knee replacement failure

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NowhereMan
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Date Joined Sep 2017
Total Posts : 9
   Posted 9/25/2017 2:31 PM (GMT -6)   
I had chronic arthritis pain in my knee for years (decades) and finally had a knee replacement.

All you hear about knee replacements is patients saying "I wish I had done it sooner."

I'm having about the same pain levels afterward as I had before.

Surgeon mostly shrugs and points to xrays on how bad it was prior to surgery and says it can't really get any better.

Over the counter medication does nothing. Prescription meds make me a dull boy.

thoughts?

straydog
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Date Joined Feb 2003
Total Posts : 15010
   Posted 9/25/2017 6:01 PM (GMT -6)   
Hi NoWhereMan & welcome to the forum. Like you said, I know many that have done the replacement & say they wished they had done it sooner. How long ago was your replacement done? What sort of odds did your surgeon give improvement wise prior to surgery? Have you considered perhaps getting a 2nd opinion?

Sorry for so many questions just trying to get a little more info.
Susie
Moderator in Chronic Pain & Psoriasis Forums

NowhereMan
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Date Joined Sep 2017
Total Posts : 9
   Posted 9/26/2017 10:39 AM (GMT -6)   
Thank you Susie for your reply. I'll answer your questions here:

-My knee replacement was done nearly 3 years ago.

-I don't recall my surgeon giving me any personal "odds" for improvement. On the other hand, I definitely went to him (I sought him out based on reputation) to have surgery done. I had already decided it was what I wanted. I remember telling him that previous doctors I had seen suggested putting it off as long as possible/as long as I could "take it." He said that's common. I had decided that enough was enough.

-I did get a 2nd opinion about 1-year ago. I found a surgeon who had retired from surgical practice but still met with patients to advise or help them decide on knee or hip replacements, which was his specialty. I told him in advance that I wanted him to examine me and to discuss alternatives, but that I would initially hold back what my surgeon was saying until after he gave his 2nd opinion...which was fine with him. There is one and only one thing that could be done surgically, which is to open it up and swap out the "disk" piece which is in the middle (it essentially replaces the cartilage). The surgeon can put in a thicker disk which might reduce the current laxity (it shouldn't be lax after surgery), which might reduce persistent inflammation, which might reduce pain. No guarantees.

straydog
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Date Joined Feb 2003
Total Posts : 15010
   Posted 9/27/2017 9:01 AM (GMT -6)   
I know some drs, depending on the surgery will say you have say 80% chance of improvement, just using this as an example. Have you ever tried Voltaren, its available only by script & for arthritis pain? It comes in gel form & oral. I prefer the gel & have found it helps with my knees when they get bad. I have had numerous scopes for tears, adhesions, cleaning out arthritis & ACL issues. Some people have good results with TENS Units, what about moist heat & getting in a jacuzzi or heated pool. A heated pool helps arthritic bones, you cannot injure yourself in water which is another plus.

I can understand being hesitant going forward with more surgery. The word MIGHT reduce the pain cuaght my eye. Keep us posted.
Susie
Moderator in Chronic Pain & Psoriasis Forums

NowhereMan
New Member


Date Joined Sep 2017
Total Posts : 9
   Posted 9/27/2017 1:03 PM (GMT -6)   
Thank you, again, Susie.

You caught that hesitation, huh? I went through a lot of pain and rehab for my knee replacement, with very marginal improvement to show for it, so yes I am hesitant. I understand that the surgeon would be unable to give assurances, but he wasn't even hinting at the notion that it was likely to improve my pain.

I've tried some of what you suggested. I saw a chiropractor for a while for a back issue and he had a big professional/clinical Tens unit. about a year ago, for about 10 sessions we tried it on my knee but it made no noticeable difference.

I have a hot tub, and other than just a momentary sensation I feel nothing lasting even when putting my knee right up to the nozzles for minutes.

I'm not familiar with the topical you mentioned. The more aggressive meds, as I originally said, make me "a dull boy," so I've largely avoided them. I think that over the decades of pain (the original ACL/MCL/Medial Meniscus injury—triple death, they used to call it—and failed intervention which ultimately led to the replacement was from the early 1980s) I built up a large tolerance level.

Thanks again for your comments. Still contemplating.

straydog
Forum Moderator


Date Joined Feb 2003
Total Posts : 15010
   Posted 9/27/2017 1:19 PM (GMT -6)   
At least consider the Voltaren gel, its topical but a script will be needed. You can go to Drugs.com & read about it. At least it will not be anything that will mess with your head.
Susie
Moderator in Chronic Pain & Psoriasis Forums

Abilene
Veteran Member


Date Joined Apr 2014
Total Posts : 943
   Posted 9/28/2017 8:56 AM (GMT -6)   
I'm very sorry to hear about your surgery results, rather your lack of results. I just wanted to add to this conversation for others who might read it that knee specialists for the most part, no longer say to wait as long as possible. The new materials last longer so there is no need to tolerate the pain and possibly cause more damage.

One friend who had this surgery on both knees while in his 40's was told the procedure of replacing the disk could be done if his wore out. Perhaps you could find a doctor who has done this without so many 'mights' and get that opinion. I did not understand if the retired doctor had actually done this. This procedure was described as minor compared to the whole original surgery. My knee surgeon also described this as a 'fix' if my recent new knee wore out again after 30 years or so. If you happen to be in or want to travel to N. Texas I have a suggestion for a very good doctor.
Posterior C3 - C7 laminectomy and fusion 2 rods and 10 screws, local bone graft from surgery site-lamina and other bony tissue 12/17/2013; Hyperthyroidism; Sleep Apnea-update-it's gone after a 25 lb weight loss; Total Knee Replacement 2012 and 2017.
Thankful for my husband of over 40 years

NowhereMan
New Member


Date Joined Sep 2017
Total Posts : 9
   Posted 9/29/2017 11:38 AM (GMT -6)   
Thank, again, Susie. I'm going to keep that in mind to discuss at next visit...depending on whether or not I make a decision to go forward with disk replacement.



Thanks, Abilene. I'm pretty comfortable with my selection of the top ortho practice in the region. When George Bush had his knee replacement, he flew from North Texas to Chicago, to the practice I go to, to have his done.

The functional life of knee replacements is primarily dependent on the use and abuse one gives it...so it can vary widely and has to be generalized. In today's technology, a knee replacement can only be replaced once due to how much bone gets cut off each time, so without counting on a leapfrog improvement in one's lifetime, the rule of thumb on not having it done too early in life is to avoid running out of options when much older. The disk replacement is a simpler operation which does not involve the bonded upper and lower metal pieces, so it does not count as a replacement. It certainly is, therefore, a simpler operation—although any general anesthesia operation should not be considered minor—and requires PT rehab (usually about half of the effort which follows full replacement). Both my surgeon and the 2nd opinion surgeon had done the disk replacement; despite their expertise, neither had full success in all cases with it eliminating the issues, so I understand and greatly appreciate their hesitancy to commit to success in my case. It's a bit of a gamble on my part whether to commit to the time, effort, resources, etc when there is less than very high likelihood of success.
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