Banner - Hide this banner





Author Topic: TKR gone bad as well as revision and original DR. to blame??  (Read 2142 times)

0 Members and 1 Guest are viewing this topic.

Offline ritzput

  • MICROgeek (<20 posts)
  • *
  • Posts: 2
  • Liked: 0
TKR gone bad as well as revision and original DR. to blame??
« on: January 06, 2011, 02:55:22 AM »
I had my TKR 2007 and had severe pain in inside of knee.  3 months later surgeon sent me to fellow DR. for 2nd opinion.  That Dr. said looked ok and NO overhang according to xrays.
Continuous problems, swelling and pain and numerous different PT didn't help.  Had to have it forced bent 4 months later which set me back almost 2 months!  Went back to original surgeon and they suggested i see associate who's known for knee revisions.  He said i did have some instability and that a revision could work by  increasing thickness of poly-exchange.  I believed him and had that done 1/2010. Felt slightly more stable after wards but continuous swelling and pain and instability.
Just went to 2nd doctor in December with all my medical records, test results and xrays.  They viewed original post op xrays and current ones and said i definitely have tibial plate overhang and that the tibial plate is seated below fibula which means instability from the start and didn't understand why a tibial stem was cemented in as that's mainly for severe osteoporosis.  Suggesting more PT to build up quad but seems like first Dr. basically screwed me!!  Only fix is another TKR plus i have a tibial stem and all is cemented.

Trying to research online to find specific guidelines to where tibial cut should be and is it a judgment call on surgeons behalf?  So far i found:
"There is no specific guideline for level of tibial cut except that it should not be below fibular head."
Considering I've been complaining of pain due to overhang since post-op in 2007, I'm confused how original surgeon denied there wasn't any overhang and never said anything about instability and yet associate does revision admitting to instability?
Recently had cat scan which shows overhang both sides and that tibial plate is even with fibular head causing too much space between femur and tibia resulting in my instability since 2007!!  I'm absolutely shocked and angry.  I just can't understand why first surgeon didn't say anything......fear of law suit....that's so disappointing as i really had faith in them both.
Found Doctor at Columbia Presbyterian and is head of knee dpt.  Going to get 3rd opinion there to try and understand if original Dr. really made this mistake or is all this simply a judgment call on their behalf and us patients are the victims of their bad judgment calls!  Is this a case of "Doctors code of ethics?"  That only leaves me with 4 years of intense pain and only more in my future.  Is there Ortho Doctor here that can answer some of my specifics to guidelines of tibial cut and how much overhang is ok?
« Last Edit: January 06, 2011, 03:10:58 AM by ritzput »

Offline fischbein

  • MINIgeek (20-50 posts)
  • **
  • Posts: 42
  • Liked: 0
Re: TKR gone bad as well as revision and original DR. to blame??
« Reply #1 on: January 07, 2011, 05:05:47 PM »
WHILE I AM NOT A DOCTOR I DO HAVE A PhD. IN KNEE PAIN.  AFTER 12 KNEE SURGERIES AND A FAILED T.K.A., I AM WAITING FOR A REVISION THE END OF JANUARY.  THERE IS A VERY HIGHLY RESPECTED RESEARCH PRACTICE KNOWN AS THE ANDERSON ORTHOPEDIC INSTITUTE, OUTSIDE OF WASHINGTON D.C RUN BY DR'S. ENGH, (UNCLE AND NEPHEW) AND DR. WILLIAM HAMILTON.  DR'S. ENGH HAVE WRITTEN ON A NUMBER OF SURGICAL KNEE PROCEDURES, SOME OF THEIR WRITINGS APPEAR ON KNEE GEEKS, OR YOU CAN FIND THEM ON THE INTERNET.  I THINK THE ACTUALLY WRITE THE STANDARD STEP BY STEP PROCEDURE FOR VARIOUS KNEE REVISION SURGERIES.  I HAVE BEEN TO JOHN HOPKINS, UNIVERSITY OF PITTSBURG BONE CENTER, GEORGE WASHINGTON UNIVERSITY BONE CENTER AND I FOUND NO GROUP AS SKILLED AS THE DOC'S AT THE ANDERSON CLINIC AND INSTITUTE.  THEY ACTUALLY HAVE A COMPLETE FLOOR ON A MAJOR HOSPITAL OUTSIDE OF D.C. DEVOTED TO ONLY THEIR KNEE PATIENTS.  THEY HAS MANY ARTICLES ON ALMOST EVERY ASPECT OF REVISION SURGERY YUOU WOULD WANT.  I WOULD SUGGEST YOU READ ABOUT THE INSTITUTE AND THEIR DOCTOR'S PUBLISHED WORKS

I WENT TO NEARLY 10 UNIVERSITY PRACTICES BEFORE I SET ON DR. HAMILTON TO DO MY REVISION LATER THIS MONTH.  IF YOU CAN GET TO SEE THEM THAT WOULD BE GREAT, IF NOT ON THEIR WEB SITE THEY HAVE A LIST OF THEIR FELLOWSHIP TRAINED PHYSICIANS THROUGHOUT THE UNITED STATES, AND WORLD.  THEY HAVE A MAJOR FELLOWSHIP TRAINING PROGRAM FOR BOARD CERTIFIED ORTHOPEDIC SURGONS WHO SPEND A YEAR LEARNING FROM AND WORKING WITH THE DOC'S A AT THE INSTITUTE.  THEY RECRUIT FELLOWS ALL OVER THE WORLD AND IT IS ONE OF THE MOST DIFFICULT POST GRADUATE PROGRAMS TO GET ADMITTED TO.  AS I SAID THEIR WEB SITE HAS A LIST OF THE DOCTORS WHO COMPLETED THEIR FELLOWSHIP PROGRAM SO IF YOU CAN'T GET AN OPINION FROM THE DOC'S AT THE INSTITUTE DIRECTLY ONE OF THEIR FELLOWS WOULD BE A GOOD BET.

OF COURSE BE VERY CAREFUL ON WHO YOU CHOOSE FOR ANOTHER SURGERY, AS YOU HAVE FEW SURGICAL OPTIONS AND IF A SECOND REVISION WERE TO GO BAD, YOU COULD BE LOOKING AT ATHRODESIS OR WORSE.  THINK EVERY STEP OUT AND TAKE THE TIME AND EFFORT TO SEE THE BEST UNIVERSITY STAFF DOCTORS YOU CAN BEFORE YOU MAKE A DECISION.
GOOD LUCK,  IF YOU WANT YOU CAN CONTACT ME, I POST ON KNEE GEEKS AS (FISCHBEIN)















support