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Author Topic: My new knee: a Stryker Triathalon  (Read 3184 times)

Offline Erikka

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My new knee: a Stryker Triathalon
« on: October 18, 2011, 01:19:31 PM »
Today is the one year anniversary of my TPF accident. I thought I was getting better after surgery and going through four months of rehab. But as soon as I tried to start walking again, my levels of pain increased. I knew something was wrong but the surgeon kept looking at the x-rays and said everything was just fine. 

I was nervous and pretty scared about having a total knee replacement. It seemed drastic. Maybe I could just have the hardware removed? Did I really have to have my leg chopped in half?

I kept getting worse and worse, practically on a daily basis. 

I had the surgery done with a new surgeon on September 8, almost six weeks ago. When he had my knee open in the OR, he saw that the structure had crumbled. The surgical repair had failed. I was never going to get better. 

There were monuments of excruciating pain the first few days, but they kept me well medicated for the most part in the hospital. You can stand and put weight on your foot hours after the surgery when they make you get up. It strictly depends how much pain you can tolerate, but you are fully weight bearing from the start, at least with my doc. I used a CPM in the hospital several times a day and had PT twice a day. 

I was in the hospital for only four nights and I came home. A therapist came to my home for physical therapy for four weeks. I was a recluse for those four weeks. They ordered a CPM machine for me at home. The therapist wanted me to do my exercises twice a day and use the CPM and save my strength. He didn't want me to do any extra walking beyond what I needed to get to the kitchen, bathroom, etc. Basically, if I was awake, I was sitting up in bed with my iPad or a book. 

 I hated to see him leave. I get pretty attached to caregivers. I could have had more therapy if I really wanted it, but the doctor really didn't want me to have more therapy now. The doctor said it was time to start going back out in the world and returning to my regular schedule. If I don't improve over the next three months, I can have more therapy then. 

So, how am I? I feel good but not perfect. From Day 1, I felt steadier and more balanced walking than I ever did last year after the TPF repair. My ROM is 125. I'm supposed to do something twice a day. I can do one set of exercises and take a walk, or two sets of exercises, and I can go out. I can drive. I can go up and down steps. I'm just starting to take walks. I'm going to NY in two weeks and think I'll be able to get around pretty well. And it's only six weeks. I'm supposed to get better for the first three months following surgery, and then continued gradual improvement for the whole year.    
10/18/2010 Fell -didn't see a step in the dark
10/19 -Surgery, plate, 3 long and 4 shorter screws
10/23 Transferred from hospital to rehab
11/6 Went home from rehab NWB, in-home PT
12/1. WB 50%
1/7/2011 Full WB, no brace yay! Driving again. OP PT
3/23/2011 discharged from PT
9/8/2011 TKR

Offline Grandhoux

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Re: My new knee: a Stryker Triathalon
« Reply #1 on: October 19, 2011, 08:04:43 PM »
Hi, Erikka, glad to hear your tkr has gone so well after your initial disaster. I just hope it keeps improving for you.

In a couple of weeks I see my surgeon (in France) to find out what will be the next step for me (no pun intended, I think). I'm now 3 years on from my traffic accident and broken femur a year later. I had all my hardware out a year ago and can get around but I feel my knee has reached its optimum and is now slowly deteriorating. Nothing concrete, it just feels less stable, seems to be bowing more and is getting a bit 'clicky' again. Not a great deal of pain but a little more than there has been.

On the tkr thread in the arthritis section I've asked the question 'is a tkr the answer'? You seem to be happy with yours, have vyou got any advice for when I see the surgeon?

Dave
Accident in France 1st December 08. TPF, plate and 7 screws
22 weeks later, now only 6 screws!
11 months, slipped and broke Femur. Plate and further 10 screws in femur
16 months now only 15 screws, another came out!
2 years hardware removed.
January 2012 High Tibial Osteotomy to straighten leg.
tkr?

Offline Erikka

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Re: My new knee: a Stryker Triathalon
« Reply #2 on: October 20, 2011, 07:03:04 AM »
Hi, Dave. Thanks for your good wishes. Regarding your balancing, I was at the point where it would take me probably 30 seconds or more to rebalance before I could walk every single time I got up. After this surgery, I never had that unsteady feeling. The therapist in the hospital made me wear that stupid belt because I guess unsteadiness is not unusual, but I felt very centered and stable immediately.

I wish I had something really smart to tell you before you see the surgeon. I do still have some of my lists of questions for my doc, so here goes, but first, have you been using the same surgeon all along?

The truth is, both of my surgeons are very highly regarded. My new doc praised the work of the first doc, and stressed that a TPF is such a bad, messy break that a poor outcome is not unusual. But the big difference became clear over a period of months when I was having appts with both docs.  The first doc became defensive and kept telling me how good things looked and was not responsive to my pain and my concerns. I felt like the second doc really leveled with me. He said because my knee was compromised, the recovery might take longer and not be as close to perfect as someone coming in with an arthritic knee. He said the knee joint really looked bad to him. He said that physical therapy during the first 6 weeks is critical, and that what you can get in ROM in 6 weeks is what you get. You don't really improve after that point. I appreciated his honesty.

But I digress. Here are some of my questions:
How much improvement can I expect in returning to normal (pre-accident). A: 95-100%
what about just taking out the hardware? A:the joint surface is too irregular and that's causing the problem
Is my bone strong enough? (My surgery was about 5 weeks short of a full year from the accident)
Do you know what is wrong from the CT scan?
What knee do you use and why?
Is this a gender knee?
Do you use cement?
Staples or glue?
Will there be much bone left?
Will I set off alarms at the airport?
Do you use the CPM machine in the hospital?
Will I have a CPM at home? A: yes
Do you remove some of the scar tissue during surgery?
How long is the hospital stay? A: 3-4 days (don't go in on thurs or Friday)
Do I go to stay at rehab? (I stayed at a rehab facility for 2 weeks after the TPF) No, a therapist came to my house for 4 weeks.

Well, I hope this is some help and gives you something to think about, and triggers other questions you should ask. Good luck, let me know what happens after you see the surgeon.   
 
10/18/2010 Fell -didn't see a step in the dark
10/19 -Surgery, plate, 3 long and 4 shorter screws
10/23 Transferred from hospital to rehab
11/6 Went home from rehab NWB, in-home PT
12/1. WB 50%
1/7/2011 Full WB, no brace yay! Driving again. OP PT
3/23/2011 discharged from PT
9/8/2011 TKR

Offline Grandhoux

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Re: My new knee: a Stryker Triathalon
« Reply #3 on: October 23, 2011, 07:16:59 PM »
Hi, Erikka,

thanks for that. Unfortunately I have to take what I get with surgeons over here in France. As we're in the country there isn't a lot of choice although my surgeon has a good reputation locally. He did my original emergency operation and it was complimented by the surgeon back in the UK. I'm here in France partly because they have stopped routine knee ops in my home town in England due to budget cuts and also because the French insurance company won't even talk to me unless I'm in France.

My hardware came out a year ago and it was an improvement although a small part of the scar hasn't healed properly yet. I do give my knee a hard time, for example, in the last week I have cut down 5 trees, logged them, split and stacked the logs and built a large bonfire, moved about 3 tons of timber, dug the garden and built a rockery moving all the soil and rocks with a wheelbarrow . I can't walk too far but I do try, but after a tough week the knee gets very tired and swollen quite quickly.

I'm hoping (if they propose a new knee) for some input on the implant as I've heard some good things about the Smith and Nephew one and the fact that it should last about 25 years is a plus. In reality I think they'll just shove in a French one as everyone knows they're the best! ( ::)) I may sound negative but that is how it is over here, unfortunately. I have to be grateful if they operate.  :-\ I'm a bit nervous that I'd wear out a new knee but I find it difficult to slow down as I'm about halfway through renovating an old house.

Dave

 
Accident in France 1st December 08. TPF, plate and 7 screws
22 weeks later, now only 6 screws!
11 months, slipped and broke Femur. Plate and further 10 screws in femur
16 months now only 15 screws, another came out!
2 years hardware removed.
January 2012 High Tibial Osteotomy to straighten leg.
tkr?

Offline Erikka

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Re: My new knee: a Stryker Triathalon
« Reply #4 on: October 25, 2011, 02:53:11 PM »
Hi, Dave. Well if you don't get a choice, I hope you really like your surgeon! It still won't hurt to ask some questions so maybe what I wrote will be helpful in some way or trigger questions of your own.

OMG! You are tremendously active! Yes, you are demanding a lot from your knees!

I didn't research the brands. My doc uses what he uses and he likes it. The hospital has a class 'what you need to know about your TKR' and they did say that at 6 in the morning (and all day, of course) the reps are standing by with all sizes and parts that the docs might need for their surgeries. Woe to the rep that doesn't have exactly the needed part!

Keep us up to date on what happens. Good luck!. 
10/18/2010 Fell -didn't see a step in the dark
10/19 -Surgery, plate, 3 long and 4 shorter screws
10/23 Transferred from hospital to rehab
11/6 Went home from rehab NWB, in-home PT
12/1. WB 50%
1/7/2011 Full WB, no brace yay! Driving again. OP PT
3/23/2011 discharged from PT
9/8/2011 TKR

Offline morgana

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Re: My new knee: a Stryker Triathalon
« Reply #5 on: October 25, 2011, 04:56:49 PM »
 :o   Wow - the reps are standing by?!?

Thanks for the info Erikka!  It has been illuminating. Hope your healing continues at a remarkable pace!

Grandhoux;D you are hard on your toys aren't you?!  Good luck on your continuing home reno projects!  And may your surgeries be smooth with immediate relief!
5-26-08 Severely comminuted bicondylar fracture-right tib plat - locking plate & 6 screws  Bicycle Accident
nwb for 12 weeks
6-12 started pt
7-21 added swimming
8-25 pwat with walker
9-02 four prong cane
10-07 cane
10-15 cane as needed,slight limp
10-27 OS:next visit 10-2009

Offline Grandhoux

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Re: My new knee: a Stryker Triathalon
« Reply #6 on: October 25, 2011, 08:46:17 PM »
I think I should move to The States! Here in France they have yet to hear of 'Customer Service' or 'Choice'. As for 'Reps', the only ones in this backwater are selling animal feed and ugly pills!  :-\

Fortunately I have one excellent knee to go with the shot one, I'd like to get the same from a replacement. I'm managing OK in some ways at the moment but walking any distance is the problem; the bad knee just starts swelling. I can stand up for long periods, kneel and lift, mainly because my good knee is incredibly strong. As soon as I go on to my bad one it lets me down.

As for my surgeon, to say he's 'a little abrupt' is being nice to him. I was speaking French on one appointment and he just said "tais toi!" (shut up!), "Speak English, your French isn't good enough". The next appointments he would only speak French! Unfortunately he's supposed to be the best around these parts and I don't know of another anyway.

It certainly makes life challenging interesting!  ;)
Accident in France 1st December 08. TPF, plate and 7 screws
22 weeks later, now only 6 screws!
11 months, slipped and broke Femur. Plate and further 10 screws in femur
16 months now only 15 screws, another came out!
2 years hardware removed.
January 2012 High Tibial Osteotomy to straighten leg.
tkr?

Offline Erikka

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Re: My new knee: a Stryker Triathalon
« Reply #7 on: October 29, 2011, 03:12:13 PM »
@morgana: I guess the surgeon has an idea what size knee he'll need but when he actually has your leg open, he can be precise. I think the reps have all the likely sizes. It's pretty cool! Glad it was interesting to you.  Thanks for your good wishes. Still some pain but it's diminishing. Going to NY city next weekend and hope to do some real walking. Have my fingers crossed. 

@grandhoux: well, surgeons aren't known for being warm and fuzzy people. Hopefully he's good at what he does, even if he's short on people skills. Incidentally, almost from day one, my new knee felt more stable and stronger than it ever did with the TPF repair.

Incidentally, I've had a terrible thought. My husband always says I follow cars too closely and I don't want to have to slam on my brake. Well, last January, when I started driving 12 weeks after my accident, I did have to slam on the brake one time. I fear and wonder if that could have jarred the surgical repair and caused all my misery.
10/18/2010 Fell -didn't see a step in the dark
10/19 -Surgery, plate, 3 long and 4 shorter screws
10/23 Transferred from hospital to rehab
11/6 Went home from rehab NWB, in-home PT
12/1. WB 50%
1/7/2011 Full WB, no brace yay! Driving again. OP PT
3/23/2011 discharged from PT
9/8/2011 TKR

Offline Grandhoux

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Re: My new knee: a Stryker Triathalon
« Reply #8 on: November 02, 2011, 08:21:53 PM »
Hi, Erikka,

I've just posted the following on the tkr thread in the Arthritis section:

Thanks everyone for your replies. After my meeting with the surgeon today it looks like the tkr will not be for some time yet. I'm too young and a bit overweight, although it's mainly my build though I could lose up to 30 pounds if I really had to. (I weigh 200 pounds now at 6 feet tall)

His main concern with my knee is the bend which he measured at 15 degrees from true (compared to my right leg). I've been booked into the hospital for surgery on 24th January when he will saw through my tibia just below the knee joint and then trim off a wedge to straighten the leg up. It means taking off about 1/4 inch on one side so I'll no longer be 6 foot!

The problem is it's essentially a broken leg with an incision so after about 4/5 days in hospital I can't put any weight on it for a month, then 1/2 weight for a month and back to work after 3 months ... as long as it goes OK! He also says I have to stay in France so he can monitor progress. As we live in the country, 1km from the nearest small shop and 15 km from the nearest small town, and as my wife can't drive it's going to be a buggar for 3 months! And it sets back the building work somewhat!

Bloody lorry driver!   >:( >:( >:( >:(


Looks like a new knee will have to wait. I just hope this resolves the problems and I can start walking more. I'm not particularly confident but he insists I need to get rid of the bend or it will just get worse and the pain will become too great in a few years. I see it as a prelude to a tkr, sort of ,preparing the foundation'.  :-\
Accident in France 1st December 08. TPF, plate and 7 screws
22 weeks later, now only 6 screws!
11 months, slipped and broke Femur. Plate and further 10 screws in femur
16 months now only 15 screws, another came out!
2 years hardware removed.
January 2012 High Tibial Osteotomy to straighten leg.
tkr?

Offline Erikka

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Re: My new knee: a Stryker Triathalon
« Reply #9 on: November 04, 2011, 05:59:26 AM »
Oh, man. Thanks for the update. It makes sense about getting rid of the bend and straightening out the leg. It won't be easy, but I know you'll get through it and you'll be in better shape for the future after the surgery.

I'm sorry. I can't think of anything more upbeat to say, but I know it will be a big improvement from today. I'll be thinking of you often!
« Last Edit: November 04, 2011, 06:00:59 AM by Erikka »
10/18/2010 Fell -didn't see a step in the dark
10/19 -Surgery, plate, 3 long and 4 shorter screws
10/23 Transferred from hospital to rehab
11/6 Went home from rehab NWB, in-home PT
12/1. WB 50%
1/7/2011 Full WB, no brace yay! Driving again. OP PT
3/23/2011 discharged from PT
9/8/2011 TKR

Offline Grandhoux

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Re: My new knee: a Stryker Triathalon
« Reply #10 on: November 04, 2011, 10:22:08 AM »
Thanks Erikka. The more I read about the procedure the longer the name gets! At the moment it's a closed wedge high tibial osteotomy, there is a fair bit of published literature on it here (http://www.kneeguru.co.uk/KNEEnotes/node/2154) and elsewhere. The prognosis looks good although it's another one of these long recovery things like a tpf. It seems like 6 months to a year is the norm! Oh, well, I've been there before!  ::)
Accident in France 1st December 08. TPF, plate and 7 screws
22 weeks later, now only 6 screws!
11 months, slipped and broke Femur. Plate and further 10 screws in femur
16 months now only 15 screws, another came out!
2 years hardware removed.
January 2012 High Tibial Osteotomy to straighten leg.
tkr?