Worried and anxious

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I had TKR in June 2018, my knee has been paining me since day one. I had a review 5 weeks after and told everything was ok....I wasn't called back since, so I had to contact hospital for an appointment which I had last Monday...7 months post op,

I was so shocked when I was told my knee implant is loose and stretched....he told me I had 2 options...1, do nothing and wear a knee brace or 2, have the operation again..( revision )

This was based on an X-ray and physical examination. I have decided not to have op again, I'll wear knee brace and pain relief.

I had blood tests done and told if I dont hear from them everything normal and if abnormal they'll be in touch.

I'm so worried and frightened and anxious now because I got letter to have an aspiration done next Friday...

Does this mean I might have an infection in my new joint and might have no choice but to have the operation again 😨.

The surgeon's secretary told me my bloods were a little off and nothing to worry about...I'm convinced this is just something they tell everyone....

Please help with your thoughts, I'm hoping if I have an infection it's only superficial and anti-biotics will work...or maybe i have no infection at all, they just doing aspiration to rule out infection...I'm so nervous, I'll be feeling sick until I know. Has anyone out there have similar problems.

Rose

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  • Posted

    A friend of mine had a very similar experience to yours. He did go ahead and have the revision and he said within three days he felt like a new man. It’s been a couple of years since he’s had it done and he says he doesn’t even think about his knee anymore. So sorry you were having this problem. Makes me realize my clicking is bad but I could be in so much worse shape. Praying you get some help.

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  • Posted

    Dear Rose, Oh! So so sorry you are having that problem. I have had 4 surgeries, and two replacements on my right knee over the last two years. I am 6 mo out from the last surgery and happy to say I am doing fine, still hurts and swells but nothing like it did before and it gets better and better. I didn't have the same issues as you, it was an ill fitting partial then extreme arthritis set in. But, I felt scared and depressed, like I would never be able to walk again. But, TIME and working with my doctor and physical therapist has brought me to a successful knee replacement. So, be patient and try not to be scared.(not easy) I read when we worry it makes the cells in our body less able to heal so I found a really nice healing meditation to practice everyday to stay calm. Also, I asked for help in prayer. I will keep you in my prayers. Wishing you the best.

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    • Posted

      Thank you Leslie, was second operation more painful than 1st..

      My knee is also the right knee...I believe your right about worrying, does make things worse...I'm working on prayer and I too, will get my meditation book out.

      Rose

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  • Posted

    Hi Rosemary, No, the second surgery was not more painful, it's just been a long time dealing with pain, and two years of not being able to do much and used to a busy active life. I had to have shots to boost my blood levels but it was no big deal. I worried unnecessarily. It did however , take a year and a half to get my wits to decide on another surgery. There is a very nice guided mediation on you tube called Cells Healing the Body under Mind Set if you have trouble finding it. It's calming and gets the mind to settle down. And, if you can, try to keep up exercises, not so much weight bearing but some you can tolerate even doing them on your bed. My blood pressure is an issue if my heart isn't kept active so I did 50 sit ups a day and leg lifts, arm weight exercises, anything to get the heart rate up, it also helped with depression. The meditation, if you can find it, helps to focus on you where you want to be.

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    • Posted

      Thank you so much Leslie for your advice and help, I will look that up on you tube..I am active enough, some days more than others..I heard revision is more painful than the initial op but I feel today I will get it done again if I have to...I mean how unlucky could I be for it to go wrong a second time...I also have an issue with depression...

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  • Posted

    Sorry to hear about your problems. When they do blood tests they are checking your SED rate and your CRP and maybe your white cell count. Of course there are also a few other tests they can do that take a week or two to get results for.

    If they are higher than normal, there is the possibility there is an infection going on, Unfortunately implants can be "magnets" for bacteria. The safest thing to do is open up the incision and either, 1. Clean out the site, implant some antibiotic eluting beads, close the site and follow with a course of antibiotics, or 2. Do, what they call a two-step revision where they implant a spacer so you can bend the knee and get around, after removing the implants of course, followed by waiting 4 to 6 months or longer to make sure the infection is gone and then replace the implant.

    If the implant is doing well, at our hospital, they like to try to save the implant because the original, if it's working well, is always better than the second one. Why? Because when they remove the first implant, they have to scrape bone away and there is less to work with for the second implant. NOT to say the second implant won't be good also but, like I said, the original (if it is working well) is the best.

    My wife chose the first option and is recovering now with antibiotics through a PICC line and maybe a year (or more) of oral antibiotics to make sure the infection doesn't come back.

    Hopefully your test results will come back negative and you won't need option one or two.

    Let us know what the results are (they have to tell you, if you ask) and what country you are in.

    Good luck!

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    • Posted

      Hi Robert, thank you for your very knowledgeable reply...I'm happy to hear your wife is recovering well, I think I would go for option 1 also if I had to choose.

      The blood tests that were carried out, are, D-Dimer, and ESR....I will be told these results on Friday 8th .....also that day I'll be having aspiration on knee...I'm concerned why I'm having this done ? Did bloods show something abnormal ? 😨 I live in Ireland

      Rose

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  • Posted

    Hi Rose im going through the same ordeal at the moment. i had my TkR in september 2017. It's been a tough recovery and after my one year anniversary i had a repeat xray where there is a dark patch at the top of the Tibia. In order to see my consultant i had to see him privately and he took one look at the xray and said it looks like its moved. He sent me for bloods which are all normal and a bone scan which shows a lot of activity in the left knee indicating that the implant has become loose probably due to an infection. I've been referred to another consultant who wants to aspirate it as soon as possible but my blood pressure is too high to do anything yet. I'm in the hands of my GP who is being over cautious and even a BP of 142/81 Is too high in her opinion. The new consultant said that if the loosening is caused by an infection he can always put a plastic joint in so at least i can walk about and bend my knee. i will require 6 weeks of IV antibiotics. I asked why my blood results are normal if he suspects an infection and he said that infections in joints can stay contained and are different to any other infection. He said in his opinion he thinks the infection is where the dark patch is. I'm also worried as I'm only 49 and I was planning a trip of a lifetime in September to Japan to celebrate a special birthday x

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    • Posted

      Hi snooze.. they are very quick to suggest another operation....you'd think it was a picnic we were going for😡 that should be the last resort after trying everything else....and both yours and mine consultants say " they think" a lot...think is not good enough...." sure " is the word I'd like to hear not " think "!!I'm sick of this now to be honest with you..I wasn't told about the risks....and I like you had plans for this year, thinking I'd be like a new woman after this TKR... I'm worse than I ever was before...how do we know that it wasn't fitted properly in the first place...and whats the guarantee the same thing won't happen 2nd time....do they want us to let them open up the same scare again and just carve away more bone until they get it right...it's just like carpentary work. Sounds like another infection waiting to happen in my option.

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  • Posted

    Morning Rose - Im in a similar position, in that I had my LTKR in June 2017. Albeit I had no prior experience, it didnt feel right from the start. Some 17 months on and (after a referral to a proper surgeon) my knee has finally been condemned. Many issues, the main one being the lower prosthesis wasnt fitted in a straight line. Unfortunately, the top prosthesis needs to be removed to get at the lower one, so I have a similar choice - Remain in pain and unable to do much at all, or opt for the revision. As I said to the new consultant, 'there is only one thing I want less than to go through that again and that is to remain with my current TKR situation'.

    Unfortunately Im now on the NHS waiting list, which seems to slip each week making any planning for the next 12 plus months impossible. The TKR was a disaster, so I wont be having the other leg done, but I do need the first one to work, so a revision it is. I used to think my knees hurt like hell, hence the TKR's, but having experienced post-tkr pain for over 18 months so far, my pain threshold has increased dramatically....

    Famous last words, but I dont see how it could be any worse than it currently is...

    All the best should you choose the revision route.....

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    • Posted

      Hi Peter, it is so good to hear from someone in same state as I am, meaning I can feel your pain and struggle everyday and how you feel.

      I have so many questions Id like to ask you if you don't mind?.

      Are you really angry? because I am..I plucked up the courage to have this TKR done after a lot of thinking as I am absolutely terrified of hospitals, feeling proud of myself for doing it afterwards and endured the pain after wards in between the morphine injections and pain killers...and now they are telling me I need it done again, 😡🤢🤮😱😨...like you I haven't had a day free of pain since I had it done 21/6/2018...I still have to take 4 tramadol a day and some days a couple of paracetamol also...

      Another question how did you find out your lower prosthesis wasn't fitted straight...

      I was just told my knee replacement was loose when I asked did he see that on x-ray he said it was by my story and physical examination that x-ray doesent show all problems..

      The surgeon that did my knee has retired so it was a different surgeon I'm seeing now.

      Did you get an apology for the error they made...

      I'm furious as I know my knee hasn't been fitted properly either.

      I'm like you I don't have private health insurance so I was waiting 18 months for the operation date...you should be a priority patient now and not have to wait again..

      Have you found the pain, stiffness and soreness holding you back? It has added years to my life, every is so hard to do, I'm 60 since last May ans feel about 80 ,and I bought a step counter for after op to go for long lovely walks with my dog and I was all set to be really active and enjoy life, I thought I was going to be a new woman, as many people told me I would, 😫☹ such a let down, I'm in more pain now then before I got it done....hope to hear back from you as your problem is so like mine.

      I hope you will be placed on a priority list, they owe you that after messing up first time.

      Rose from Ireland

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    • Posted

      Morning Rose - I don't have a word to express my anger, but Im somewhat resigned to my situation. Im unhappy with the poor installation, then having to endure 2 MUA's and plenty of excruciating physio. To be then told by the same surgeon that I had chronic pain syndrome as a way of explaining away my pain. The surgeon was adamant that my problem was with a 10mm cartilage he fitted and almost talked me into having an 8mm fitted a few weeks after. Thankfully I didn't as the knee is a little 'floppy' as it is and an 8mm would have made things worse.

      I'm even more angry that the hospital who did my knee are private (but my procedure was funded by the NHS) who after bouncing me around to see a couple of their other surgeons for a second opinion, finally condemned the knee (after MRI and full leg length xrays), yet told me to get lost and I am now on the (continually slipping) NHS waiting list.

      I'm off the pain killers as they don't do a great deal and I'm keen to avoid issues down the line from taking so many. I still have carrier bags of the stuff lying around, as I took so many in the first few months. I do however take a couple of paracetamol when I have to walk the dog...

      One of my other 'issues' is that my leg wont bend beyond 90 degrees and that is what I would call a 'physios 90'. It was down to 70 degrees before my second MUA and had a high of around 110 in the very early days. This is made worse by the fact that my knee cap is poorly located, so as and when it used to exceed 90 (during both MUA's) it hit my lower prosthesis. This probably explains why after the first MUA I was in so much more pain than after the tkr. The surgeon who condemned the knee stated that 3 of the 6 parameters that define a decent tkr were missed. My lower leg was bowed pre-tkr and still is, despite that being one of the main reasons for the tkr, so as before my weight runs trough the inside if the knee.

      As if that wasn't enough, I was also told by the proper/grown-up surgeon that he would have snapped the lower bone, made it straight, screwed on a plate and 6 weeks later things would have been very different. i.e. the knee would still hurt when in use, but not when its not. Essentially, he wouldn't have done a tkr !!! That makes me pretty cross too !

      My main problems are therefore a misaligned lower prosthesis and an incorrectly sited knee-cap. Problem is that the top needs to be removed to get at the bottom !!

      Absolutely nothing in the way of an apology. Worse still, should I wish to sue the hospital and surgeon, I cant as the NHS paid for it.

      Aside from the pain, even putting on a sock is so frustrating and painful with limited bend. I cant even reach to cut my toe nails..

      I too did this so I could walk more, not less, so a complete disaster. Driving (my source of income) is unpleasant due to the sloppiness in the knee. It rattles and eventually becomes painful.

      I'm 54 and this year was planning on a holiday, celebrating my 25th wedding anniversary and my daughters 21st. The first 2 are out of the question as I'm unable to plan anything.

      My passion is and (since first being stopped by the Cheshire Police at 14 with a saucepan on my head) always has been motorcycles. My surgeon was also a biker and I was absolutely assured that my riding wouldn't be affected. Of course it is as my knee doesn't bend. Despite having a custom seat made and my footrest extended by an engineering company I cant ride in any degree of comfort and that makes me very, very angry.....

      I'm going back to see my GP this morning to raise the stakes and demand something is done sooner.

      On another note, I heard from an old friend (whom I found on this forum after many years) who just yesterday was told she needs a revision. She went to the same hospital as I !

      Rant over. For now...

      Peter from Surrey....

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    • Posted

      Hi Peter

      I'm in Surrey too. Which hospital were you in? My local hospital is Kingston, but all the knee and hip surgeries are performed at the Elective Orthopaedic Centre in Epsom. http://www.eoc.nhs.uk

      I saw my surgeon in October and had TKR in January. Because they only do elective surgery their waiting lists are not as long as other NHS hospitals. I could have had my operation in December, but we were away for Christmas. I couldn't fault the care I had. They do take referrals from outside the area, one lady came from Manchester. It can be done under the NHS choose and book option. Have a look at their website. They have an excellent reputation. Wishing you all the best for the future.

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    • Posted

      Hi again peter, I think it's dreadful what has happened to us...you were making plans with your family for this year and I bought myself a step counter with the intention of getting really active this summer after missing all last summer due to TKR in June...the surgeon made it sound like I got a bad hair cut not a major operation...when he was telling me I had to get it done again.😡 I'm taking actions about this. My life and yours are on hold now...not to mention the time we have lost already and with pain..what does MUA mean Peter and I don't know anything about the workings of the prosthesis...you understand 8mm and 10mm I just trusted the surgeon to do the job properly. I believe it's like carpentry work..ie putting a judge on a door..I was told my knee is loose that why I in pain...so it was fitted too loose, how can i get the surgeon to admit that...when I asked him he just said some surgeons fit them loose to obtain range of motion...how can that make sense...that's such a shame your hobby motor cycling is now not fun anymore, ( funny story about saucepan on your head as a kid ) 😆. Yes you do right going to your GP ...and ask for asap revision...they have taken enough time off your life already.

      Rose

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