Is a TKR normally the same size as the other knee?
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I had a TKR in August of 2014.
The new joint is 10 mm in diameter wider than the original knee and than the other knee. This means it always looks swollen - although it often is anyway.
I am 1.84 m tall and have thin legs.
Are TKRs usually the same size as the original knee, or are they one size fits all?
0 likes, 18 replies
ken25066 francis24843
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This should have been caught preoperatively on X-ray. At 25mm to the inch 10mm is quite a large discrepancy and could lead to irritation of the collateral ligaments. I would see another orthopedic surgeon for consultation. This might have been avoidable or maybe not. It would be good to know which.
sueisobel francis24843
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francis24843
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Pre-op I was not examined by the surgeon in order to determine whether I needed a TKR - all done via an X-ray and an examination by the arthroplasty nurse. Spoke to the surgeon for less than 1 minute the morning of the op in the waiting room at the Royal Inf, Edinburgh, with all other patients and relatives also present. Prior to that my total contact with an orthopaedic surgeon had been for c. 5 minutes to sign my consent form. I asked whether my previous pes anserinus transfer (1977) would affect the TKR and was assured it would not.
Post op I have not seen the consultant who carried out the op and only seen a registrar for about 2 minutes in the ward.
Since discharge I have not seen any of the orthopaedic surgeons at all - only the arthroplasty nurses. I cannot walk on rough ground without severe pain on the outside of the operated knee.
What I would really like now is for them to give me the arthritis in my knee back and chuck the TKR in the recycling bin.
veronica91735 francis24843
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ken25066 francis24843
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Being in a socialized medicine system. You probably received a low cost implant that lacked the features that would have allowed the surgeon to give you a proper fit. Not his fault nor yours. It the result of the system that GB has settled for.
Without a doubt your previous surgery complicated this surgery and they were completely unprepared for it during your procedure.
I wish I could offer something helpful. I ho
sueisobel ken25066
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sueisobel francis24843
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sueisobel veronica91735
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ken25066 sueisobel
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She said that she saw the surgeon for five minutes and that's probably all the surgeon got too. He is supposed to show up to work and perform his scheduled surgeries with the implants at hand. When he encounters a situation that falls outside the norm, he cannot order in another system and complete the surgery the next day. He has to do the best he can with what he has. In this case what he had was insufficient.
Who is to blame? The surgeon or the guy who accepted the low bid from the manufacturer? Neither! They were both doing there jobs within the framework of the laws of the land.
THAT'S what is wrong with socialized medicine. It takes individual incentive out of the picture. Nobody did the wrong thing but the poor patient didn't get the RIGHT thing.
sueisobel francis24843
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They say the pain in women is probably due to ill-fitting knee replacements caused because women having narrower femurs, or thigh bones, than men.
The design is based on findings presented at the Computer Methods in Biomechanics and Biomedical Engineering Conference last year.“ For a lot or women, the replacement doesn't quite match the end of the femur ”
But some surgeons have warned that the changes in the new design might be too subtle to have a significant effect on patients.
In the study, the differences between male and female knees were mapped, and it was found that women's femurs had a different shape.
During knee replacement operations, the femur must be coated by a metal plate, and typically surgeons choose the best-fitting implant from a range of designs and sizes.
It is important that the replacement knees fit as perfectly as possible to maximise comfort and mobility for patients.
'Phenomenal success'
The new knee cap, called Gender Solutions, replaces the thighbone portion of the knee, and is designed specifically to match the shape of women's femurs.
Nick London, a knee surgeon who has been using the new design, said: "Knee replacements have become a phenomenal success, but surgeons have noticed in the last few years that men and women are behaving differently after the operations.
"For a lot or women, the replacement doesn't quite match the end of the femur, and in the last few years that has made a difference to their pain."
He said although he believed the new knee implants would make a significant difference to the success of the implants in women, it would be some years before these effects would be confirmed by studies.
Oliver Schindler, a specialist knee surgeon at the Droitwich Knee Clinic, said there were differences between the knee caps of men and women, and that increasing the variety of implants available was a good thing.
However, he warned that the small design adjustments made to these implants might not be enough to have a significant clinical impact. UNQUOTE
veronica91735 sueisobel
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sueisobel veronica91735
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francis24843 veronica91735
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The whole joint also starts to ache if I lie on my back for more than 5 minutes - preferred the arthritis!
I have a feeling that Ken's point about cost has a bearing on the decision on which implant to fit.
veronica91735 francis24843
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janice60986 francis24843
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