Revision TKR PT Post revision surgery

[dislocate]

I read that the average long-term recovery for TKR patients is approximately 6 months although it can take up to a year to be totally complete and feel normal again. What is normal? I’m in my 22 month post TKR with progress subsiding in the 5th month. Both my Orthopedist and Physical Therapist were pleased with my progress but I’m constantly reminded that I have a prosthetic knee that gives me pain, limited range of motion, and the never ending clunking (some call it clicking) whenever I move my knee. Simply walking gives a feeling that the knee is not connected. The incision has healed remarkably well.

 

[Jockette]

Hi and Welcome!

Please tell us the date of your surgery and we’ll make a signature for you, so we can see the date in every post.

I’m sorry to hear that you are not happy with your knee. For some of us, complete healing can take 2 years or more. I saw much improvement in my second year, and even some more improvement now in my third year.

I had a partial, and even with my improvements, it has never felt right. I don’t consider it a success.

I’ve had 2 second opinions. The first one told me:
Not everyone gets a good outcome.
Sometimes doing it over can make you worse.
And some people’s bodies just don’t like the implant.

That was not encouraging at all. My X-ray looked fine, end of story. That was at 15 months post op. (And he did not take new xrays, he was looking at my one year xrays.)

My next second opinion was at 22 months post op. This one did take new xrays, again they looked fine, he was sorry I had discomfort, but there was nothing to fix.

So, I understand where you are coming from.

Have you considered getting a second opinion? Sometimes, maybe most times, a new set of eyes sees a problem and offers to fix it. If you do, I suggest seeing someone a distance away, who has no association with your original surgeon, so you get an unbiased opinion

 

[sistersinhim]

We need the dates of any previous knee surgeries that you might have had added to the TKR date that Jockette asked you for. Knowing all these dates and surgeries will help us to be able to better advise you.

I agree with Jockette that you need a second opinion. It needs to be with a doctor that has no affiliation with your TKR doctor, not even golf buddies. That way the doctor will not be swayed by someone he knows that did your replacement.

 

[dislocate]

Surgery was on March 13, 2018. I share some of the blame for my situation by not doing my homework. I saw my orthopedist to address a torn ACL and he convinced me that a TKR would correct my issue.
To answer your question whether I had any previous knee surgeries, the answer is no. I won't see another doctor to get a second opinion. My confidence level with the medical community is low. My doctor was indifferent to my concerns at the 12 month post surgery visit, and had the body language of "it is what it is." This TKR experience where I had a no pain normal healthy knee (except for a torn ligament from sprinting) to a knee that has altered the quality of my life. I can no longer do simple home repairs requiring a ladder nor go on my knee. Sharing a day at the mall with the family and dancing are things of the past! I'm not looking for sympathy just want to advise others to do their research before undergoing knee replacement. From the many TKR blogs and readings in this forum TKR technology has a long way to go.

 

[Jockette]

You should not blame yourself. We should be able to trust the doctors we see. But I do understand why you say that, I trusted the first and only Orthopaedic surgeon I saw and went ahead with the partial he said I needed. I was so ignorant it never occurred to me to get a second opinion. Long after the fact, my husband said, we didn’t even know what questions to ask.

 

[sistersinhim]

There's no reason why could can't research a different OS and find someone to correct your poor knee. You've lost faith in your current doctor. I get that and agree with you. But, there are very good OSs out there. You didn't research the first one. You have the opportunity to do just that now. You are not the only one who has had a bad outcome, had a revision and are doing wonderfully. Just click on the revision button on the main knee recovery page

and you can see how they are doing.

You are too young to give up and live with a knee that can be fixed!

 

[dislocate]

Thank you for replying but from all the responses given to others I detect boiler plate answers giving hope. My surgery has given me much time to read and ask questions of TKR recipients. When they state they are better off having TKR (I personally know six) they refer to the trade-off of having less pain but admit to all the other short comings, e.g, they all have clicking in the knee!
When I originally stated that I didn't do my research I was referring to the TKR procedure and outcome, not the doctor. My particular doctor was the first Orthopedist to do robotic TKR in the area and was highly recommended and he is correct by saying "it is what it is."

 

[Jaycey]

Thank you for replying but from all the responses given to others I detect boiler plate answers giving hope.

Sorry but I have to disagree. You might get "boiler plate" answers from your "friends". But everyone here either has experience or is going through joint replacement. What you will get here is some honest input from those who have been there.

Revision may not be for you. But for many it is life changing. All the best to you!

 

[Helizabug]

I really think you have stated very clearly what’s wrong, and you should ask another doctor to help restore your well being. You deserve better than what you describe below.

This TKR experience where I had a no pain normal healthy knee (except for a torn ligament from sprinting) to a knee that has altered the quality of my life. I can no longer do simple home repairs requiring a ladder nor go on my knee. Sharing a day at the mall with the family and dancing are things of the past!

If you don’t ask for help, you might not ever regain days at the mall with your family, dancing, and days where you can do the things that make you who you are. Maybe it’s not in the cards for you, but stopping with one doctor seems like judging every pair of shoes by the first pair you ever try on.

 

[Tykey]

Have you considered that a "robotic" procedure has caused your problems? The cynic in me would always get a real live craftsman to saw/chisel and hammer my knee.
The really cynical part of me always makes me question as to who "highly recommends" a surgeon.
So I'd also suggest you get searching for another experienced surgeon to have a look.

 

[LD of Michigan]

Interesting. It's my limited understanding that the Robotic option only helps in the alignment of the cuts (I had the Robotic option), the surgeon is still pretty engaged. I'd like to know more about the process. I know I have an additional wound area where the Robotic apparatus/ arm was temporarily implanted/ used. Makes you wonder...?

 

[Tykey]

I might be totally wrong, but my understanding of a robot is asked to do it's stuff on the basis of x-rays prior to the surgery.
Normal procedures use jigs put into place by the surgeon on the basis of what he sees after the knee is opened.
As I said, I might be wrong, if I am, I'm sure someone will advise me.

 

[InkedMarie]

I’m 16 mos post op, I think. Some days, I forget I had a TKR, most days I know it. My pre op pain is gone but it’s achy during wet cold weather. I cannot kneel which isnt a big deal except at work but I get around it) and I can’t squat but I couldn’t do that before surgery.

To be honest, I think this is more normal than not. There are many who have TKR and never know it but I think that’s not the norm. JMO.

I’m sorry you’re in pain. I urge you to go to another surgeon. If you don’t, you will never know if anything can be done.

good luck.

 

[dislocate]

Thanks to all the good intention replies. I was reluctant seeing another Orthopedist but yesterday I had an appointment with the same results. The X-Rays show a good TKR and the doctor said "maybe I expect too much." He also did not recommend re-doing the surgery since I may not realize any benefits and there's a high risk of worse results. His comments agrees with my readings.
To Tykey, you are correct. The term "robotic" is a matter of semantics, i.e., the doctor uses on screen information generated from a 3D Cat-Scan to assist him. There is no independent mechanism involved. Best wishes to all TKR recipients.

 

[Tykey]

Best wishes to you as well.!

 

[Celle]

@dislocate - Is the surgeon you saw for a second opinion one who specializes in fixing knees with problems? I suspect not. Don't be put off by seeing two surgeons who are not prepared to do anything to help you. To me, that says they don't have sufficient experience in doing knee replacement revisions - not that there is nothing that can be done to fix your knee's problems.

There are surgeons who specialize in doing knee replacement revisions and who spend every working day in dealing with problem knees. That is the sort of surgeon you need, because those surgeons can often spot a problem and suggest a solution that has eluded other surgeons.

Don't condemn yourself to a life that is less than it could be. In spite of the impression you've gained, the percentage of people who are dissatisfied with their knee replacements is actually low, when compared to those who have a successful outcome. It's 10-15%, compared with 85%-90% of successful outcomes.

When you come to a site like BoneSmart, you tend to get a slightly distorted impression about the outcomes of knee replacement surgery. That's because many of the people who come here are having problems with their new knees and they're looking for advice. The people who have uncomplicated recoveries and go back to leading a normal, pain-free life don't come here. They have no need to search for help and advice.

I have had three knee replacements. One of those was a revision, because a partial knee replacement failed. I Had that knee revised to a TKR and it's now 8 years old, and serving me well. In fact, both my knees are good. I can do anything I want with them and the only time they hurt at all is if I twist them by accident. The rest of the time, I actually forget I have bionic knees.

Here are some stories of people who have done well after knee replacements, and who are participating in activities most of us would not have contemplated, even before our knees became arthritic. While their levels of activity are probably exceptional, most people return to a normal life, with more mobility and less pain than they had prior to surgery.
Stories of amazing knee recoveries

 

[Rubyroo]

Take care of yourself dislocate and keep your chin up.

 

[dislocate]

With all the negative aspects of a TKR the most annoying is the consistent clicking with the slightest movement of my knee that is an ever present reminder that I possess a prosthetic knee.

Walking makes a distinct double knock when walking, one when the leg lifts and another when the foot touches the ground again, something like a wooden mallet striking the bottom of the femur. It never lets me forget things are not normal. My wife can hear me walking when the room is quiet.

When I reviewed the knee replacement model in the doctor’s office I was impressed with the highly polish (like chrome) appearance and movement like wax in warm butter that gave me the confidence to make the final decision to proceed with a TKR. After 27 months post TKR my knee joint feels like a pry bar in a bed of gravel whenever I move it.

 

[Jaycey]

@dislocate you will notice that I have merged your two threads together as we prefer that members in recovery only have one thread.

This is for three reasons:
1. if you keep starting new threads, you miss the posts others have left you in the old threads
2. it often ends up that information is unnecessarily repeated
3. it's best if we can keep all your recovery story in one place so it's easily accessed if we need to advise you.

Please keep all your questions and updates on this thread. I changed the title slightly. If you would like a new thread title just give a shout.

 

[dislocate]

I had TKR 45 months ago on my left knee and 12 months ago on my right knee. Where I had a strut in my walk prior to surgery my prosthetics give way to a limp. With both knees I anticipated a better outcome following the painful months of recovery; limited range of motion was anticipated but not the continuous pain. Prior to surgery I would experience pain following a long day of knee exertion that could be managed with pain meds. Following TKR on both knees the prosthetics are a constant reminder that things are not right, from ROM, limping, knocking, and pain. I haven’t had a pain-free day in 45 months.
I followed up with other orthopedists with one revision orthopedist to hear everything looks good and give it more time. They all agreed additional surgery doesn’t guarantee improvement and risk of a possible worse outcome. It is what it is!