Oxford Uni-compartmentalise knee problems

With respect 12 is not very long. My x-rays are excellent but I still have extreme symptoms. Every visit the expected date of improvement is extended. I have a daily record of exercises, knee measurements, quad measurements. I suspect the scale of problems is being disguised. VERY upset / frustrated / worried / annoyed & of course £20,000 lighter!!

I am at 5 weeks and have the exact symptoms your describing.  So I did a lot of research and found a lot of pain comes from shortened tendons, muscles, and scar tissue.  So I got myself a small massager and used it on both of my legs; reason being is walking different will affect both legs.  I massaged lightly around my knee and pushed more on my legs.  The outside of my TKR leg hurt when I massaged it but I kept it up and the next day, today actually, I was on my legs 3 1/2 hours with virtually no problem but medium swelling.  I am icing as I type and then I will use that massager again.  Also I have been getting the nerves waking up with those electrical shocks that run the leg making the eyes bulge out.  The massaging lessened those electrical shocks quite a bit today.  Make sure you stretch your leg every day...for the rest of your life.  The knee has very little blood circulation and a fake knee will make that circulation even less.  I stand and push my knee backwards and pull my knee under the chair with a strap.  Every morning out of bed I stand and reach towards the floor to give my tendons a good stretch.  If you let your leg tendons seize up then you will be riddled with pain forever more.  Make sure you build those muscles as well, weak muscles will give you pain.

Sadly, I am way ahead of you. I had a previous accident so I was well prepared for this op. I had 2 physio`s one solely to address/ massage scar tissue, the other to develop exercises. I have been VERY meticulous with exercises and gym work, I have pushed, eased, exercised, teased, varied the work, used a swing to push the knee extensions. More work than you can imagine and CAREFULLY gauged to ensure it was constructive rather than damaging. Physio`s have contradicted physios / Consultants have contrdicted physion`s. I can cycle / row but walking is painful / uncomfortable and I CANOT engage my quads which have lost 6 Cm since the op. There are no figures re completed ops v ops completed with good outcome. Depressed.

Hi Catherine , thanks for replying. I do exercise faithfully. I start with a 20-30 min bike ride( stationary) then do lots of straightening exercises. It does feel like all the tendons or ligaments are pulling when in extension and can barely touch around the knee. I actually did massage my leg last night with a electric massager. My bend has been no problem from the beginning but the pain in extension is pretty much the same. After it’s warmed up it goes flat but with the pulling and pain.I see my surgeon tomorrow , I’m hoping things will just subside on there own and nothing is wrong. I’ve read so much on the internment about soft tissue imbalance . I am 48 and very active , I just need this pain to ease so I can get my gait proper. Thank- you for all your advice and I hope you recover well. 

I hope this helps...my mom had 2 TKR, 1 left, 1 right within a year of each other.  With both knees she took almost the 2 full years to recover to the point she walks everywhere now.  She does have bad days, maybe 1 or 2 per month, some more some less.  I have heard most end up with a few bad days.  I asked my mom if she would do it again, its been 3 yrs, and 4 yrs.  She said in a heart beat.  She was 70 and 71 when she had them done.  I heard the younger you are, the faster you heal so the pain may be more because you regenerate faster.

I wish you the best.  I bet your just healing faster in some areas than others and everything is great.  I am 56 so I will probably heal somewhat slower than you meaning less pain and things change.

I love hearing positive things! I felt I did well on the initial healing. I’m just trying to figure out why it’s only weight bearing full extension I’m having so much grief with wich is what you need to walk properly. I hope it’s just time, it has been a long 3 months and was told I’d be pain free by now with a partial . I know everyone is different and heal a different rates. I hope in the end I will be like your mom and be happy I chose this surgery.  It’s definatley an emotional and physical roller coaster!

Nerve damage healing time: 3 months

Muscle healing depending on a mild to sever strain 3 weeks to 6 months.

Bone is 1-3 months after a fracture.

You have 3 things your working on healing, some may heal faster some not.  With a knee it takes up to 2 years for recovery...you have a while to go.  I really would not stress or worry about it until you have more time under your belt.

Thank-you Catherine

Hi Catherine, I saw my surgeon today and looks like my intuition was right that something was wrong. The plate is not tilted enough and is why I am getting so much pain on the extension. The surrounding tissues are very irritated and that’s why I’m experiencing the pulling. I am happy I got the answers but am not happy I need to have a revision surgery  He is hoping he can just fix the partial if not he will be doing a full knee replacement wich I do not want to happen. 

He also gave me a cortisone injection and I bought a brace to help in the meantime. 

Make damned sure he is named & shamed - carefully - don't want anything libelous BUT you will not find info re failed ops - long overdue.

Lesa,

Very sorry to here that!  I am hoping that I don't have something wrong with the way I can't walk normal.  I have my month and 1/2 appt next week and I will tell him what is going on.  

So fix the partial?  How will he know it is fixed?  Is he going in, sewing you up and then if the same thing happens give you a total?  So when you try to straighten it hurts a lot?

I am curious why the Dr. should be shamed and named?  There is not one person on the face of the earth that doesn't make mistakes.  And he might not have made a mistake, her body might have moved it, or a certain move, or rejection etc.  But I do not see why anyone would want to ruin someone's life because they tried.  If the Dr. said oh well to bad, work it out and see what happens, then I can see to bring him to light.

I hope you don’t either. Yes it’s impinging on the bone. He felt it was placed correctly at the time,it’s catching under my knee cap. It’s not off by much but enough to cause me pain and not be able to fully extend leg withought major pain. I am not very happy at all but he feels he can just do an adjustment on the partial, not having to replace it all, but you always have the chance once in things won’t go that way. I’ve shed my tears and have to prepare for this hell all over again. I have lots more questions to be answered . Should I continue getting this partial adjustment  or just get a full knee replacement . We have had a trip planned for over a year , that we leave on in 2 weeks for our 25th Anniversary . I will see him when I’m back and guess make the decision. Not how I wanted this to go but what can I do? I just want out of pain and be able to walk properly. He has started all the paper work so will happen quickly.  Please keep me posted on what your surgeon says. I knew something wasn’t right and am greatful he aknowledged it, and wants to fix it. Hoping the cortisone shot gives me a bit of relief while away.

Indeed. We know there are risks of things not going right when we agree to surgery. Horrible when it doesn't work out but never impossible. I worked as a dental nurse for ten years. Even with the very best surgeons things can not work out.

My experience shows far too much complacency to the huge consequencies of failed advice / ops.

Yes we all make mistakes but this APPEARS to happen far more often & there is no data base which shows No. of ops v No. resulting in problems.

Huge-research,

I understand the need for a data base for understanding failures, that would be prudent.  I would have a tendency to think the medical field has one for continued progress.  I would venture to say that mistakes will always happen, every day to almost every one.  There are so many variables like how does the individual heal, what did they do, do they have other issues that break down bone faster, heal slower, heal faster etc., etc..  I would think the way to go is have a patient data base so they can record healing processes and issues to help the medical field go forward.  A Dr., is usually disbarred for abuse of drugs and patients.  I think we should report abuses not a "possible" mistake, especially when no one knows if it was due to the body rejecting or some movement or...

There are data bases:  https://www.ncbi.nlm.nih.gov/books/NBK236556/

Agreed Jenny, even the best maintained machines, computers, programs (which eliminate human error) can break down and causes issues to the output.  I do not agree with slam dunking a Dr.  I have a good example of one that should be reported.  I broke my foot and had a Dr operate.  He told me he had years of experience 25 or something and I thought he was young so talked to him a little about it and he gave me a story.  So he operated on my foot, put in screws, plates, and 1 metal joint.  My foot was MESSED up.  I lost my job and insurance with it, was in a wheel chair or on crutches for a year.  I went back to him, told him my issues.  He said well that's to bad but you don't have insurance to pay for any more help so I'm not helping you.  That is one a..hole Dr.  I found another Dr. that was sympathetic to my story and helped me for pennies on the dollar.  He found out the last Dr. had screwed the screws right through my joints so as I walked the screws were breaking my bone off.  The new Dr. took care of it but my foot is forever not quite right.  Oh the original dr had to saw through the bone, same as a new knee, and so he had to put a pin through the top of my top and it went all the way down and into my foot.  The pin held my toe on.  Well he pinned my toe to my foot off to the side and a little twisted.  On my 1st return visit to my original Dr., I told him it was sideways and he said, oh that is no problem, it will straighten.  Well he was wrong.  The 2nd Dr. that actually helped me said I should sue the 1st Dr. ( a powerful statement coming from another Dr.).  I looked into it and since my 2nd Dr. worked with my 1st one here and there in surgery he did not want to be a witness.  I would have had to get an expert witness that would have cost around $2,000.  Money I did not have since the year in a chair I made money by selling flowers online.  I had 2 kids, no husband and was just making it by.  A mistake, by a Dr., wanting to fix it should not be penalized.  

Lesa,

I would wonder if your flexible?  I would venture to say that if your flexible things can move around before everything is solid.  Just a guess.  There is another shot, that vets give to horses in joints.  It is a thicker liquid and works better than a cortisone shot.  I forget the name, maybe hyaluronic acid.  If you ever may have to get the other half of the knee done, I would just do it now.  How does a fake joint wearing on real bone fair as in time before the real bone is wore down by it, if it is? 

https://www.premierortho.com/knee-injury/partial-knee-replacement-versus-total-knee-replacement-right/

THE PROS AND CONS OF PARTIAL KNEE REPLACEMENT

When it comes to surgery, less invasive surgery nearly always results in decreased blood loss, less pain, and quicker recovery. A partial knee replacement is no different, and typically results in a better, faster recovery for patients. Unfortunately, partial knee replacements are only recommended in a limited number of cases. When there is a possibility that a patient’s knee problems will get worse over time, which is usually the case, a partial knee replacement patient may eventually need a total knee replacement. When this is the case, it is much better to perform just one surgery than to perform multiple surgeries.

Evening Catherine, well, whilst respecting your views, im afraid I do not agree with them.

I have no interest in suing anyone or vilifying anyone but surgery is hugely expensive & if you have had a knee op. damned painful & requires huge dedication & effort to get the best out of the op.

i sought detailed info & researched many consultants but nowhere will you find info re  poor outcomes, in fact, it’s the Consultants who volunteer to provide info for the data base - turkeys do not vote for Xmas.

How can you possibly make a judgement other than by the number of ops. & the date of the ops without a quality factor? You could probably gauge the ability / quality of the surgeon by reputation in the industry? - well, this is the route I took & still I believe that the outcome / manner / concern / attitude / approach  / aspirations / contradictions /solutions were / are pretty poor. As said, I was meticulous. 

As you say, no-one makes a deliberate mistake but there must be access to a source which allows qualitative judgements to be made AND of course regular failures should be identified & addressed - but not in house - a separate independent / non- political body should oversee.

I harbour a concern that poor performances are MUCH more common than we are led to believe; its for this reason I was attempting to discover if there were many other recipients of the Oxford Unicompartmental knee who’s outcome was also poor (accepting that “poor” is subjective).

I hope all goes well for you and you end up pain free.  I too have a lot of pain with my outer knee when walking, it snaps and makes me want to fall.  I am hoping it is just all the scar tissue being pushed aside and with that it pulls other parts in there...I am hoping.

I read your other entry and I, like you, respect your opinion.  My mom was in pain 2 years plus, now she walks 10 miles a day easily and said she would do it in a heart beat again.  She had both knees done, 1 year apart.  I hope this type of outcome is the same results we all can expect!