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Author Topic: Patello Femoral Implants  (Read 6708 times)

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Offline Yankee

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Patello Femoral Implants
« on: August 22, 2013, 07:17:58 PM »
I'm moving this here from another forum on Vickster's advice:

Hi Everyone,
I'm doing some research into PF Arthrosurface. I have severe arthritis behind my patellas, one ruined by a  surgeon and one ruined by being the only 'good' one and getting destroyed in the process.  I have no other cartilage damage elsewhere, just the kneecaps.  I've reached my limit with the pain and quality of life, so I'm considering it seriously, and actually thought of having both knees done at the same time. I'm not sure how realistic that is. I've read some of the diaries, some good some bad, the promotional videos on the site seem positive (of course they're not going to show the failures), so in my mind, I"ll have them both done, spend a week or ten days at home and go back to work (mostly sit-down admin work). I also live alone, and it is unlikely that there will be anyone who will be spending more than a few hours at any time with me, so how is it to cope with the pain once at home, and how easy is it to be mobile? Anyone have experience with bilateral PF implants?

I have yet to be officially evaluated, they tell me they have to scope it first which is hard enough, but if that's what I need to do, I can deal with it as long as I have hope of getting rid of the pain.  Thanks for any help!

Offline Mr.F

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Re: Patello Femoral Implants
« Reply #1 on: August 22, 2013, 10:55:17 PM »
Hello Yankee,

I had bilateral patella femoral replacement in 2005.  My knees were so bad that my OS recommended that he operates on both knees at once "because he was not sure which knee was worse" and did not want to risk blowing one knee out from all the pressure put on it.
First, 7 to 10 days and back at work.  Good luck.  If you live alone you might want to check into a rehab facility.  It is going to be very difficult to walk, get up and down, dress yourself, physical therapy etc.  I can tell you I went home from the hospital 5 days after surgery.  It took my 20 minutes to put on boxer shorts and socks.  That was just the beginning.  To get from my apartment to my car took another 20-30 minutes.  And this was with the assistance of my wife and a friend.
If you are living alone how do you plan on the following: getting dressed, bathing, using the restroom, cooking, cleaning, driving, walking, and these are just the minor issues?  Are you going to go to a physical therapy center or is somebody coming to you?  If you are going to the center, how are you going to get there, back home, what are you going to do about the pain after PT?
If you do bilateral PFR think about everything and talk to people who had it done. 
Hopefully your will find relief from your pain....
Mr.F

Offline Yankee

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Re: Patello Femoral Implants
« Reply #2 on: August 23, 2013, 11:48:38 AM »
That's a pretty grim story, Mr. F.  I have always been independent and self reliant, my motto is "Move or Die", LOL, so I am assuming (perhaps ignorantly) that aside from some pain and mobility, I will be able to cope on my own with some help for shopping, the dog, etc. Perhaps both knees is a bit ambitious and ignorance is bliss. 

I take great comfort in reading Elissa's post op diary, driving herself two weeks post op and going back to work, if only on one leg. That's the kind of recovery I expect, but I guess I'll know more after talking to the doctor.

How have you done with the implants since - have they relieved your pain?

Offline Mr.F

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Re: Patello Femoral Implants
« Reply #3 on: August 23, 2013, 01:42:48 PM »
Yankee,
I had both of my knees replaced when I was 35.  I have always been independent and self reliant.  I can tell you the reality of a strong willed person.  Reading about what happens with replacing one knee is totally difference than bilateral replacement.  I hope your vision of recovery and the reality of bilateral replacement never meet. 
Because you are independent and self reliant will not replace what happens after the operation.  The hours of physical therapy you will endure, not having a "good leg" to stand on, limited range and motion, and yes the pain.   I hope you can will yourself to cook, clean, walk, drive, have full range and motion after 7-10 days. 
Because you will have an open wound, yes there will be staples and/or stitches, your doctor might not want you to return to work so quickly.  (I had a revision in 2011 and my doctor made me wait one month prior to returning to work...open wound and chance of infection).
I am not trying to spoil your vision and potential goals after surgery.  You asked a question and I am telling you what happened to me.  I also suggest you talk to other people who had bilateral PFR and hear what they have to say.  (One knee being replaced is totally different than two).
I wish you all the luck and a speedy recovery in the future.
Since the operation...well that is a totally different story.  I will not get into that.  Let me say everybody has different experiences and progression.  I have had good times and bad times.  Yesterday I saw my knees in an x-ray and the replacements look good, there is a smooth grove between the patella and femur (both knees).  I am experiencing an issue with scar tissue in one knee and as mentioned earlier I had a revision on the other in 2011.
Good luck,
Mr. F

Offline Yankee

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Re: Patello Femoral Implants
« Reply #4 on: August 24, 2013, 04:12:17 AM »
I appreciate your honesty, that's why I'm doing this kind of information gathering, I want to know what I'm in for.  Being out of  work for a month is not doable for me, I don't have that much vacation time and can't survive on disability, however long it takes them to pay it.  Did your sutures/staples stay in for an entire month?

How well I can manage depends on how much pain I'm in and how incapacitated I am by it, I guess.  Given that I can't get a walker in my bathroom, maybe doing both knees at once is not going to be possible.  I'll know more next week.

Offline Yankee

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Re: Patello Femoral Implants
« Reply #5 on: August 27, 2013, 05:07:15 AM »
Well... not good news from the doc.  He was shocked when I mentioned the implants, as if it was extreme at this point.  What are my options, really? I'm missing cartilage, I can feel the bare spots when I sit with my knees bent, it burns like crazy, and he already told me he can't fix that. He did a couple of xrays and ordered an MRI and he wants to do an a'scope first to see the situation and maybe clean stuff up. I think that would be a complete waste of time and money. I'm hurting because I'm missing cartilage in spots, and he can't fix that with a scope, so why bother putting me through that for no result, spending my limited funds on something completely pointless, or as with the other knee, making it worse?  We'll talk again after the MRI, if necessary I'll get another opinion, there are two docs who work nearby who do it as well. He definitely said that doing both at once wasn't recommended for me, he would be nervous about me having two dodgy knees. Hello?  I have two dodgy knees right now!

This is a thought that popped into my head  - and for those who never seem to get relief. Have you ever considered that you might have an allergy to the bone cement, or the implant?  I know for sure I have a nickle allergy, so if there is any nickle alloy, there might be trouble.  The bone cement is a gut thing, I have some odd allergies, and this just seems like if you're sensitive, it would make sense to be tested for that before surgery.  Has anyone done that here? 

Offline FMRCathelete

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Re: Patello Femoral Implants
« Reply #6 on: November 06, 2013, 05:18:54 PM »
I would highly recommend testing beforehand for cement & metal allergies before having any implants put in.  Especially if you have a known metal allergy.  In US, Orthopedic Analysis (www.orthopedicanalysis.com) can do both.  They send a kit to you or MD, you have blood drawn & has to be shipped overnight back to them.  If I remember right it cost about $500 & you need to pay & then submit to insurance-well worth it to avoid foreseeable complications.   Good luck!  A
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