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Total replacement after partial replacement?
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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?
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_swank_ responded:
First, no, you don't tell your doctor you're fine. Tell him exactly how you're feeling. Why would you tell him anything else? Sometimes things don't work out as planned and it's nobody's fault.

I had a partial replacement on the lateral side of my knee when I was 49. It worked perfectly and my knee felt great. Unfortunately, 3.5 years later I fell up my stairs and tore up the other side of my knee. I ended up needing a total replacement. My knee is good but not great. That was the 8th surgery I had on that knee since I was a teenager so I wasn't expecting miracles. My surgeon said the surgery was difficult. It still feels better than it did before surgery but there are certain times when I still have pain.
 
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ScorpioRox responded:
Just updating my post. I went back and saw my doctor, and explained to him the constant pain I have and how difficult it is to move around. My right knee would get stiff and hard to stand on if I sat for even 5 minutes. At first, he acted like he didn't believe me, but after my hubby stepped in to back me up, doc decided to do a scope, since he said X-rays would not be able to tell.

I had the arthroscopy with severe synovectomy done yesterday, and I can already feel the difference. I still have pain, but it is where the scopes were used, not in the same spots I had before. He said he removed some scar tissue and took care of the inflammation of the synovium. He said I still have some arthritis in there that the partial replacement didn't seem to get rid of, and thinks that may have partially contributed to the pain. I will have to wait it out the next few days to see how it heals, but if he took care of everything while he was in there, then hopefully I can get back to a normal life again.

I do wonder, however, about the synovial fluid. I'd seen on some sites that said even after the inflamed tissue is removed, it can come back again, and more arthroscopy would be needed. Has anyone else had this issue?
 
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Scott Zashin, MD responded:
I am sorry to hear about your right knee. Consider posting this on the Web MD Ortho site as they may have more clarity on this issue than I do.


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