Revision TKR Wberry knee is up<

[NAUChick]

I'm having revision surgery with Dr. Pappademos on November 14 to downsize my prosthesis. Hopefully, the stems are salvageable and I will only need the knee component replaced. My problem is insignificant compared to what you have gone through. Did you have your surgery at the surgery center next to Advanced Orthopaedics or at a hospital? I'm coming from Oklahoma so will be stranded at the center for at least three days. I chose Dr. Pappademos partially based on your experience with him as related on Bone Smart, and he seemed very decisive, emphathetic and knowledgable during our appointment. Any comments or advice you can give me would be appreciated.


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[NAUChick]

Belay most of my last. I saw your response on my thread, many thanks. I am interested in whether you used the Surgery Center or hospital, though. Seems like an ideal situation compared to a hospital environment as far as infection risk. I'll be following your journey with interest.


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[wberry]

@Celle actually he has only had one go at it. he is who i went to after the first surgeon. I picked him as the most experienced revision specialist I could find. I did see him and one other and picked him. I do plan to seek our another surgeon after I see him this week. I just feel more comfortable if two or more surgeons give me the same conclusion. I will ask my surgeon for the medical records and xrays from his procedure to get a second or third opinion before I decide. My knee and my pain, so I am past worrying about hurting anyone's feelings, ya know. I am not upset with him about the results persay, he did fix the original issue, this just occurred as a side unexpected issue.

 

[wberry]

@NAUChick I picked the hospital in case there are issues. I know either can have an infection risk. Look at the history of the facility and make the call. Did they give you a choice?

 

[Celle]

@Celle actually he has only had one go at it. he is who i went to after the first surgeon. I picked him as the most experienced revision specialist I could find. I did see him and one other and picked him. I do plan to seek our another surgeon after I see him this week. I just feel more comfortable if two or more surgeons give me the same conclusion.

Oh, I'm sorry I go that wrong.
I'm glad you're seeking other opinions, though.

 

[NAUChick]

@wberry Yes, I had the choice though Dr. Pappademos' preference was the surgery center. I've had sinus surgery and three knee surgeries at similar surgical centers in Tulsa and preferred their newer facilities and nursing care to that I experienced at St. Francis and St. John's Hospitals. I picked up a nasty staph and strep infection at St. John's having a tear duct repaired so that probably skews my opinion regarding surgical center vs hospital.


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[newlybionic]

I went back and looked at the most recent x-ray that you posted and it is very similar to the x-ray of my knee after my original surgery. The original OS put a button on the back of the patella and my current OS was able to use it the way it was . He replaced everything else and the patella now tracks where it belongs.

 

[wberry]

Well visit with the OS was a long one. We went through xrays, CT scans everything. My OS does a lot of revisions and TKRs, around 500 a year. He thought he had gotten everything fixed and never anticipated this at all. The work he did last year took care of all my issues. But this patella is a totally new issue. He wants to consult with a couple of other surgeons also.

Right now we have a plan as follows:
1. remove the existing button and redo with larger one while releasing to get patella tracking back to center.
2. remove the bone growth that has occurred since the surgery on the over hang of the patella.
3. because the CT scans all show very good alignment, changing the femoral component and adjusting alignment of the knee.

He also considered what @newlybionic had done, he is trying not to do a complete replacement because of the bone loss and the extensive recovery time. He is sensitive to what I have gone through so far, but is considering it. I gave him the information on the surgeon in PA I got. I plan to wait to hear back from him before I consider another opinion. He also said he went from a 11mm to an 18mm spacer and it was really good and tight fit back 6 months ago. Now I am loosened up again and I shouldn't be.

Seems like there are several factor all moving around in this situation. Bottom line i can't do anything until next year around march. I am stable except for stairs and hills for now. I have several events and conferences i can't miss start of next year.

 

[Celle]

I'm glad you discussed you knee thoroughly with your surgeon and I'm even more glad that he is willing to seek consultation with other surgeons.
I'll tag @Josephine , so that she can see your post, above, and add her comments.

 

[KarriB]

Sounds like the OS is considering everything. How is the other knee holding up?

 

[wberry]

Beriable for not. PA offered an injection if I needed it


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[Kansas Teacher]

@wberry , I'm so sorry this saga continues. I was so in hopes your second surgery would fix things. It does sound like your doctor is working hard to find a solution. @NAUChick , I had my knee replacement (about 18 months ago) in a surgery center but not the one in Wichita, even though I live here. I had mine done at a surgery center in Kansas City by a surgeon there that my daughter recommended. It was a good experience and I would do it again. It was a small facility so I had plenty of attention when needed, always got my pain meds on time and, best of all, had no problems with infections or any of the other issues that can go along with a hospital stay.

Roxie

 

[Josephine]

@wberry I edited your images but they are not of diagnostic quality so I am unable to give an opinion on them. It's impossible to tell what's going on when the pictures are all skew-wiff like that. Sorry.

Beriable for not.

Sorry again but what was this supposed to say?

 

[NAUChick]

@wberry Dr. Pappademos is the only surgeon I've spoken to except Dr. Cobb at VA Hospital in Muskogee who was willing to spend as much time as needed to review X-rays and test results and answer my questions. I never got more than five minutes attention from my original surgeon and he was extremely defensive when I questioned his work. I'm sorry you have to wait until March to get your problem resolved. Frustrating to be sure, but you say the pain is bearable. I am feeling much better about my upcoming revision after hearing your experience with Dr. Pappademos.


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[Kansas Teacher]

@NAUChick , I live in Wichita and have heard only good things about Dr. Pappademos too. I would have probably used him if my doctor daughter hadn't so strongly recommended the doctor in the Kansas City area, which also turned out to be a good decision for me. I think you'll be in good hands!

 

[wberry]

@Josephine actually they are no different from the earlier images i posted in this thread. There was no difference from last exam and this one. The patella is still coming in contact with the patella on its right side when knee bends and I either step up, or down. Apparently the action pulls the patella tight against the knee upper component. Pain in the exact same spot every time as the back of the patella comes in contact with the front of the component.

Yeas @NAUChick Dr. Pappademos is really good about taking time to talk, and explain and he asked lots of questions to make sure he knows what the patient is going through. He is not defensive, and even stated he wanted to consult with my permission other surgeons.