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Total replacement after partial replacement?
ScorpioRox posted:
I am a 43 year old female and I had a catastrophic injury to my right knee in high school. My knee never healed 100%, and over the years my left knee wore out as well from me compensating for my right one. At the end of this last February, I had double partial replacement on the same day. I got a late start on physical therapy because I developed aspiration pneumonia and a blood clot in my lung post-surgery. I don't know if this 2 week delay is the cause of my problem, but I don't think it helped.

I completed all my therapy sessions, and things seemed to go well. Though my right knee didn't heal as rapidly as my left, my therapist assured me that over time it would catch up. I have continued to do my therapy at home to no avail.

My left knee feels fantastic-better than before the surgery. I can feel the implants, so it almost makes me feel bionic, lol! I have no pain in the left, no swelling, better range of motion, and no problem with stairs, as long as I'm pulling up with that leg. My right knee hurts around the clock, makes it nearly impossible to sleep, and if I sit for more than 1 minute, it stiffens up, making the pain worse. Instead of getting better, it is now worse than before surgery. I see my ortho on Oct 17. I feel he's going to say it's a failure because of my weight, but my left knee is better than it ever was, so how can that be? Is it possible that the damage was worse than originally anticipated, and therefore the implant isn't working?

Before the surgery, I asked if I would ever need total replacement, and he said that the partial is supposed to put that scenario far into the future, given my age.We didn't really discuss what would happen if the implant didn't work, because he said he "hoped" the partial would fix me.

Has anyone ever had a partial that didn't work and needed to have a total after all? If so, what kind of prognosis were you given and did it work? How long after partial did you have your total done?

I am worried about seeing my doc because I don't want him to think I'm a failure. But I can't stand this pain, walking is becoming more burdensome, and my husband wants me to ask for a permanent handicap placard because where we live, regular parking spaces are in precarious areas that during the winter could cause me to fall. Do I suck it up, tell the doc I'm fine and hope it is just taking longer to heal? Or should I do what my DH suggests and tell the doc I feel terrible and need assistance?

I originally posted this to the Osteoarthritis Community forum, but it appears this is the place my post belongs.
_swank_ responded:
I had a partial replacement on the lateral side of my knee. It worked great except 3.5 years later I fell on the stairs and tore up the other half of my knee. I ended up having a TKR. My doctor said it was a difficult surgery because he first had to take out the partial knee.. My new knee isn't perfect but it's better than it was before.

You need to tell your doctor what's going on. Why wouldn't you? Everyone heals at a different rate and everyone will have a different experience, that includes people that have both knees done at once. They may heal at different rates. I can't believe you would even consider thinking you were a failure. This isn't a contest. It's your knee and if somethings wrong you need to figure it out.
ScorpioRox responded:
Update-I saw my doctor last month, 8 months after my replacement surgery. By the time I got in to him, I could barely walk. My right knee was a mess, and he looked at me like I was lying when I told him I was in constant pain. He pointed at the X-rays he took in April that showed the implants looked to be in good order, and said I "shouldn't" be having this problem. My hubby, who made a point of going with me, almost jumped on him. He stated I was a wreck and pretty much demanded the doc do something. So, I wound up having an athroscopy with extreme synovectomy. I did not even know what that meant.

He told me he removed some scar tissue, which was pushing on the kneecap, keeping it from moving smoothly, and removed the synovium, which is the lining of the knee (I think this is correct?), plus drained a lot of ucky-looking fluid. And he didn't believe that anything was wrong.....

I was told that within a couple of weeks, I "should" (there's that word again) be fully recovered. I have to admit, after the surgery, it definitely felt different. The pain I had before was pretty much gone, and most of the swelling, even post-surgery, was gone. I could sit without my knee getting stiff and painful, and the pain I did have seemed to be related to the arthroscopy itself.

Bad news, though. I had the procedure done on Oct 24, it seemed to be much better for a few days, but here, now Nov 2, the pain I had before is coming back, and it's getting hard to walk again. Even with Aleve twice a day, the swelling has not diminished. My ROM is half what it was prior to arthroscopy, and I feel like crying every time I consider the possibility that this is my life now. I see the doc again on Nov 6, and I'm supposed to be completely healed by then. I dread facing him, and telling him it still did not work. Have I just not given it enough time? Is this type of recovery to be expected? Am I doomed to have more arthroscopy? He did say that I still had some arthritis in there, and that by removing the synovium, it may cause me to have total knee replacement much sooner than expected. He said even if I heal from this, he's thinking 5 years or less. Would I be wise to get a 2nd opinion? I can't bear the thought of feeling pain every day and not being able to walk normally for the rest of my life......
arbob5 replied to ScorpioRox's response:
I'm so sorry to hear about your situation. Such severe pain is so difficult and it manages to run a persons life. There should be some answer and cure for your problem. Why your Dr. is seeming to be somewhat indifferent is beyond me. My ortho doctor is the most understanding and sympathetic person I know. He listens intently and is really concerned. Where are you located? A second opinion certainly seems to be the way to go.

Try to be patient for a while longer until you can see another doctor. I know that's easier said than done, but sometimes it takes awhile to get an appointment with a new doctor. Maybe a trip to the ER is the way to go. They may have an ortho doctor available to assist you right away.

These are just a few suggestions. I can only imagine how frustrated you feel. Stay strong, which you obviously already are, and get that second opinion.

Keep us updated on how you're doing. We really do care here. And God bless.
ScorpioRox replied to arbob5's response:
Thank you, I will post what the doc says. I'm trying very hard to stay strong, especially for my family. If it can't be fixed, well, there are people that have lived full lives with much worse than this, so I'll learn to cope. You have a great day, and thanks for the encouragement!
arbob5 replied to ScorpioRox's response:
You're very welcome. Just remember that we are all here for you. It helps so much to know there are others with similar problems, or other problems that we can all relate to in some way. That does definitely help.
KevinHilton responded:
I ask your doctor to make sure you don't have an underlying infection in your knee. I'd be very suspicious of one given your symptoms.
ScorpioRox responded:
So, I saw the doctor, and he was excited to show me pictures of the inside of my knee from the surgery. It was kind of weird seeing all the scar tissue in there (I won't get into details), and one of the pictures he pulled up showed there is already some wear on the plastic part of the implant. He believes it's from the scar tissue. There was no sign of infection, although he did say it's a little unusual for a knee to still be this swollen 2 weeks after this type of surgery.
I go back to see him in 8 weeks, and he said if there isn't any significant healing by then, we may have to discuss other options for me. I am to work on keeping my knee flexible to work out the inflammation, though I still am recommended to take Aleve every day, as I have been, and told to go back to taking my painkillers to help me through this. He seemed perplexed that I stopped taking them a couple of days after surgery, but said even if I take them at night to ease the pain so I can sleep a little better that it would help with the healing process.
I'm allowed to do light exercises, such as the stationary bike and leg lifts, but he wants me to limit weight-bearing activities, especially those that involve stairs. That one is tough since I live on the 2nd floor of an apartment building. He said when I go back to see him, he'll take some X-rays then to make sure everything is fitting where it should, and that the implants have not come loose or anything. So, I wait, again, to see if I can heal.
I told my hubby I hope he thinks peg-legs are sexy, because if I have to have one more surgery, I'm going to have them chop the whole durned thing off at the knee, lol!
Caprice_WebMD_Staff replied to ScorpioRox's response:
Thanks for coming back here to update everyone, ScorpioRox.
We never touch people so lightly that we do not leave a trace. ~Peggy Tabor Millin

Helpful Tips

You must do the exercises when having TKR. It alleviates stiffness and that hardening feeling. Also, see if you PT will do massage of knee, ... More
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