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Revision TKR Would like advice please, I think knee has moved

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Got some good news, appointment with new surgeon has been brought forward to the 11 September. Still haven't heard from Microbiologist.

I'm still struggling. Not walking very much and sitting with my knee elevated and icing every night. I even have resorted to using my crutches in the house a few times. When I go out I use my mobility scooter. The pain isn't good at times. My left knee is 4cm larger than my right knee measured over my knee cap. It is worse when I twist my knee, especially in bed at night when I turn over. I have trouble sleeping. I think I have some lateral movement in my knee now. It is still warm to touch. I have a low grade temperature some of the time, it seems to go up and down.

I didn't think I would be like this so far out. I was very low last week and just wanted to hide away and do nothing but have come round a little now. I had a lot of painkillers last week and had trouble with my colon. I have an extreme form of IBS caused by adhesions between my colon and surrounding organs and have trouble normally with bowel movements. I have to be careful not to get a blockage or I will end up with a stoma. I have already turned down an elective stoma as I can't cope with that at the moment. They will not operate to remove the adhesions any more. I got them over 8 years ago after gynae surgery complications. I take a large amount of laxative every day. I don't seem to have much luck with surgery!

I'm going to get in touch with the GP reception tomorrow and see if there is any news
 
GP got in touch on Friday afternoon. Still no news from Microbiologist despite multiple contacts. GP and I together have decided to sit it out now until the 11 September in case new surgeon wants to do more tests. I was only off antibiotics 2 weeks before scan and aspiration and blood tests so may have affected the results. I will be 6 weeks without antibiotics by the 11th.

Had family day out yesterday, mostly on my scooter. Cheered me up, but paid for it last night.

Still no better overall. In fact knee now keeps giving way a little, not enough to loose my balance but enough to make me wobble. This afternoon I twisted my ankle of my replaced knee going into the garden from the conservatory down one step. I've been RICE (Rest, Ice, Elevation, Compression) on it since it happened. Need more ice packs now if I have to do both my knee and ankle!

Counting down now til the 11th

bottomshollow Please can you change my thread title to 'Almost 2 years out still swollen and in pain' I think it would be a more appropriate title.
 
[Bonesmart.org] Would like advice please, I think knee has moved busylizzie, I have changed your thread title per your request. Sorry to hear about that twisted ankle. Seems like when it rains it sometimes just pours and pours and pours on one's parade. Hope the new surgeon will be the answer to whatever is going on.

Take care and keep us posted. We care.
 
Well 24 hrs to my appointment now at last. Got 2nd text message today reminding me of the appointment. Knee is getting worse. I bandage 2 ice packs on my knee every night when I go to bed to ease the pain. Knee feels to move sidewards a little when I turn over in bed. Not really sleeping and I have great trouble actually getting to sleep. I forgot to put the ice packs on one night and the pain was much worse. I had to get up and get them. Ankle has settled down now but I have sciatica down my right thigh and leg.

Hope tomorrow brings some answers. I will let you know. The thought of this continuing upsets me and gets me down.
 
RestAssured Josephine

Back from seeing Peter Kay at Wrightington. What a nice man he is. The whole hospital setup there is so much better. :)

He is almost convinced I do have an infection. Wants to do another aspiration in 2 to 3 weeks and stay off antibiotics until then. I will have been off antibiotics for about 9 weeks then. Then on to a two stage revision. Doesn't know yet whether to use a spacer or not or what the final knee will be made out of yet or whether to use cement. I asked how long off to the first stage and he said 4 to 6 weeks. Maybe up to 12 weeks before the new knee goes in after that. I've given him the go ahead to do the op and will finally kick Salford into touch. They kept telling me it wasn't an infection all this time and were going to replace the knee as though it was an infection on the grounds it might improve things.

He said infections do not always show up on the tests, but can be still there. He said my body could have been fighting this for a while. I believe it may have been there since the original TKR. The antihistamines I take that help with the pain and inflammation could be helping with the inflamation from the infection not from an allergy. He wasn't sure whether my allergies would affect my knee. He could see that I was in a lot of pain.

I printed off all my correspondence about my knee and took it with me but didn't need any of it.

I'm still down but feel a lot more positive about the future. I'm fed up of just sitting/lying down all the time feeling unwell and in pain and not being able to walk. I went on my crutches this afternoon not my scooter, but didn't do much weight bearing on my left leg. I'm shattered now. Had another MRSA swab done again for the aspiration which will be carried out in theatre again.
 
I know Peter Kay and he is a very nice, very caring and very experienced surgeon. He also does a lot of revisions (48 last year which is a goodly number) and deals with a lot of infected joint replacements so you are in very good hands with him.
 
I am so glad you found a great surgeon! I hope they get this problem taken care of and that you are on the road to a the life of pain free enjoyment you had hoped for! Life is so much better when you can move without pain!:happydance:
 
Has anyone had a cementless knee replacement? Please can you tell me your experiences with it. Sintered beads were mentioned yesterday and I can't find much recent information about them.
 
We have had some members who have received cementless TKRs. This is a case where you must put yourself in the hands of your very capable surgeon and go with his decisions on what to do. Please let us know how things proceed. It does sound like you have one of the best guys to deal with your problems. Josephine is the best person to provide additional technical information for you. I've tagged her.
 
busylizzie said:
Has anyone had a cementless knee replacement?
Click to expand...
I think it's more likely he will use a stemmed device but they doing quite well overall. Not too many of them used as far as I know.
busylizzie said:
Sintered beads were mentioned yesterday and I can't find much recent information about them.
Click to expand...
Never heard the term 'sintered' before - though the word definition is "Sintering is a method for creating objects from powders, including metal and ceramic powders", but he's talking about gentamycin beads which are made of gentamycin impregnated bone cement. Gentamycin is one of the high end antibiotics greatly favours in joint replacement.

[Bonesmart.org] Would like advice please, I think knee has moved
 
Josephine
I don't think it was the antibiotic beads.

Mr Kay mentioned titanium sintered beads in connection with not using a cement. There aren't many recent references to it on 'google', and they are mostly referring to hip replacements. I have found this link https://link.springer.com/content/pdf/10.1007/s11837-012-0528-5.pdf and I think this must be what he is referring to. Some of the references in this paper are quite old although the paper was published at the end of 2012. I will ask about it when I see him for the aspiration. I think he was mentioning alternatives to bone cement at the time in case I'm allergic to the cement. He hasn't decided as yet any of the materials he will use.

I worked in industry in the past as a Metallurgist/Materials engineer and when I started testing positive to Cobalt and Chromium on the patch tests they think I could have developed a sensitivity to the materials then. I also worked with other chemicals, one of which I tested positive to and regularly used Methyl Methacrylate resins (used as bone cement).
 
You're a metallurgist? Oh wow! I stand in awe of metallurgists! :bow:

And yes, previous exposures could certainly explain any current sensitivities to such as cobalt and MMa.
 
Well two weeks have passed and I still haven't got a date for the aspiration. I rang yesterday and they couldn't tell me when I'd get an appointment. So much for the two to three weeks wait. Mr Kay is only in theatre on Mondays now so it is unlikely that it will be next Monday.

The pain is getting me down. I was in tears most of yesterday. My painkillers don't kill the pain. I'm getting more and more sensitive to the side effects. I can't take high doses as they stop my bowels working even with huge quantities of laxatives. I have a bowel problem and must avoid a blockage, I'm not ready for a stoma. I've tried two new painkillers recently but I've had to stop them. I've been itching all over despite being on antihistamines all the time since April 2012. Icing is the only thing that really helps. Antibiotics help with the pain but I have to stay off them until after the aspiration. I am living from day to day at the moment, not planning anything. Sorry about the moan.
 
That's a tiny moans considering how you've been put off. I don't know how things work in the UK, but here in the US I'd be pestering the office every day -- I don't know, phone calls, flowers, cookies, to work my way in. But then again when you're miserable, there is no energy for dealing with a medical system. I hope you've at least gotten the support of your GP in whatever way you could.
 
I am so sorry you are going through all of this! :cry: The pain is unbearable as I know, and to have to wait and wait is crazy! I will put you on my prayer list! :angel:
 
Thanks for the replies. I still haven't heard. I will chase again on Monday if I haven't heard by then. The pain has eased a little now. I've been out on my scooter this afternoon for a little retail therapy to keep my mind off it. My GP is very supportive. She has tried all the painkillers she can. The latest one was Temgesic sublingual tablets. I go very dizzy and nauseaus with them and my bowels stop working so I had to stop them too. I was still dizzy 36 hrs after taking the last one.
 
I suggest you write to Peter Kay himself and tell him you are still waiting and can he expedite things for you. You have probably dropped off his radar just now. My sister did that once, sending the letter by email at 3.30am and pouring her heart out to her surgeon. He took action immediately which was good but it resulted in discovering her MRI results had gone missing and that was the reason for the hold-up - everyone was just waiting for them to arrive in the post! [Not that I am suggesting this has happened to you. just telling a tale.]
 
Thanks Josephine.

My plan of action is:-
  1. Tomorrow morning I'm going to ring Mr Kay's secretary (she is a lovely lady) and explain what is going on or not as the case may be.
  2. If that doesn't get any action I'm going to get in touch with my GP and see if she can help. She is very pro-active when she needs to be.
Its Mr Kay opererating day tomorrow so he should be around and Wednesday is his clinic day. Hope I get some response. The piece of paper he filled in when I met him in clinic definitely said 2 - 3 weeks for the aspiration. This was re-inforced by letter to my GP, I was copied in on it. I think the 1st stage of the revision which Mr Kay told me would be 4 - 6 weeks from the aspiration will also be delayed as I've heard that they book operations 6 weeks ahead, so it will be 6 weeks wait at least. Lets hope I can have antibiotics like he said after the aspiration to keep me going.

I'm swiftly approaching the 2 year mark and have no improvement to show from having the TKR. Last Tuesday my pain level was at a 7 or 8 out of 10 all day when weight bearing. It has come down since but still is very painful. I took part in pain trial research a few years ago and was almost not accepted due to having such a high pain threshold.
 
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