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Author Topic: Patellofemoral Replacement - neep help  (Read 3503 times)

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Offline dukejeffries

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Patellofemoral Replacement - neep help
« on: October 25, 2010, 05:25:10 PM »
I am 43 years old and active, but the knee is shot and I am a good candidate for PFR.  I consulted with Dr. Lonner of Philadelphia and I am planning to see Dr. GRELSAMER in NY.  I am looking for some real advice.  Lonner told me that the Zimmer PFR implant does not wear out but his nurse gave me a different story.  He has on his website active people that has had PFR saying they run.  Activity level is important to me, I am doing this to be more active not less active, any imput?  Any input on type of PFR implant zimmer vs. Kinamed custom fit in which Grelsmaer uses.  Any other suggestions on the best surgeon for this procedure and can this be done without cutting the quad?  Can the pfr be rivised if something wears out or do you have to go to a tkr?  As you see I'm absolutely confused and I need some real advise.  I would love someone to help me.   

Offline KW

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Re: Patellofemoral Replacement - neep help
« Reply #1 on: October 25, 2010, 06:08:00 PM »
I would suggest seeing Dr.  Lee with Penn medicine.  Fantastic OS...Personally I like him better then Lonner.   I had my PFJR (Zimmer) done 09-04-09 by another fantastic OS at Penn Medicine...Dr Nelson (has since moved to western PA).  I had a much better experience with Dr Nelson and now Dr Lee then I did with Dr Lonner.  The time and attention given to my case was (and still is) beyond anything I could have imagined.

I am TOTALLY IN LOVE with my PFJR.  I am 99.9999% PAIN FREE and able to do anything I want.   I did choose to give up the high impact sports that got me into this position (competitive volleyball mostly) but will be getting on my skies at least once this winter (fingers crossed that works ok!!).  I'm not a runner but have had to jog a few times (me vs.. a bus)...no pain!   

Best of luck,
Karen

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 dukejeffries

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Re: Patellofemoral Replacement - neep help
« Reply #2 on: October 25, 2010, 09:33:46 PM »
Do you know if the zimmer wears out like the plastic buttom, can that specific just be replaced?

Offline KW

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Re: Patellofemoral Replacement - neep help
« Reply #3 on: October 25, 2010, 10:38:33 PM »
Any replacement can ware out if abused consistently.  I don't know the answer to the question about revisions.  I want to say I believe so...As long as the Femoral plate is in good shape.
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 dukejeffries

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Re: Patellofemoral Replacement - neep help
« Reply #4 on: October 26, 2010, 02:16:13 AM »
KW, thanks for your posts.  did you doc. do min. invasive procedure, quad spareing?

Offline KW

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Re: Patellofemoral Replacement - neep help
« Reply #5 on: October 26, 2010, 02:36:07 AM »
Honestly,  thats not something I cared about at all.  I wanted to know that my OS had the skills to get the parts in there right so they were going to work well for a good long time.  How the OS actually got them in my knee was totally up to him.  If I did not have min invasive quad sparing then I'm not sure how much better things could have gone! I had a fab recovery.  I was off most heavy pain meds within the 1st 10 days...only before PT and at night.  I worked with home PT for 4 weeks and when I went back to see my outpatient PT, who I have been seeing off and on for 10 years, his 1st comment was "I have never seen you walk that well".  It did talk me a little linger then normal to get my flexion back but this knee has had a total of 7 surgeries.  I'm at 130* now and 100% functional.  at 6 weeks PO I flew from Philly to Chicago and helped a friend House Hunt (up and down stairs plus in basements).  Over the next 4 weeks I helped pack a house and then flew back to Chicago and unpack.  I could not believe at 10 weeks I was able to do so much with so little discomfort.
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 dukejeffries

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Re: Patellofemoral Replacement - neep help
« Reply #6 on: March 08, 2011, 05:43:28 AM »
how long were you in hospital after surgery?  how long do they recommend not going back to work, I work in a medical office and don't require a lot of being on my feet.  I'm going to see Dr. Lee, I already saw Lonner, but he left the practice recently.

Offline KW

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Re: Patellofemoral Replacement - neep help
« Reply #7 on: March 08, 2011, 12:32:52 PM »
I was in the hospital for 4 day (held captive i like to call it) but could have easily gone home earlier. I started to ask to leave at 3 days with no luck.  The dr's found it funny to find my sitting up reading the paper 2 days after the surgery.

As for work....i worked from home at the time and was back to working at 3 weeks. I did not start making the trip into my office (1.5 hr each way) until 6 weeks. I'm not sure i could have done that earlier not because of pain but because of swelling. The swelling is amazing and takes alot of ice and elevation to controll.

Intresting about Lonner. Wonder where he went?

Best of luck. Let me know how you likw Lee or of you have any additional questions.

Karen
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 FMRCathelete

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Re: Patellofemoral Replacement - neep help
« Reply #8 on: March 10, 2011, 10:41:35 PM »
I am new here, but am 4 months post-op R PFJR by Dr. Lonner.  I am glad to hear you have had a good outcome.  I am not doing so well.  Still having significant pain, swelling and warmth.  New onset of a catching feeling and yes Dr. Lonner is no longer at 3B, and I do not as yet know where he will be.  He has resaponded to my e-mail, but repsonses of little help.  Not sure why he left and he will not disclose to me where he will be, only that he wants to see me ASAP when he completes the transition -REALLY!!! 
Anyone else out there have problems post PJFR?  Most seem to have good results and I am thrilled for them, but frustrated with my own situation.  Thank you for any feedback.

Duke - I met w/Dr. Grelsamer prior to Dr. Lonner and really liked him -was very helpful and took a lot of time with me (& I was 1 1/2 hours late to appt!).  Our experience in NYC was quite horrible though and I could not bring myself to go back -thinking now that was a mistake.  Dr. Fulkerson had referred me to him after my OATS procedure failed to alleviate my pain.
Lat release 5/08
OATS 7/09
PJFR 10/10
Scope, plica removal/synovectomy 1/12
Scope, Medial retinacular release and debridement of excess tissues 2/13
Knee Denervation 3/2014

Offline KW

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Re: Patellofemoral Replacement - neep help
« Reply #9 on: March 10, 2011, 10:52:23 PM »
FMR - I'm sorry you are having some issues.  There have/are some floating around the board that have had tough rehab or bad outcomes with the PFJR.  Some have developed some Nuro issues and some have just need longer to get those muscles back in working order again.

I won't get into the impression I got about Lonner from my meeting with him but if you don't want to wait until after the "transition" I can strongly recommend Dr Lee at Penn Medicine.  He replaced my original OS (Dr Nelson) and has been fantastic.  Another KneeGeek used Lee for a PFJR and was nothing but happy.  Penn Med gives fantastic treatment.

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 FMRCathelete

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Re: Patellofemoral Replacement - neep help
« Reply #10 on: March 12, 2011, 12:22:07 AM »
Thank you KW.  Dr. Lonner is going to be working with the Rothman Institute as per his former nurse - never heard of them before, so will make decision soon.  Find most docs don't want to take on someone else's problem cases.
Lat release 5/08
OATS 7/09
PJFR 10/10
Scope, plica removal/synovectomy 1/12
Scope, Medial retinacular release and debridement of excess tissues 2/13
Knee Denervation 3/2014

Offline *Tiffany

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Re: Patellofemoral Replacement - neep help
« Reply #11 on: March 12, 2011, 12:43:52 AM »
Hi All,

I dont' have time to go into a lot of details.  But just something to consider...I had to have both PFJR's taken out after 18 months and changed into TKR's...at 33 years old. 

Most of my issues were chronic patella dislocations...

I am happy that some are having great outcomes, but this surgery really has to be done for the RIGHT reasons or it doesn't work. 

Rehab wasn't so bad, 4 or 5 days in the hospital.  Walking within a few days. 

Good Luck
Tiffany
Age 8/Bilateral -Lateral Release '85
Bilateral Patella Resurfacing '86
Bilateral TTT '88
Bilateral- Lateral Release '03.     
Bilateral PFJR '05
PRJ to TKR 1/16/07
PRJ to TKR 6/19/07
TKR Revision  8/17/10
Total Hip Replacement 11/5/15
Rt Elbow Reconstruction 4/27/1
Patellectomy 2/2020

Offline KW

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Re: Patellofemoral Replacement - neep help
« Reply #12 on: March 12, 2011, 12:53:12 AM »
Tiffany - You are exactly right...Not only does a PFJR need to be done for the right reasons it needs to be done RIGHT...meaning all underlying alignment issues MUST be corrected or either it will not last or there will be continued issues.  Every OS i saw about the PFJR was very clear about this before going into the surgery. 

To be honest the same can be said for a TKR.  A underlying rotational issue that is not addressed correctly is only going to continue to cause the same issues even with a TKR.

Take care,
Karen
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