The OSTEOARTHRITIS DEPARTMENT => KNEE ARTHRITIS - Unicompartmental knee replacement => Topic started by: amy1 on July 02, 2008, 01:25:33 AM

Title: partial question
Post by: amy1 on July 02, 2008, 01:25:33 AM
I have severe patella femoral arthritis.  It is unclear whether I have arthritis in the other joints.  My doctor said that a nuclear scan would identify whether or not there are hot spots in the other compartments.  He said if I am a candidate for a partial, then it would take about 8 weeks for a "custom implant" to be made.  Are all partial implants custom?
Title: Re: partial question
Post by: rottenkid on July 02, 2008, 05:05:21 AM
There are so many partial knees on the market now. If your doctor is looking at custom fit I would go with him, it has to be better then generic. Some of us here had resurfacing done which in some cases like mine is considered a partial knee replacement. I had the hemi-cap system installed which is very custom job. The surgery lasted about 2 1/2 hours Mt knee cap along with the troclear grove were fixed with implants. I was walking within a week and full flex at 16 days. Now the down side I am 6 months post op have not returned to work yet and I probably will never kneel again. I am however pain free in daily activity's so there is a trade off. Are you having an enhanced MRI were they inject your knee before they scan you? If your doctor will let you start up physical therapy a few weeks before surgery to build up the quad muscle trust me that will help. Also get him to get you a ice machine I have the polar 300 and love it!
 Good luck with your knee
Title: Re: partial question
Post by: amy1 on July 02, 2008, 06:31:30 AM
Thanks for your response.  The doctor wants to examine the old mri's more closely.  If the old MRI's show arthritis in the other compartments, than I am not a candidate for a partial and it is all a mute point.  If the MRI doesn't show multicompartmental changes, he would order a nuclear bone scan which he said is more accurate than a standard MRI.  It would show any "hot spots" areas that were starting to break down. I am guessing that the nuclear part is contrast.   He did mention that the troclear groove would be rebuilt which would help the knee track better. My trochelar groove is now nonexistent for the most part.  He said that the partial is made based upon the information provided from the scan and takes about 8 weeks to receive.  He would most likely have to resurface.  I am currently taking water based PT.  I know that my doctor was instrumental in getting ice machines in every room on the orthopedic wing.  I would definitely go home with the ice machine that you an control the temp settings, even if I had to purchase it for about $140.00.  I used it twenty four seven for the first week or two following my realignment. Did you use a CPM machine?  My doctor said that high impact sports, sports with lots of twisting and rotation and extensive kneeling would be out.  For my job, I have to walk - flat surfaces, get in and out of chairs and from time to time, get on the ground to work with the kids. I sometimes have to move around a lot especially working with the autistic and preschool disabled kids.  However, no lifting or kneeling is required for my job.  I DO NOT sit in kids sized chairs....just adult sized chairs for the sake of my poor little knees.  My goal is to be able to walk pain free, maybe even go on a  two hour hike over even terrain.  I would love to ride a bike, swim and from time to time dance.....nothing crazy but just once in a while normal going out for an evening a doing a few dances.  Oh yea, going up and down steps without cringing at the thought would be awesome.  Could you imagine sitting in a car without having to constantly stretch your knee out so it doesn't cramp up on you? No more rice krispies in my knee!!!!  Wow, I could sneak up on my husband and kids without the crunching giving me away lol.  I am just looking for pain free or even just pain free most of the time with a few minor twinges of a 2 or even 3.  I could definitely live with that.  I am so tired of never knowing if I am going to wake up with the good, kind knee or the evil masochistic knee that loves inflicting pain on others!!!!!!  I used to go four to six and sometimes eight weeks with minimal pain not exceeding a two or three and then go through a one week flare ups.  While annoying, it was tolerable.  Now, I am lucky if I go through a week with minimal pain followed by two or three days of the evil knee doing its stuff. Unfortunately, I am not getting the longer respites in there.  On a bad day, I try to modify my activities at work as much as possible and wear my breg pto knee brace with takes the edge off.  When the flare up is bad, I keep my crutches in the car....just in case.  My doctor is big on keeping ahead of the pain with meds (he will prescribe adequate meds) and ice machine, For a TKR he gives a spinal for medication the first few days when pain is at its absolute worse and then weans off and puts you on the other meds.  He believes in getting quickly into rehab and keeping that knee moving to avoid scar tissue.  At this point, we are not sure if I am a candidate for a PKR. I would do a partial more quickly than a total at this point.  At least the partial is more easily changed if need be.  Are there other jobs you can do that don't require kneeling?  Would the dept of labor retrain you so that you can find a job with comparable pay that would not mess up your knees even further?  Didn't you mention that at work they were giving you a hard time about not being able to kneel due to your disability.  You should have legal protection under Americans with Disabilities Act.  Hopefully you have a good lawyer who understands the ada law.  Worse comes to worse, that could make a really good expose on 60 minutes or your local news show...if you catch my drift. Poor individual, hard working for years suffered an injury still willing to work hard but with some modifications.  The big mean cooperation is going to abandon you in you time of need after providing them with years of good services!!!!!!!!!!!!!!!!!!!!Good LUCK  keep me posted

ever feel like a car that makes a horrible sound for a week.  You bring it in to the mechanic and the sound goes away.The next day, the sound comes back.  THats what happened on my last doctor visit.
Title: Re: partial question
Post by: rottenkid on July 02, 2008, 02:50:09 PM
WOW $140 for an ice machine. Mine was $1100 and it looks like it should of been around $50. I lived on a CPM machine the first two weeks after surgery that and vicodine. I know what you mean about the rice crispy knee. I thought the sound would go away with the surgery but it hasn't. Every time my gets inflamed my knee makes noise. I do have to say that I can walk around with little to no pain and distant doesn't bother it terrain does any slopping area especially down hill bothers it. Kneeling is a joke anything more then a couple of minutes and it hurts. Sitting doesn't bother me even long car rides are fine now as long as I can stretch out my leg from time to time. Planes are uncomfortable because of the tight quartered however. My damage was very specific do to an accident I had two major lesions one on the femur in the troclear grove and the other on the bottom of my patella. The grove got a chrome molly implant and the patella got a plastic implant. Both very custom fit pieces. You should be able to sit in the little chairs and on the floor it will just be a little different getting up from those positions. I can swim, bike and hike right now with little to no pain. Impact sports or what I like to call real sports are gone forever. My current job that I haven't been at in 18 months requires lots of kneeling and crawling. I don't believe I will be going back to that job. I am open to other positions and am looking forward to change as long as its good change.
Take care and keep posting, you will find a lot of good people on this site.