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Author Topic: Should I try again for chondal implant or TKR?  (Read 1013 times)

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Offline fluffysmom

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Should I try again for chondal implant or TKR?
« on: August 06, 2007, 08:00:02 PM »
Hello,

I'm pretty new here, and am at a loss.  I've had knee problems for many years.  I had a revision reconstruction on my left ACL May 26, 2006.
I did my rehab like a woman on a mission.  I walk a lot, and do water aerobics.  I had last follow-up with OS Jan 07, and he told me my knee was in great shape and would last a long time.  I had the op report, so I asked him about the grade 3 and 4 chondromalacia on femoral trochlea, medial femoral condyle, patellofemoral compartment, etc.  He told me not to worry; that it didn't mean I would get arthritis anytime soon. 

In March and April I stayed with a friend with stairs and a recumbent bike.  Soon my knee was popping and hurting and then aching all the time.  I asked my Sports & Spine med doc about it, he sent me for an MRI, said I have a large chondal defect that needed OATS and suggested a OS.  I saw OS, who said my defect was too large for OATS; I needed large allograft chondal implant and would need to be put on a waiting list, but said that my original OS should take care of it, since he knew the inside of my knee.

I saw original OS, who was put off that I had seen other OS, said I wasn't a candidate for any surgical intervention, and would have to rely on viscosupplemention and tough it out until I was old enough (I'm 45) and worn down enough for a TKR.  I got his chart notes and he made very bad comments about me.

My question for all of you, is should I try again, or "tough it out".  I'm making appointments for Euflexxa and PT (my left quad is atrophying), but am afraid of things getting worse.  My hips are hurting.  I try hard not to limp, but it's not always possible.  I would really appreciate any input.

Thanks,

Kathy (Fluffy's Mom)
1991 lft menisectomy
1994 lft ACL
1998 rt menisectomy
1999 rt ACL.
Large chondral defect, medial femoral condyle, grade 4 chondromalacia femoral trochlea, patellofemoral compartment lft knee Both shoulder acromioplasty, '01, '05 
'86 compression fracture of T-7
SI joint hypermobile & arthritis

Offline Nettan

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Re: Should I try again for chondal implant or TKR?
« Reply #1 on: August 06, 2007, 09:40:00 PM »
I would never go back to the original OS..he doesn't sound like he has some interests in you. I would go back talk with this new OS or get a third opinion if that is possible and from that find a surgeon you feel confidence in and make a decision in how you should move on.
There are several here among that is younger then 45 and have had TKR.
Surgery 6 times left knee torn meniscus, RSDS,chondromalacia, nervdamage cause constant nervpain,chronic inflamm.
Spinaldamage wheeler 100%.
Right knee damaged aug-06, use brace surgery 4/9-07.LCL tear.

Offline fluffysmom

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Re: Should I try again for chondal implant or TKR?
« Reply #2 on: August 06, 2007, 10:39:20 PM »
Thanks for the reply, Nettan. I can't go back to the new OS because he's in the same office as the first OS and won't see me.  I'm looking into finding an OS that is interested in helping me.  I've also contacted the OtisMed Corporation that has a newer way of doing the TKR that has an easier recovery time.  They sent me the name of an OS not too far from home, so I have a place to start.  My sports & spine doc has been helpful; I see him for Prolotherapy in my SI Joints and lower facet joints in the morning.  I'm in Oregon, so my time is so far off from most people posting here.  Oh well, glad to know you're there!
1991 lft menisectomy
1994 lft ACL
1998 rt menisectomy
1999 rt ACL.
Large chondral defect, medial femoral condyle, grade 4 chondromalacia femoral trochlea, patellofemoral compartment lft knee Both shoulder acromioplasty, '01, '05 
'86 compression fracture of T-7
SI joint hypermobile & arthritis

Offline Nettan

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Re: Should I try again for chondal implant or TKR?
« Reply #3 on: August 07, 2007, 07:05:22 AM »
I hope this OS will be good and help you out. So awful when docs says there's nothing to do, deal with this.
Like you I am long way from most members here..Sweden. But over the net we can try help each other though distances.
Hang in there.
Surgery 6 times left knee torn meniscus, RSDS,chondromalacia, nervdamage cause constant nervpain,chronic inflamm.
Spinaldamage wheeler 100%.
Right knee damaged aug-06, use brace surgery 4/9-07.LCL tear.

Offline Sandy_F

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Re: Should I try again for chondal implant or TKR?
« Reply #4 on: August 07, 2007, 12:32:22 PM »
You are not too young for a TKR.  I had my right knee done at 45 and my left at 48.  Of course that does not mean I recommend it.  If you can get relief other ways then I would persue it.  Get second or even third opinions.  Make sure that whatever route you choose that the OS is experienced and that you are comfortable with the game plan.  Know your options and choose what is best for you and your circumstances.
Right knee - 14 surgeries including a fulkerson, patellectomy and finally a TKR.  Left knee - Lateral release, microfracture, TKR, then another LR, spacer replacement.

Offline fluffysmom

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Re: Should I try again for chondal implant or TKR?
« Reply #5 on: August 08, 2007, 06:48:02 AM »
Thanks for the support!

I had my Prolotherapy injections today; three shots down each side of my lower back / SI Joint.  Ouchy, but I know it will help.  I am doing all I can to put of more surgeries until really necessary.  The chondral implant sounded like too much pain and recovery time for iffey results and all that nwb time, then to have it possibly last only a few years, or to have it fail.  I've had two opinions, will wait for other measures to have effect before I pursue another.

I see my new PT tomorrow and hope he can help me strengthen my quads and the rest of me so I can put off the TKR a while.  I start the Euflexxa injections on August 16th.  I'm going to my Aqua Moves class in the morning ( have to take it easy for a couple days because of the injections).  I'm doing all my body can take to give my body the best chance of holding together.  Now if I could just lose thirty more pounds, that would help.  I've lost more than 80 but I've been bouncing up and down since my last surgeries and increased pain.  I bought two new healthy cookbooks this weekend; one on lowfat vegetartian Indian cuisine.  Now I need to cook!  I already have a huge bookcase of healthy cookbooks that helped me lose as much as I did.

My best friend is a compliance officer; works for a Radiology Billing office and Cigna Health Care.  She belongs to Medical orginizations.  Her daughter works for a company in CA, showing sugeons how to use new clamps and other latest technology.  Between all those connections, I should be able to find a caring, competent OS who is truly interested in finding out the best course to take with my knee, and who isn't afraid to peek at the other knee (last MRI in '03 showed bone on bone) and see how it's fairing.

I'd better head for bed.  The question is, do I take an ice pack with me?  Prolo works best with a good inflammatory response, but then again, I have to be able to sleep.  Sigh.  Thanks for being out there, women!
1991 lft menisectomy
1994 lft ACL
1998 rt menisectomy
1999 rt ACL.
Large chondral defect, medial femoral condyle, grade 4 chondromalacia femoral trochlea, patellofemoral compartment lft knee Both shoulder acromioplasty, '01, '05 
'86 compression fracture of T-7
SI joint hypermobile & arthritis















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