SURGICAL DISASTER

[dave t]

After going in for a half knee replacement that would supposedly last around an hour and a half, i came round after 4 and a half hours. I was told my knee was worse than expected and that a full knee replacement was carried out.

When the nurses changed shifts later i heard them saying i'd had a full knee replacement and surgery to mend a severed medial knee ligament.

When i questioned the surgeon the next morning as to what had happened to my medial ligament he nonchalantly said he had accidently severed the ligament at the start of the half knee op so had to repair that and carry out the full knee op from the other side and this was the first time in 30 years he'd ever made this mistake.

The physio grimmaced when i told him the state of my knee and the fact that the ligament was severed and not torn was very serious when it comes to the long term strength of the knee. Plus the fact that the 2 operrations overlap in healing time was a problem.

I am needless to say quite distraught at the minute after waiting so long for this operation, and i really need to know the long term prognosis and the level of seriosness involved with a severed medial ligament.

I was assured pre op that a half knee replacement if not satisfactory still left the possibility of a full knee op to correct anything, that cushion has now gone i was also told i'd be walking un aided after 2 weeks, i now have no idea for how long i will be layed up. Needless to say i will be takiing legal action against the surgeon and any advice people have on that front is very welcome.

thank you

[maryc]

Sorry about all this.  I wish I could offer something else besides healing rays for a speedy recovery.

[MartinsGirl]

I'm so sorry Dave,

Like Mary, I can't offer any advice or help. I'm just very sorry and will have you in my thoughts.  I also think you should re-post in the "Emergency-crisis room thread". that's where you go to post about surgery complications, mistakes, etc. I'm sure a LOT more people will see it there, okay? Right now you're in the general question room. WHat you're going through is definitely more of an emergency/complication. Post here:

http://www.kneeguru.co.uk/KNEEtalk/index.php?board=5.0

Good luck. So sorry.....
~Nevella

[FormerlyActive]

Hi
So sorry to hear your story. First thing I would do is write down everything you remember the nurses said also the doctor and the dates, times, all to the best of your recollection. Type it up and sign it.
Next get a copy of the surgical report and if they made a tape, a copy of the tape.
I would try to find out if something like this is fairly common, if it is his first one in 30 years I would guess not.
I would file the appropriate documentation with the hospital's ombudsman or whatever they are called where you live of the incident.
You have some choices and you should find out what they are. In some states in US now if they make a major mistake they won't bill your insurance or it will be a reduced bill. I'm sure its more expensive for a full than a partial.
Good luck and let us know.   

[jathib]

I'm kind of confused as to why he even repaired the ligament. Last I knew, when they did a total replacement they removed all four ligaments anyway. It might have been an issue if you had a partial replacement because they don't cut any of the ligaments for that.

[ATsoccergirl]

Most surgeons will retain all four ligaments, although some less skilled surgeons will remove the posterior cruciate ligament.  In order for a total knee replacement to be sucessfull the four knee ligaments must be balanced to allow for proper biomechanics of the joint.  This is the hardest part of the surgery.  From the biomechanical changes associated with osteoarthritis the ligaments can become contracted.  Balancing the ligaments involves releasing the contractions and attempting to restore the knee to it's pre-arthritic level of alignment.  Without proper balancing the knee replacement can feel, in some cases, too tight, or more commonly, too loose.  The resulting instability, and looseness feeling, is the most common cause for a revision arthroplasty.   

The removal of the PCL is more of a convience factor for the surgeon, as it is technically more demanding to properly balance the PCL than any of the other ligaments.  Although study after study has shown that patients have a much better outcome with a drastically lower rate of revision if the PCL is retained and balanced. 

[mark1e]

Amazing. Surgeon makes a major mistake, then proceeds with a major and unplanned surgery and nobody screams bloody murder?
I mean, if the surgeon went from half-knee to total knee replacement he achieved several important factual differences:

• he performed an operation that will require longer time to recover from, resulting in more discomfort, trauma and worse health outcome for the patient
• he destroyed various natural tissues, limiting patient's options in the future and introducing additional risks

I think that the patient should press charges against the surgeon. It's much more than only which insurance covers the cost of TKR operation: it's both the physical and physiological damages done to the patient, plus the cost of the future risk (increased insurance premium, treatment costs, lost income due to future problems, pain & suffering).

[UK Girl !]

bravo to your surgeon I say !

i would have been gutted if he had opened me up and then sewn it all up again  to wake me to say i needed a total and would reschedule it another time when i had signed the relevant forms - did he discuss the possibility of a tkr?  was this ligament going to be removed for the pkr but needed for the tkr and subsequently replaced. I had my ligaments removed for my tkr. All depends on the prosthesis used - he may not have had the right one for how he would have like to have proceded and had to change plan. - you need to ask him !

I absolutely detest all these shouts of sueing the surgeon - ya think they do these things on purpose - why the hell would it be in their interest to mess up your surgery and their reputation !

I think you have to ask your surgeon these questions and take it from there and certainly dont waste your life worrying about what you would have liked to have been a pkr cos u got a whole new one which it appears is often better than having stages  of replacement.

Good luck with it - and remember that your OS has a LOT more knowledg of what he is doing than the physio - you wouldnt let your physio do the op would you !

[mark1e]

UK Girl: If I were to accidentally crash my car into yours, would you sue me for damages?
Starting legal action is OK if any kind damage is done. That's how conflicts are resolved.

[jathib]

I think that the patient should press charges against the surgeon. It's much more than only which insurance covers the cost of TKR operation: it's both the physical and physiological damages done to the patient, plus the cost of the future risk (increased insurance premium, treatment costs, lost income due to future problems, pain & suffering).

Press charges? Geesh, if surgeons got arrested every time surgery didn't go as planned none of them would ever do surgery. There are risks associated with every surgery. We all sign a consent form beforehand and some of us even read them. I knew there could be a possibility of a TKR when I went in to my PKR. According to the original post the TKR was not carried out because a mistake was made but rather because the knee was far worse off than expected. This is not the surgeon's fault. I'm with UK Girl in that I'd be very upset if I came out of surgery only to find out nothing was done. I've come out of surgery on more than one occasion with more than I bargained for because I had more damage to my joint than expected. That is always a possibility going in and it's something we all should prepare ourselves for ahead of time. If you're not psychologically stable enough to accept the possibility that things may not go as planned then you shouldn't have surgery.

I also hate when someone's first reaction is to sue the doctor because things didn't go perfectly or because the doctor didn't tell them about the possibility of 'x' happening. They can't cover every possibility. We all go in knowing we could die on the table yet we still proceed.

[UK Girl !]

Hear Hear Jathib !

Thing is also - if a tkr was needed instead of pkr why would you sue !??!  I would be thanking my surgeon for sure !

[Nettan]

Everyone can make a mistake. But if mistakes are done, they should be reported by the surgeon that made the mistake.
Have you reported what happened or has the surgeon done that ?
In our system if a mistake is done you can get some payment for the damage or the suffering you have to go through.
Check that out before making legal action and have to pay out of your own pocket.

[UK Girl !]

well all i can say is that is my opinion to which I am entitled just as anyone else is ! and anyone who doesnt like it doesnt have to take any notice ! We are all here to help each other - so the more angles we can get on things the better !

I dont know who you are referring to Luckygrandma6 referring to having peoples threads removed  and I understand you have had and are having a tough time of it, but I think that Dave T's case is somewhat different to yours.

Dave - what is the prognosis for your recovery - I assume you are braced and on crutches , doing controlled exercises to build up the quads - which is something that needs a lot of work for TKR as well.


anj

[jathib]

I disagree wholeheartidly that no matter how much a doctor screws up your life they should get away with it. You go into surgery trusting your doctor and what he tells you.

You'll have to point me to where anyone has said doctors should get away with screwing up your life. Nobody has even come close to suggesting that. Doctors are human, they make mistakes, even the great ones. Sounds like this doctor even admitted such. I don't think Dave's life has been screwed up at all. Rather he's going to have a longer rehab than expected. And he has a TKR instead of a PKR. That was going to happen anyway. Not the doctor's fault and not anywhere near close to malpractice. He would have had a TKR even if the doctor hadn't accidentally severed a ligament.

In my case it wasn't what the surgeon did but what he did not do that has left me crippled.

Your case is not Dave's. Not even close.

Why do you think doctors have malpractice insurance. To cover their butts that's why.

Hell yeah, they're covering their butts. And who could blame them when people are so quick to file lawsuits in this country. Doctors can be sued if a patient has an allergic reaction to medication even if the doctor was never told about it and even if the patient didn't know they were allergic to the medication. I'm sure you have liability insurance for your automobile in case you slam into someone. I know I have it even though, in 34 years of driving, I've never caused an accident. All doctors have malpractice insurance, even the great ones.

There are bad doctors out there that need to be held accountable and it is too bad that the good ones have to suffer in the process, but that is life. Good people suffer becauseof bad people's mistakes.

Making a mistake does not make someone a bad person. It makes them human. Making a mistake does not make a doctor a bad person any more than you slamming your car into someone makes you a bad person.

I thnk the same person that screwed up my thread is trying to screw up this one. My advice would be to write to the Moderator and have them removed from your thread. We are here to help each other and we don't need people putting poisones venom into the mix.

I'm pretty sure you're talking about me. Since when is disagreeing equal to trying to screw up a thread and putting poisonous venom into the mix? Supporting people is great, but supporting them unconditionally is counterproductive.

[subail]

All very well said, Jathib...you said quite eloquently what I wanted to say....