Revision TKR YYZ Back To YYC!

[Jockette]

What are you dealing with at this stage?

Cannot go downstairs foot over foot, unless the steps are short and I have a railing that I can use to support my body, basically using my arms to lift my body up as I step down, protecting my replaced PKR. This action takes a toll on my whole body.

I still have that horrible sensation when I wear pants, that something big and hard swells up on the lower lateral side of my knee the second I put pants on. Nerve damage? Summer is great, I can wear shorts all the time, but winter is coming.

My knee often feels out of joint, especially when I’m doing things in the kitchen, I’m constantly leaning over the counter or sink a bit, and turning from one counter to another. When I told me third second opinion that my knee often feels out of joint he looked at me and said “can you describe that?” I thought to myself, I thought I just did. What part of “out of joint” did he not understand!

 

[celynda]

@Jamie may be able to suggest surgeons close to the US border maybe in Buffalo. My original OS was Stoeckl of Northtowns Orthopedic. If you’re okay with traveling to NYC, i very much recommend the Complex Joint Replacement team at Hospital for Special Surgery (HSS).

As you may remember, I traveled to HSS in May for my 2nd revision in May. They are in no way responsible for my current infection issues.

Good Luck.

 

[Jamie]

An additional opinion would definitely be a good idea. From your description, it does sound like you may actually have some adhesions, which an MUA could help. The alternative treatment is arthoscopic surgery, but it needs to be done by someone who has a lot of experience dealing with adhesions, as it's possible to have them return if the surgery is not done properly. Sadly, the number of surgeons that fit in this "experienced" category is very small, even in the US. I have no idea about Canada.

If you can travel and have a consultation in the US, I would suggest HSS in New York city.

 

[2chains]

but says everything in the x rays looks “fine” and nothing else he can do.

That’s pretty much the situation I’m in, and I‘ve had 3 second opinions over 6 years, all with surgeons who do revisions.

What are you dealing with at this stage?

Cannot go downstairs foot over foot, unless the steps are short and I have a railing that I can use to support my body, basically using my arms to lift my body up as I step down, protecting my replaced PKR. This action takes a toll on my whole body.

I still have that horrible sensation when I wear pants, that something big and hard swells up on the lower lateral side of my knee the second I put pants on. Nerve damage? Summer is great, I can wear shorts all the time, but winter is coming.

My knee often feels out of joint, especially when I’m doing things in the kitchen, I’m constantly leaning over the counter or sink a bit, and turning from one counter to another. When I told me third second opinion that my knee often feels out of joint he looked at me and said “can you describe that?” I thought to myself, I thought I just did. What part of “out of joint” did he not understand!

So sorry you are still in this situation! If you can’t bend to do regular height stairs and it feels out of joint it sounds like the two parts of the implant are twisted or misaligned with each other? How about your kneecap, are you able to move it gently side to side? Part of my issue is a too tight patella that is restricting knee bend/movement.

 

[2chains]

An additional opinion would definitely be a good idea. From your description, it does sound like you may actually have some adhesions, which an MUA could help. The alternative treatment is arthoscopic surgery, but it needs to be done by someone who has a lot of experience dealing with adhesions, as it's possible to have them return if the surgery is not done properly. Sadly, the number of surgeons that fit in this "experienced" category is very small, even in the US. I have no idea about Canada.

If you can travel and have a consultation in the US, I would suggest HSS in New York city.

@Jamie thanks for the info, do you have a list for experienced surgeons closer to the west coast, Canada or USA ? Hoping for someone within a single stop over.

Are MUA’s commonly performed at 18 months?

 

[Jockette]

it sounds like the two parts of the implant are twisted or misaligned with each other?

I have a Patellofemoral partial replacement, so my only pieces of hardware are the femoral implant and a patella button. X-rays show they are in the right place, and so far all 4 surgeons (original and 3 second opinions) will not look past the X-ray for the problem. My latest second opinion was this past January, and I specifically asked for an MRI of the knee, and he refused. He is with a well known and highly respected group in Philadelphia.

How about your kneecap, are you able to move it gently side to side?

I don’t touch my patella, but they have tested it‘s movement and they say it’s fine.

Thanks for your commiseration! It’s been six and a half years, and I never thought my PKR would even last this long. I do what I can to accept the situation and manage life as best I can.

 

[Jamie]

It is not common to have MUAs. Much less so to have one at 18 months. But not unheard of. You do need a surgeon who knows what he’s doing, though. MUAs are not surgery, but the manipulation process is rough on your knee. It has to be done just right.

How about some surgeons in Seattle?

 

[2chains]

It is not common to have MUAs. Much less so to have one at 18 months. But not unheard of. You do need a surgeon who knows what he’s doing, though. MUAs are not surgery, but the manipulation process is rough on your knee. It has to be done just right.

How about some surgeons in Seattle?

Thanks for the reply! My knee doesn't like the bending at all and I think the procedure would be unbearable to recover from. I've only just started the end range bending again after three month break... new PT and this is significantly flared up again. Cannot image what it would be like to have it bent back all the way!

I will take the surgeons names though anything in Alberta or British Columbia by chance? Seattle along with Phoenix is a direct flight for me so both would be great!

 

[Axx72]

Sorry you are having such a hard time at this stage of recovery. Setbacks are very frustrating.

I had my TKR surgery done in Calgary on March 10, 2022. Maybe try Alberta Hip and Knee Clinic at Gulf Square in Calgary. They have some of the most highly rated OSs in western Canada. A number of them are leading physicians at the orthopedic joint replacement research department in the University of Calgary.

Let me know if you need further information.

 

[2chains]

@Axx72 Hi there! How is your rehab going? I see you are over 12 months at this point!

I’ve got someone from that clinic consulting on my case. I’ve had a 6 and 12 month x ray and everything looks fine. uugh

 

[Axx72]

@Axx72 Hi there! How is your rehab going? I see you are over 12 months at this point!

I’ve got someone from that clinic consulting on my case. I’ve had a 6 and 12 month x ray and everything looks fine. uugh

Honestly, I'd think it would be better to have confirmation that you are not dealing with any prosthesis issues.More surgical interventions are not neccessarily a good thing. Glad to hear you are in contact with that clinic. My OS is a member of the team at the Alberta Hip and Knee Clinic but my procedure was actually performed at Canadian Surgery Solutions in downtown Calgary.

This journey has not been an easy road and I have more personal goals to work towards both in the near future and the long term. I feel that my recovery has been quite successful and I am looking forward to enjoying many more active and happy years riding with my new knee. Thank you for asking.

Staying positive and accepting what we view as setbacks is our body's way of telling us what our limits are. Hearing when our knees speak to us can be difficult if we don't want to listen. During times in recovery, I wanted to blame an alternative issue or something out of my control for my setbacks or irritations. It always ended up that I just needed to take 2 steps backward in order to get 3 steps forward in my journey. Forcing yourself to stay active both physically and mentally, within your limits, is a key goal to success. Celebrate those little victories even if they seem insignificant. Lots of those little 'wins' equal big goals.

Stay positive! We believe that you can do it! You need to believe that you can do it too!

 

[Jamie]

I will take the surgeons names though anything in Alberta or British Columbia by chance? Seattle along with Phoenix is a direct flight for me so both would be great!

Here are some possible options for you:

Seattle, Washington
Revision surgeons in the Seattle, Washington area:

Dr. William Barrett
Proliance Orthopedic Associates
4011 Talbot Road S, Suite 300
Renton, WA 98055
Phone: 425-656-5060

Dr. James Crutcher
Swedish Medical Center/Cherry Hill Campus
500 - 17th Avenue
Seattle, WA 98122
Phone: 206-320-2000

Fredrick B. Lee, MD
Orthopedic Surgery, Joint Replacement
Orthopedic Physicians Associates
601 Broadway
Suites 600 & 700
Seattle, WA 98122
206-386-2600
Works with osteomeylitis patients

Dr. Navin D. Fernando
University of Washington Medicine Hip & Knee Center
Northwest Outpatient Medical Center 10330 Meridian Ave. N
Seattle, WA 98133
Phone: 206-520-5000

Vancouver, British Columbia

Dr. Hooman Sadr
St. Paul's Hospital
Footbridge Clinic
221 - 181 Keefer Place
Vancouver, BC V6B 6C1
Phone: 778-945-6756

Phoenix

Dr. Jimmy Chow
Chow Surgical, LLC
3700 N 24th Street
Suite 160
Phoenix, AZ 85016
480-490-6561
Dr. Chow is no longer “in network” for Medicare and most insurance companies, so it may be more expensive to see him now than in the past. He does do tele-medicine. His fees are: $250 for an initial consultation (you provide all x-rays prior to meeting), $150 for pre-op and any post-op appointments, and $5450 for the surgical fees.

Dr. Mark Spangehl, Mayo Clinic

broken link removed: https://www.mayoclinic.org/biographies/beauchamp-christopher-p-m-d/bio-20053097

Dr. Eral Feng

broken link removed: https://northazortho.com/physician/mark-b-davis-d-o/

 

[2chains]

@Jamie thanks for the info! I’m interested in Dr Sadr in Vancouver, I was wondering who recommended his work?

 

[Jamie]

I’m sorry, but I don’t have that information. Sometimes people are added to my list when I do searches of possible good revision surgeons in a particular area and there is no actual “recommendation.” If you’re interested, it’s best just to make an appointment for a consultation and see what you think.

 

[2chains]

22 month update

Waiting to hear back from revision specialist Dr Sadr in Vancouver. Sent email September 16.

Continue to go to a PT that is a movement specialist(6 months now he's a knee specialist) every three weeks. (He is in Calgary if anyone is having long term issues and looking for different treatment approach.) He carefully watches the way my knee and surrounding ligaments and muscles activate as my knee is extending and flexing. He can identify what is deficient and has been treating me with various knee mobilization techniques. He prescribes exercises and emphasizes certain movements to "work" the deficit aspect.

I have graduated from the concentric exercise ie. lying leg lifts and seated leg extensions w/band and have added eccentric movements ie a lying leg drop exercise where I start with an extended leg and try to lower to ground keeping the leg straight, very difficult. I would be very interested to know at what point others can do this post surgery!

Daily routine also includes diclofenac gel, naproxen, treadmill 9min day, forefoot walking, backward walking, kneecap mobilization, fascia massage, and lying on side gentle bending with a strap. Pretty fed up with it all at this point but still see small gains. Uugh!

Stairs are getting easier and my walking routine can be done daily which is an improvement! Purchased an inexpensive powered treadmill and walking backward has really helped as it forces you to try to straighten your leg. Unfortunately I'm still walking with locked/straight knee can't seem to complete that soft knee bend at heel strike without a significant limp. I'm hoping this won't be a permanent disability as I'm not currently working due to this significant limp and lack of ability to walk for more than 30 mins!

***SEASONS GREETINGS***KINDNESS***PEACE*** to all around the World!

 

[EalingGran]

Daily routine also includes diclofenac gel, naproxen, treadmill 9min day, forefoot walking, backward walking, kneecap mobilization, fascia massage, and lying on side gentle bending with a strap. Pretty fed up with it all at this point but still see small gains. Uugh!

Stairs are getting easier and my walking routine can be done daily which is an improvement!

Sorry it is still such a slog- but I guess any improvement is something. Does your movement specialist PT have any ideas about what the underlying problem is?
Hope you get your appointment soon.

 

[Axx72]

I can't see if I left you my surgeon's info above but for what it is worth

Dr. Rajdrishi Sharma
Orthopedic Surgeon
Alberta Hip and Knee Clinic
Calgary, Alberta, T2P 3C5
403-221-4359

Dr. Rajrishi Sharma on Calgary Doctors Directory

Learn about Dr. Rajrishi Sharma, Orthopedic Surgeon in Calgary, Alberta Canada. Find Dr. Rajrishi Sharma reviews and more on Calgary Doctors Directory.

www.calgarydoctors.org

It sounds like you are progressing albeit slowly.... small steps are better

 

[2chains]

Daily routine also includes diclofenac gel, naproxen, treadmill 9min day, forefoot walking, backward walking, kneecap mobilization, fascia massage, and lying on side gentle bending with a strap. Pretty fed up with it all at this point but still see small gains. Uugh!

Stairs are getting easier and my walking routine can be done daily which is an improvement!

Sorry it is still such a slog- but I guess any improvement is something. Does your movement specialist PT have any ideas about what the underlying problem is?
Hope you get your appointment soon.

Slog but still moving in the right direction! The PT indicates there is an issue with my kneecap and it is lacking of mobility. We've been working on the loosening/relaxing surrounding muscles and ligaments. Also he says that my radial pain on the lateral side of my knee is likely from the retractor and where it was placed during the surgery. It severely aggravated the peroneal nerve... that nerve runs right against the bone. He says the surgeons won't admit it but it not an uncommon symptom in his experience and no other explanation when there was no previous issues.

 

[2chains]

I can't see if I left you my surgeon's info above but for what it is worth

Dr. Rajdrishi Sharma
Orthopedic Surgeon
Alberta Hip and Knee Clinic
Calgary, Alberta, T2P 3C5
403-221-4359

Dr. Rajrishi Sharma on Calgary Doctors Directory

Learn about Dr. Rajrishi Sharma, Orthopedic Surgeon in Calgary, Alberta Canada. Find Dr. Rajrishi Sharma reviews and more on Calgary Doctors Directory.

www.calgarydoctors.org

It sounds like you are progressing albeit slowly.... small steps are better

Thanks for that info! Yes definitely progressing and the mild temps here really add to the positive outlook! Bowness Park clears some asphalt paths so even able to do outdoor walks still, awesome!

Also, I haven't resumed using my handicapped parking tag yet due to the lack of snow. Win-win!

 

[Axx72]

Yeah! Did you know that today in Calgary it is 10°C. Comparatively December 20 in 2022 was -28°C?

Would be pretty cool to get some more outside cycling opportunities this winter.