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year later still in pain

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suezw

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I had tkr right knee 1 year ago. I have only gotten 90 degrees of flex and am still in bad enough pain to be on fentenal patch. The Dr at pain clinic says it's caused by friction of kneecap to metal joint due to adheaions. He mentioned I could get kneecap removed a piece of metal attached to bottom then havee it reattached. Has this happened to anyone else? If so does it help and how bad is pain and recovery?
 

Jamie

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Suezw.....I think you need to be getting advice from an actual orthopedic surgeon instead of a doctor at a pain management clinic. Please pardon my bluntness, but this is NOT his area of expertise. In fact, you really need to see a knee revision specialist...one that does revisions and deals with the more difficult cases.

You should not have only 90 degrees of flexion after this amount of time. If you do have adhesions, it is possible that a good surgeon can deal with that through an MUA or maybe even arthroscopic removal of scar tissue.

I am not familiar with the procedure your pain doctor is describing and I cannot recall anyone on BoneSmart having something like this done.

If you need help locating a revision specialist, you can use the BoneSmart Clinic Locator (link is in the blue tool bar at the top of every page).
 

referee54

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Hey Suezw, I moved your thread from the Frequently Asked Questions Sections to the TKR Post-Op Section so more people could see it and comment.

I am sorry to hear that you are having these difficulties at a year post-op! I agree with Jamie---you should not behaving these difficulties at this time. You should schedule an appt. with an ortho who does TKR's and revisions, as he will have more insight to what may be causing you problems---and, more importantly, how to correct them so you can renew your lifestyle.

I also agree hat an MUA or a scope---of needed---may be the route to go---although I would like to hear what the ortho/specialist says about your situation, first. He could also help you with the pain, too.

Please keep us posted and up-to-date on how things are going and what is determined about your situation.
 

Josephine

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No it's certainly not his area of expertise. What a load of codswallop! If you want a proper assessment, you should go see your OS. It's possible you do have adhesions but the treatment for that is either a manipulation or an arthroscopy to divide them.
 
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suezw

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I did see one of top orthopedic surgeons in boston who told me removing internal scarring 90% of time makes it worse in the big picture. My pain center is in a leading hospital in worcester and my pain dr. works with various other doctors dependoing on root cause of pain, mine being an orthopedic doctor. He has seen this surgery done sucessfully. He did say very few hospitals have the level of expertise to be performing it....could be a big hospitals in Massachusetts thing.I do have to add a fentenal patch by far helps with pain better than digested narcotics.
 

PhoenixS

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Suesw:
Didn't they put a plastic "button" on the back of your patella during the knee replacement?
Maybe that is what they are talking about, who knows?

I'm not sure that what the top guy in Boston said is actually true. There are quite a few people on this board who have had arthroscopy with good results.
If it makes you feel any better, I am a year out and I still have pain too. Not enough for fentanyl, but I do take a percocet at night for the general knee ache and ligament issues. I do, however, have full ROM.

I also have an adhesion outside my joint that I was offered arthroscopy, but I am giving it more time as deep tissue massage appears to be slowly resolving the issue. I'd like to avoid opening the joint if at all possible.

Why don't you try to do the least invasive thing first?

What was your ROM prior to the surgery?

Lots of folks on this forum have had excellent results from MUA.
At least it is a closed procedure with essentially no risk of joint infection as the joint is not opened.
Which hospitals in MA are you talking about? There are some very big names here (though I did mine at a small community hospital).

Best,
Sandy
 

wevrldy

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Hi Suezw,
I'm wondering what your OS has to say - the one who did your surgery? 90 degrees and pain requiring fentanyl patch a year out seems unusual. While the pain doc can guide your pain management, it seems that you have other issues your surgeon should be addressing for your continuing recovery. I had both knees replaced a year ago (in 2 weeks) and any pain I have is managed nicely with OTC, no narcotics required in a long time. My OS told me that this is normal. Your pain seems indicative of other problems, as others have said, and should be investigated by the one who should know 1) exactly what you had done in the OR, 2) any issues that might have been encountered with you or your prosthesis, and 3) what real options you should be thinking about so you can truly recover your life! (That would definitely be your OS). Good luck with this, and keep us posted!
Martha
BTKR 4/7/10
 
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