Banner - Hide this banner

Author Topic: New to board with questions-surgery is 6-29  (Read 1153 times)

0 Members and 1 Guest are viewing this topic.

Offline Sterlingroses

  • MICROgeek (<20 posts)
  • *
  • Posts: 1
  • Liked: 0
New to board with questions-surgery is 6-29
« on: June 19, 2010, 06:01:37 PM »
I am a 54 year old female with Grade 4 chondromalacia, most of the arthritis under the knee cap. Also diagnosed with psoriatic arthritis on top of the osteo. Left knee has been most problematic in the last two years. Tried Euflexxa, worked for a while, physical therapy, Enbrel, antibiotics and now, scheduled for arthroscopy 6-29. My OS and consults all said TKR is not the way to go at this point as I am not "bad enough" I have had the knee drained 6 times in the last year along with multiple rounds of steroids and cortisone injections. Doc said he expects to find the need for ACL repair, possible synovectomy and/or patellectomy. My MRI's have never shown a meniscal tear.
I am concerned about removing the knee cap as I know I will need a TKR down the road. What is a partial knee replacement? Why not just do the TKR now? I used to run and work out 7 days a week and now on crutches. I have a consult set for this week before the surgery by another well qualified doc as I want to know what he thinks.
I am so concerned about doing the right thing. I really like my doc and trust him. He's excellent and has a great reputation here in Houston, Tx. I am just confused. THis is my first knee surgery after years of dealing with the arthritis.
Looking forward to hearing from you folks

Offline will1129

  • Regular Poster
  • ***
  • Posts: 105
  • Liked: 0
Re: New to board with questions-surgery is 6-29
« Reply #1 on: June 20, 2010, 06:12:26 AM »
I heard surgery for arthritis isn't that helpful, but I'm not an expert.
Deeply regret having knee surgery...hoping it can be fixed.

Offline Lottiefox

  • SuperKNEEgeek
  • *****
  • *
  • *
  • *
  • *
  • Posts: 2393
  • Liked: 16
Re: New to board with questions-surgery is 6-29
« Reply #2 on: June 20, 2010, 10:11:29 AM »
Sometimes a general arthroscopic clean up and wash out *can* help arthritis symptoms and stop the joint being so inflamed but it does depend on the degree of damage in there and how the joint responds. Everyone seems to be different.

One thing - PLEASE do not let them remove your kneecap. PLEASE! It is a very outdated procedure and will affect the whole dynamics of your leg and walking and muscles. How have they concluded you need an ACL repair too? Does it show as damaged on MRI or functional tests?

You should ask about your suitability for a partial patello-femoral joint replacement. (PFJR). Check out information on this through the Information Hub on here and also look at some of the Post Op diaries from people like Snorunner, KW, Kris, TwoBadKnees. This replaces the trochlear groove lining where the kneecap sits and the back of the patella so that beter function is kept. It can be converted to a TKR at a later stage if your other compartments also need it. Its a major op but far less severe than losing your kneecap. You need a patella specialist to go through this with you, but please please be wary of anyone who wants to take your kneecap off.  :(

Don't be confused - you owe it to yourself yo educate yourself about your knee and the options. These are big surgeries but with the right one you can get some excellent results. Please don't be rushed into anything.

Good luck

Lottie  :)
Bilateral patella OA since 2009, no surgeries.
Euflexxa working well x3 to current
Right forefoot CRPS post fusion surgery 2011
Refusing to let the ailing parts stop me....

Offline crankerchick

  • SuperKNEEgeek
  • *****
  • *
  • Posts: 1863
  • Liked: 26
  • How 'bout them Cowboys!
    • Derotation osteotomy & TTT Post-op diary
Re: New to board with questions-surgery is 6-29
« Reply #3 on: June 20, 2010, 01:55:16 PM »
One thing - PLEASE do not let them remove your kneecap. PLEASE!


There are MANY other options before removing a kneecap. I'm sorry, but any doctor that even entertains the idea of removing a kneecap would be first on my list to crutch away from as quickly as possible.

Everything Lottiefox has said is spot on and I would only add that even with PFJR, TKR, what have you, the alignment in your leg needs to be corrected if that is what has caused the wearing behind the patella. Sometimes the wearing over the years is caused by a structural issue that causes the patella to track improperly. That root cause has to be addressed first. Sometimes, addressing that is enough to get the pain under control, and sometimes joint replacement is still necessary. Either way, I agree with Lottiefox, it is very important to educate yourself on the options and seek multiple opinions from qualified patella specialists. Is your OS a patella specialist? What kinds of imaging has been done so far to assess your knee besides an MRI?

I would also like to note that you are in Houston, TX and there is fabolous surgeon there that just happens to be a patella specialist and most certainly would not entertain the idea of removing a kneecap. He would, however, do a good set of x-rays, possibly a CT scan, and a thorough physical examination (inlcuding testing your knee for laxity such as would result from a torn ACL). He's worth a third opinion if you ask me, a random person on the internet. Which, you did ask, LOL, so there it is.

Click the link in my signature if you are interested. You've got nothing to lose.
« Last Edit: June 20, 2010, 02:01:05 PM by crankerchick »
Mar '07 - plica excision
Oct '09 - femoral + tibial derotational osteotomy & TTT
Aug '10 - hardware removal
"You control your leg. Don't let it control you." -Smart trainer
"Get your a$$ in gear and go for it! Nothing will happen until you make it!" -Smart doctor

Offline KW

  • SuperKNEEgeek
  • *****
  • *
  • Posts: 1408
  • Liked: 1
  • My new PFJR...Love It!!!!
Re: New to board with questions-surgery is 6-29
« Reply #4 on: June 20, 2010, 07:28:48 PM »
I am in total agreement with Lottie and crankerchick......DO NOT GIVE ANYONE PERMISSION TO DO A PATELLAECTOMY!!!  Your Patella is VITAL to a functioning knee and removal should be a total last resort!  Please get more opinions (2nd, 3rd, 4th.....) before allowing any OS do such a DRASTIC procedure.  Crankerchick can point you to a very good patella specialest in Houston, Tx...Go see him and find out more about your options.
Right Knee
2000 - 2002 - Scope,LR,TTT,Unscrewed
01-10-12 - PFJR

Left Knee
04/07 TTT/LR
08/07 Bone Grth Stim
10/07 Loose/Bent Screw
1/08 Unscrewed/MRI~NON-UNION
02/19/08 Lt  TTT Revision W/Graft
12/09/08 Scope
05/15/09 Scope
09/04/09 PFJR/Unscrewed