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Offline John in GA

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arthrodesis- how procedure is performed
« on: July 20, 2010, 05:59:15 PM »
Hello y'all,
I am completely new to this type of site and so far I'm not really sure to find any replies that I might receive.

Before I go into my tale of wo, and bore you all to tears, this is my question and the answer is very important.

Yesterday My ortho Doc told me that the pain in my knee was due to the loosening of the prosthesis in my TKR.  ( After two revisions within 18 months of the original TKR.)  He says now  I probably need a knee fusion as he is reluctant to do another revision.  It has been about 15 months  since my last revision.
He is a Knee and Hip guy and admits he has never performed a fusion and that he has to meet with his colleagues to decide how to procede.  He said that a rod would be put in my leg from my hip to my ankle.
Also that after the fusion is healed, I would get used to the stiff leg and that my life would continue as normal as ever.  Even said that I would be able to play golf again, which I have not played in the three years I have been dealing with knee.
I hope this isn't boring anyone..... I want to know what the procedure entails, How the  fusion was done and the time it took to be completely recovered.  Even the name of a Doc close to the Atlanta area who performs the procedure.
OK, here is my tale of wo.  Three years ago I tore the meniscus in the left knee.  That surgery led to the 1st TKR.  All was going great until I fell off a ladder 3 months after and broke my leg just under the implant ( Tibia plateau fracture)  After 12 weeks in an external fixator the implant was revised as it had come loose due to the fracture.  I left the hospital with a low grad fever which lasted three months.  The pain was so bad the doc wsas perplexed until a large abcess appeared on the side of my knee.  Back into the hospital, Implant removed and 6 week on antibiotics with the pic line and knee spacer..  After the infection was cleared up another revision was performed  I hve been in pain since for the last 15 months or so.  The doc said too much scar tissue etc.  Now he feels the fusion is all that is left.
From what I have read so far on this site no one seems satisfied with theirer fusion.  I am 66 yoa and have read artilces that state older people should forgo the fusion for an amputation.  Needless to say I am quite concerned about what my nest step is going to be.  The Doc is supposed to call me within a day or two to advise me what he has found out.  I sure could use an immediate response to my question, if for no other reason , to put my mine at ease. 

Thank you to all who have read  this and have some encouraging information for me.  John in GA.

« Last Edit: July 22, 2010, 01:37:51 PM by John in GA »

Offline KW

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Re: arthrodesis- how procedure is performed
« Reply #1 on: July 20, 2010, 06:23:29 PM »
Hi John,

I'm sorry you have such a tale to tell. While I don't have any direct experience with the procedure you are being proposed I do have one very general piece of advise...Consider getting another opinion form a OS that specializes in problematic TKR's. While you local OS may be a great OS the problem you are having might be completely out of his league.  Large teaching hospitals are generally good places to start looking for someone with more specialized experience with complications .  You would not want to make such a huge decision without seeing another set of eyes.

Best of luck!
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

Offline crankerchick

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Re: arthrodesis- how procedure is performed
« Reply #2 on: July 20, 2010, 06:47:05 PM »
I echo KW's sentiments and add this for a bit of help:
Dr. Thomas Branch is supposed to be good with the joint replacements.
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 Lottiefox

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Re: arthrodesis- how procedure is performed
« Reply #3 on: July 20, 2010, 07:00:58 PM »
I would echo the suggestions to seek another view - if only to confirm what your OS is saying. Clearly you have a complex medical history and your OS knows you and your knee. BUT - fusion is final. No going back. So, I'd be looking to just confirm that this is the ONLY way. I don't know anyone with a knee fusion but I have met two people with ankle fusions and they were functioning well, one was even skiing and the other was rock climbing! The knee is clearly a larger and more fundamental hinge in the leg but I guess people do adapt. I'm facing a big toe fusion - and even that little joint being made stiff scares me so I can only guess how much you are feeling. If you do end up with fusion you also need a surgeon who will do it right - I understand that despite it being a joint destruction it is critical it is done properly or else it won't solve the problems.

I'm sorry you're dealing with such a tough situation and hope you get some answers,

All the best

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 John in GA

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Re: arthrodesis- how procedure is performed
« Reply #4 on: July 22, 2010, 01:49:59 PM »
Hi Y'all
Thank you for the info and the good wishes.
My OS has sent me to see another OS who is quite experienced with knee reconstruction.  I guess neither is too happy with the Fusion idea.  I will know more tomorrow 7/23.

**Personal note.  I use Y'all only because I try to keep my sense of humor.  I am a New York Transplant to GA. 
To my Cowboys friend........................GO GIANTS...........thanks again to y'all--- there I go again.
John in GA ;D

Offline caneguy

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Re: arthrodesis- how procedure is performed
« Reply #5 on: September 05, 2010, 08:59:47 AM »

I have a knee fusion exactly done the way they suggest for your case. I have a rod in my leg from hip to ankle. After surgery I was walking with crutches pretty well. Directly after surgery it was hard to get up from bed, it was very painful. But after 4 weeks it was much better. After 4 months I could walk without any aids and I was totally pain free. I drive a car with automatic transmission and the drivers seat was slightly modified with a block-out. In my case it is my right leg that was fused. Of course you had less issues with driving if your left leg was affected. Today I walk well, have no pain, drive my car. I am happy with my knee fusion.

Since 2005: wear a legbrace to keep the knee straight. I have suffered from a rare syndrome.
Around 2008: knee is now ankylosed, but not bony fusion yet
December 2009: definite, surgical knee fusion with a long nail

Offline John in GA

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Re: arthrodesis- how procedure is performed
« Reply #6 on: September 10, 2010, 02:19:40 AM »
Thank you for your reply.  As of now my OS has not made any decision on a course of action.  I had a nuclear CT scan and it show an condiserable uptake.
We are dealing with three options. Live with the pain w/ "pain management" -- fusion, which he feels will leave me with a leg about 6 inches shorter-- or the "A" word.  At least now, I can still walk my dog down the street, wearing a brace and using a cane.  I am expecting a call from my OS soon.
Your information has been most useful to me.  Thank you again.......J