TKR Revisions - how successful?

[realzed]

As I have alluded a couple of times while commenting on a couple of previous threads, I sit here now on the waiting list to have my previous (9 yr old - new to me TKR) redone in a month or two..
It has always given me so much pain and has such limited range of motion that when I went back to see the doctor who recently did my very successful hip surgery and he asked me get up and show him my new gait after the hip replacement - I couldn't even walk well or far enough to give him any idea of how well it had improved anything for me!
At that point the discussion as you may imagine, graduated from hips to knees and he questioned about my TKR and for how long it has been so painful and restrictive for me.
I did ask and he did offer, to subsequently have some x-rays done to have a 'look see' what he considered might be possible to do to improve  things.
Over the past 6 months my replacement knee has now become so restrictive and painful now that I can't even walk some days, and even standing still can be a real challenge - so he agree to open it up and try and clean everything up and replace what he thought might help (total redo is apparently a good possibility) and really give everything a detailed going through to the point where he did say it would be a much more extensive and detailed procedure than just a first time TKR considering how well he intends to be focused on getting everything as perfect as possible - including a longer than normal hospital stay to boot..
So to that end and considering how little I really want this to actually occur (although I really seem to have very few - well none.. choices to try and resolve things) I'd like to hear any and all comments from those who may have experience with knee revisions and their noted lack of success rates and/or any other comments or stories that anyone may care to share.
This is not so slowly killing my quality of life - but as I said, with no real other options and prospects for 'normal' usage going forward - I feel it is something I must do to try and become pain free and somewhat mobile again..
I appreciate any and all comments!  
Randy

 

[Chuck White]

Took me a while to figure out what "TKR" was (Total Knee Replacement)!

I feel bad that you're having a hard time with it, and now have to have it opened up again!

I hope the repair goes better than the replacement!

I'm looking at a TKR some time in the near future, no cartilage in the left knee!

[realzed]

Thanks for the wishes - I too do hope the 2nd time around will be found to be a blessing!
I'm figuring probably no one here must have ever had a knee redone - and there can't be many obviously from the responses or lack thereof, but I do know the 'satisfaction or success rate' is poor often, and I guess I was just being hopeful of hearing some decent stories to help allay my fears of going through a revision for no real gain as the end result..
Many on this blog have posted successful tales of TKR's - but I know personally that the initial procedures aren't themselves all unicorn and pixie dust stories as I'm well aware of that already obviously - it is the ones of the 'reruns' that I was most interested in, hopeful I guess of getting some solace while I await the knife again..
Your comment(s) is much appreciated!
Good Luck with your own procedure when it comes time!

[Chuck White]

There are several members here that have had knee replacements, the one that comes to mind first is @Magicman !

He's had his done for quite a while now!

[Magicman]

 

 



These X-Rays were made 6 weeks after my surgery.  

I had a one year anniversary appointment with the knee surgeon this past Thursday and the X-Rays look the same.  He was well pleased and am I.  He told me to do whatever I want to do and made me an appointment to see him again in two years.

Edit:  This topic is about "Revisions" which hopefully I never need. 

[Walnut Beast]

Since he said to do whatever you want Magicman. You are going to go into beast mode cranking wood out on the sawmill even more 😳

[realzed]

 


These X-Rays were made 6 weeks after my surgery.  

I had a one year anniversary appointment with the knee surgeon this past Thursday and the X-Rays look the same.  He was well pleased and am I.  He told me to do whatever I want to do and made me an appointment to see him again in two years.

Edit:  This topic is about "Revisions" which hopefully I never need.

Yea - I wish I didn't either..
I did note an air of indecision in your posts pre-operatively MM - but I'm sure you're glad now to have gone through with it in the end, all things considered!
Your 'new to you knee' looks great as does the right one as well - from the spacing, I don't think you'll have to worry about that one for quite a while, if ever!
Surprised that your patella doesn't look like they scraped it off at all - but the surgeon knew what he was doing if the result is all good regardless.  
Your pics look great and unfortunately mine don't appear as clear of floating 'stuff' as yours do - maybe that is some of the problem, or just poorer imaging in my case here.
Maybe they (he) can just wash mine out and button everything back up - but I do recall my surgeon saying for the trouble and time involved, he would probably take close to double the time and redo everything to his best abilities to try and make it as sure as he can be of it all, and that likely means 'everything' - OUCH..
I hate the idea of it all - but as I said I really have no choice - and almost wish my x-rays showed a real mess in there so I could be more assured of some better success than I'm feeling right now.
Actually - now with all of the Covid amping up again, it may not happen as soon as I would like - it's a bit I imagine like being in a cell and hearing that the firing squad is out of ammo and awaiting a shipment sometime in the future..
Glad again to hear of your success with it!

[Magicman]

Yes, I had serious hesitation and misgiving about having it done.  Maybe you should (or should not) have heard the conversation in the hospital parking lot the morning of my surgery.  I was seriously ready to turn around and go back home.  

My surgery was not done due to age related degeneration but it was the result of a motorcycle accident when I was 30 years old.  Cartilage had to be removed when the knee locked up and when you loose something that does not regenerate you pay the penalty in later years.  The surgeon said that my knee bones were polished like a mirror.

Having the TKR surgery was the best gift that I could have ever given to that knee. 

[realzed]

Yup - I hear you on the pre-op 'discussion thing'..  
There is a clinic here that gives pre-operative information sessions to patients-to-be a couple of weeks prior to their procedures - for those who wish to learn more about the actual operation and recovery processes to aid in helping them address any concerns or answer questions they may have, and I attended one prior to my own first TKR..
A few months later after my operation I ran into the same physio-nurse  who had been conducting the session I was in, and she laughed upon seeing me and learning I had actually managed to go through with getting my 'new knee' - saying to me.. "I've never, ever seen anyone with skin colour as grey as yours that night, I'll never forget you - I figured if there was anyone at all in that room when we had that class that wouldn't go through with it.. I would have bet on it being you!"
Seemed to be humorous then - but certainly not prior to all of it pre-operatively certainly apparently, not that I recall much of what was even talked about in the session itself!  :

[thecfarm]

My wife had her re done. 
The first one was crooked. Second one is nice and straight. And the inserts are longer too.

[Bill]

I have heard both good and bad .

One gal had hers done and within months was out dancing - like a teenager

Another not so much

I hope all goes well . . .  

[Gary_C]

I do know of a number of redo's of both hips and knees and the best advice I can give you is to find a doctor or clinic that has experience with TKR's the second time around. Perhaps much of the reason for why I recommend only the best doctors and clinics is because I am near the Mayo clinic where they do a lot of redo's where other doctors have screwed the first redo up. 
I had quad repair surgery at Mayo and my room mate when I woke up was a guy who had his third redo of a knee. He had worn out the first one and gone to a well known clinic for his first redo but he got infection and had to go back in for a second redo. He then got infection in that one and cut his losses and went to Mayo to fix the mess. They had to take his latest knee out, scraped the bone clean and put his leg in a full cast with no knee in place for 6 weeks while dosing him with antibiotics and when I met and talked to him on the next morning after both of our surgeries he had his latest knee in place.
I also had a friend from Indiana who wore out a hip and his local surgeon just sent him to Mayo because of the difficulty in redoing hips.
My father in law had both knees replaced and one done a second time. However he was the worlds worst patient, did not faithfully do his rehab and had difficult times with all three surgeries so he is not a good story to relate.
My wife had one knee done, got sick in recovery and did little of her rehab. She had to go back in surgery to break up her scar tissue that formed and still complains about the knee. I don't think the doctor got her new knee straight and I don't believe he is still at our clinic doing knee surgeries.
So best advice I can give you is to find a very good surgeon with experience in redos. Having a doctor that is willing to "take a look" does not give me a lot of confidence he is the one for the job.

[realzed]

Thanks for the tales of woe Gary - it does relate that there are a lot of variables involved - in patients, hospitals, surgeons, and situations..
The surgeon who did my hip mid-Summer did a great job and is probably the best guy around Northern Ontario here when it comes to reputation for good successful results for both knee and hip replacements.
My knee was done originally, at a time when the government had a big push to relieve a large backlog of surgeries, and then this same surgeon's waiting list (logically) was filled up and longer than all others.
Being desperate after more than a year of pain and sleepless nights, I just wanted to get it over with, not thinking there was much difference as to who could end my agony!
Obviously, I had a choice then and didn't opt well the first time as I am reminded..
When I said "take a look" I guess I was making him sound blase - and he is quite laid back, but he took great measure in my newest x-rays and sounds very committed to making sure he would leave no stones unturned - which now means my wait is considerably longer than normal since he has to 'double book' OR time for a much longer procedure over that of a 'first time TKR' and to ensure an anatomically correct job, according to him.
Typically TKR recipients are now out of the hospital after 24 hrs - but I'm apparently to be parked there for 2 days at least before I head home - which I guess falls in line with his saying that this will be a lot more than just a normal 'in and out' deal..
I wish, but don't appear to have any other or better options as you did with Mayo.
I live 4 hours North of Toronto and with all the virus-related issues, any other referrals or appointments at a distance are near impossible now and will be going forward, for probably the next year or so.
My hip (although hips are admittedly easier with higher success rates) worked out so well, that I'm very hopeful that he can rectify this knee and bring me somewhat back to life.. 
Thanks for the input - Randy   

[Gary_C]

Just for reference, there was an orthopedic clinic in the Twin Cities that advertised they did "laser guided knee surgery." When I asked what the advantage was I was told that the critical part of knee surgery was to get the bone cuts exactly right so the alignment of everything was perfect. So in essence the laser was compensating for a lesser skill level of the surgeon. So if you translate that to a redo TKR you can see that it does take a high level of skill on the part of the surgeon to remove the existing knee parts and make new cuts to get good alignment for the second one. It's certainly not a job for the inexperienced surgeon.

Sounds like you found the best one you can so I wish you well in your upcoming surgery.

[realzed]

I was awakened half way thru my first knee replacement surgery by all of the noise and hammering and actually do through a fog, recall lifting my head up in an attempt to peer over the curtain they set over my abdominal area, to see what the heck was going on!
When I mentioned this and the fact that I was subsequently told to "lie  down" and immediately given something to knock me back out.. the surgeon who did the work laughed and unsurprisingly said "we sure do make a lot of noise don't we, hammering and sawing away - how did you like my choice of music - I like it pretty loud to cover up all of the noise? We're just like a bunch of carpenters working inside your house.."
And I do truthfully think it was the hammering in of the pegs on the replacement insert pieces that locate in the bones, that actually woke me, as he did say they have to smack them in pretty good to seat them well..
He also did mention that they have a jig fixture that is affixed to the actual leg bone(s) that aligns the joint pieces and sets the angles and cut lines to tailor the inserts for height compensation, and knock-knee or bow leggedness situations, so that the amount of variance is somewhat controlled.
He mentioned preoperatively that he thought he needed to correct my slight bow leggedness a couple of degrees, so and if I got the other one done at some point so I could be 'perfectly normal looking' - which seemed strange since I never thought I had issues..  ???
Regardless, I hope this second one is more accurate - but I do think scar tissue is the defining issue in my case.
Anyway I was out shopping some today and paying dearly for it - so off to bed for me now and it's only 6 pm! Got to try and get some rest whenever I can.. and/or at whatever the hour of day.
I do hope my 2nd shot at this will improve the situation and again Gary, I do appreciate your wishes thusly!

[hacknchop]

I hope it all gets better for you Randy. I know it"s hard to do but try to keep a positive attitude,I'm sure that the confidence you have in your surgeon is not misplaced.

[realzed]

Your comment is much appreciated!  ;D