them before he will see me. I did not talk to him directly, but to a receptionist. I have sent the image file and the records to them.
 
My OS office called, said they have not been able to reach Dr. Pappademus after several attempts, thinking he may be out of town on vacation. I told them I went ahead and set up an appointment, but there was nothing until September. They said they would try to contact him to see if he could see me sooner.
 
Do all doctors downplay the amount of pain the patient tells them they feel. I gave a scale of 8-9 when the patella pain hits, he put it down as minor, go figure.
 
Way to go!!! I am glad it's a start. Good luck with you... I will be praying for sooner apt. I would go to hospital where faculty is and get you X-ray... I hope u can get some answers soon. Xxx


FaithMitchmommy
PKR December.1,2014
TKREV MARCH.2,2015
 
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