What is the Worst Case Scenario...

[JRogers]

...of opting never to have any further surgical intervention done on a botched total knee replacement? Would it likely be a case of the patient making very slow progress in terms of mobility but eventually able to walk (albeit awkwardly) without the aid of a walker or cane or are we talking possible amputation? Some scenario in between??

My Wife is approximately 6 weeks out from TKR and effectively paralyzed at and below knee level on the affected leg after some very very small and transient signs of movement in the third week. A Neurologist (associate of the OS who did this knee replacement) has confirmed there is "lots of nerve damage" and used the term "Double Crush Syndrome" or something similar sounding but would give us absolutely no hint of whether or how much of this is permanent, insisting that he was merely there to identify and locate problems and we would have to talk with the OS to ascertain what this all means in real-world-terms. Needless to say, we've got an appointment scheduled with a new knee doctor.

At this point, she seems very...very reluctant to consider any more surgery and I'm inclined not to argue. Sorry if this comes across as a rant (which, honestly, it is partially following our wonderful experience yesterday with the neurologist) but we would be interested in any input we can get here on this forum regarding the prospect of discontinuing surgical options -- what you yourself may have experienced or may have been witness to involving others.

Thanks.

 

[Jamie]

I certainly am not a doctor, but I believe your and your wife's thoughts about discontinuing any pursuit of additional medical procedures is probably related to the shock of having such a horrible and unexpected thing happen as a result of her TKR. Your decision to seek other doctors to help explain the situation and offer options for treatment is the right thing to do.

I experienced similar feelings following an arthroscopic surgery a year ago. What was supposed to be a simple repair of some torn cartilage instead resulted in osteonecrosis (bone death) at the knee joint, loss of all cartilage on one side of my knee and left me limping when I was not doing that before the surgery. I searched through 3 doctors until I found the one I was most comfortable with during the 6 months following this surgery. I was so scared at first, I thought my bones would continue to die and I would be in a wheelchair because of what I read on the internet. My problem is not the same as your wife's, but I tell you about it in the hopes you can see that things may not be as bad as you fear. There may be good options for additional treatment - even if it involves further surgery. I had a total knee replacement on February 29th and it is turning out to be the best thing I ever did. My knee is strong again and once fully recovered (full recovery can take a year or more), I expect to be better than before either of the surgeries.

Only you both can make the decisions on what to do in the future, but please do seek out additional medical advice so that you can make those decisions from an informed position.

I do recall that the forum had another husband posting for his wife who had some level of nerve damage that made it difficult for her to move her leg and foot for some time after her TKR. She was working with a therapist and, although he has not written in a while, I believe she was making progress.

Hopefully Josephine (the forums nurse) will be able to give you additional information from a medical perspective. She usually checks in to the postings every day or so.

You and your wife will be in my prayers and I hope for some positive news very soon. Please continue to post on the forum as you can. There are many good folks here who can provide support to you both.

 

[Skeet]

I don't have any advice to offer above and beyond Jamie's, but I am praying for your wife and you that you have wisdom as you make this decision, that she has relief from any pain or anxiety, and that whatever doctor you end up with is perfect for you both and can resolve this issue so she is totally and completely healed and able to walk and feel normal again soon.

God bless you both.

 

[JenniferG]

I agree with Jamie. First i'm sorry you and your wife are faced with this. But as awful as it seems right now doesn't mean there isn't a remedy. But that would require medical advice from adoctor. I think seeing another OS and nuerologist is a good plan. It is certainly understandable why your wife at this point would say not now. Watch for Josephine, she's seen all kinds of circumstances and may have some direction. And this is a good place for rants... best and prayers.

 

[Newwoman]

I am so sorry you are going through this but know you are not alone. As long as this site exist there will be caring people on it that don't care how much you rant, yell, cry, beg or plead they won't turn a deaf ear.
I can understand why you and your wife would be scared but seeking advice from another doctor may very well put things in a complete different light.
I pray that all turns out well.
Cathy

 

[Cathie]

May I also add my 2 cents..I agree with all the above advice. I saw 4 different doctors before I did any surgery. I would keep going for opinions until you are completely satisfied and your gut tells you you are doing the right thing. May I ask what part of the country you are in? I too will add you to my prayer list...
Cathie

 

[Josephine]

J, I am so sorry this has happened to you wife - and to you, for that matter.

My thoughts are this ...

If it is to do with the nerve block, then time and PT should improve matters. BUT it has been 6 weeks already and logically any recovery should be in evidence by now.

However, the neurosurgeon mentioned Double Crush Syndrome and that means that a nerve has undergone compression and/or trauma at two different sites.

Now the nerve that is mostly responsible for the 'kick' in the leg is the sciatic nerve. Damage to this nerve is largely responsible for the phenomenon known as foot drop which can occur when the nerve is damaged during hip or spinal operations. The result is a bit like have had a stroke where one cannot lift off from the ball of the foot when taking a step. Though recovery occurs, often times it is incomplete.

So, to get back to your wife's TKR, there are two sites where the sciatic nerve will come under compression. One is where the tourniquet is placed. The other is compression from handling of the leg during the surgery or swelling afterwards or both. I'm not saying this is what did happen, just that these are the areas where it COULD have happened.

Hopefully this will give you some extra information so you can ask questions of your new surgeon when you see him.