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Offline ausforce

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both knees replaced
« on: August 11, 2011, 08:03:54 AM »
Hi, so ok I have had both knees replaced twice, my right seems to be starting to come on fine after 3 yrs however its my left causing trouble. My right has had the patella removed but not the left, about a year ago I fell during rehab and ruptured my patella tendon after two attempts to repair it it has now started to slip lateral side once more. My current doctor is reluctant to do anything just yet, I can't descend stairs  without it slipping and walking over uneven surfaces is a no no. I want to know 1: would you remove the patella? and as this is causing great pain and damage to the knee joint how many time can it be replaced? I'm only 52.

Offline subwayknees

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Re: both knees replaced
« Reply #1 on: August 11, 2011, 05:48:20 PM »
Those are very specific questions, as someone who has had 12 knee surgeries over 50 years, and who has been to almost every major east coast teaching hospital and seen by to docs for a revision after failked tkr I would be afraid to take much stock in any answer from anyone who is not a doctor who has seen you and your x-rays.   Every case is different and while there are general rules regarding the number of revisions that can be successfully performed, etc . there are no patient specific answers by non professionals. It use to be the rule that only one revision could be done successfully, but with bone grafting etc, I do know of people who have had two or three revisions attempted.  As far as pain, it could be from the patella and if it is unsurfaced that could be the cause, it could also be scar tissue, a loose prothesis, nerve damage causing pain or even an infection.  You can easily have an infection in the joint or even on the back of the prothesis itself without having any symptoms other than pain, usually an infection will show as the knee being red or warm but not always if it is under the prothesis.  You really need to be evaluated by a skilled orthopedic surgeon and it may be time to get an opinion for a doctor other than the one who did the initial surgery.  Knee replacement can mean changes in lifestyle and it just may be that you will have to stop walking stairs if it causes too much pain.  I am in a wheelchair now, and can no longer drive at just age 66 from the effects of all the surgeries.  These things can sometimes be very difficult to find the cause of and once the cause is found there may not be simple answer as to the proper treatment.  I live on hugh doses of morphine and my docs from New York to Washington are not yet sure if a revision would help or athrodesis or even amputation, if there is no other way to manage the pain which keeps me in my room five days on a usual week even with morphine.

So be careful about casual advise to specific questions and seek a second opinion form another surgeon who does not work with your original doctor.
God Speed

Offline ausforce

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Re: both knees replaced
« Reply #2 on: August 11, 2011, 06:01:13 PM »
Thanks for that, I know what you are talking about I have just passed 50 knee ops starting back in 1982. they tried everything for me and Iv'e seen doctors from Australia, the US, France UK and Belgium. My current doctor is in France and is at a lose as to where to go next so I'm seeing my old doctor in the UK next week, we have also talked about cutting the knee off but not yet.

Offline subwayknees

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Re: both knees replaced
« Reply #3 on: August 11, 2011, 06:15:23 PM »
Before I would opt for amputation I would suggest the route I am going.  The top knee man at John Hopkins University Hospital, suggested I go to  Hospital for Special Surgery in New York City.  Every independent hospital rating site has them as the number ONE rated Orthopedic Hospital in the U.S. and close to top in the World, it is connected with Wiell Cornell University Medical School.  I have been referred to thier top knee surgeon a Dr. Russell Windsor, he actually only sees cases where there are few op[tions left and apparently has a great reputation for not opnly salvaging knees but for total reconstructions that really improve pain and mobility.  I have an appointment with him the last week in October and will be flying up from Virginia.  One last bit of info, if after you look up the hospital and dr windsor on the internet you decide to make the trip to see him, beware New York Hotel rates,  There is a small hotel only a short crosstown bus ride from the Hospital called The Riverside towers Hotel.  The rooms are small, but clean and the neighborhood is one of the best in N.Y. City, and the rooms come to only about $135 a night.  I attend the Metropolitan Opera frequently and stay there all the time in fact i set my appointment with Dr. Windsor for the afternoon before a Met performance I have tickets for.  I have also checked the Hospital out with orthopedic surgeons at Georgetown University Hospital and N.I.H. and everyone says that The Hospital for Special Surgery is just that,  they take very difficult and specialized oirthopedic cases and get the best possible outcomes.  In my case if it can mean salvaging my leg and giving me my old life back to some degree it will be worth it.
Good luck

Offline ausforce

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Re: both knees replaced
« Reply #4 on: August 11, 2011, 06:58:23 PM »
thank you for that, wrote down the name and will pass onto my professor next week. I could do with a few days in NY.