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Author Topic: Patellofemoral PKR next?  (Read 5891 times)

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Offline caroline889

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Patellofemoral PKR next?
« on: August 27, 2013, 10:06:49 PM »
I'm aged 41 with grade 4 under both kneecaps. I`ve had Fulkerson Osteotomies on both knees but still in pain- it's gone worse in fact.Would it be best to try and manage for a bit longer or should I go and get 2 partial knee replacements of the patellofemoral joint?
Dislocations since 1986
Lateral Release RK June 2008
Diagnosed trochlea dysplasia RK & LK 2008
MPFL Recon. &  microfractures LK & RK April  2009
Diagnosed grade 4 arthritis RK & LK 2009
Scopes  & microfractures RK & LK Nov  2011
Fulk'n osteotomy, mpfl recon& trochleoplasty RK March 2012 LK Feb 2013

Offline Mr.F

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Re: Patellofemoral PKR next?
« Reply #1 on: August 28, 2013, 12:17:18 AM »
Hello caroline889,

Wow your knees sounds similar to mine.  I have had knee problems since I was 13.  Around 20 I had Fulkerson's done on both knees.  Initially the surgery help with some relief of knee pain.  The pain eventually got worse and worse.  I went doctor hopping (no doctor would give me a second look...age).  I had doctor after doctor lie to me.  I eventually take me serious.  In 2005 I had bilateral PRF.  Looking back at it now would I do it again.  First off, I had a fantastic doctor and incredible physical therapist.  Second, I just saw an x ray of my knees and they look incredible.  Next the pain, the PT, and issues, and the set backs have been overwhelming.  Every time I take 3 steps forward it seems I get kicked back 5 steps.
As I look back this was my only option.  I joke around with my wife and say the next time I get in this situation (bilateral surgery) I will do something like parachuting and blow out both my knees at once.  This way I will not go through a year of PT, different shots, different braces.  And if my OS can not fix my knees I will be a little shorter.
I do have a positive mind set.  I am very independent.  I have a happy and healthy life (with exceptions of the knees).  Right now I am dealing with scar tissue issues.  I am in a brace that limits mobility.  I over did it at work and I am in excruciating pain.  I will be back at work tomorrow with a smile on my face joking around with my friends.
Remember everyone's story is different.  Please go out and talk to other people and see what they have been through.  Talk to your OS and physical therapist.  Make sure you know what you are getting into. 
Good luck,
Mr. F

Offline caroline889

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Re: Patellofemoral PKR next?
« Reply #2 on: August 28, 2013, 10:10:44 PM »
Hi Mr F

Thanks for your reply. It's a credit to you that you stay so positive! How are your knees now? Will you need full knee replacements?

Best wishes

Caroline
Dislocations since 1986
Lateral Release RK June 2008
Diagnosed trochlea dysplasia RK & LK 2008
MPFL Recon. &  microfractures LK & RK April  2009
Diagnosed grade 4 arthritis RK & LK 2009
Scopes  & microfractures RK & LK Nov  2011
Fulk'n osteotomy, mpfl recon& trochleoplasty RK March 2012 LK Feb 2013

Offline Mr.F

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Re: Patellofemoral PKR next?
« Reply #3 on: August 29, 2013, 02:58:49 AM »
Hello caroline889,

My knees now are a joke.  The implants look good, on the latest x ray...about one week ago.  There is a nice grove between the femur and patella.  My right knee had to be cleaned out in 2011.  I am dealing with a scar tissue issue in my left knee.  I have been placed in a brace for 5 weeks.  This brace limits my range and motion.  If this does not aliviate the pain I will be sent to another specialist and we will go from there.  Code for you will need another operation (most likely the new doctor will want to try an injection of something.  And this will not help.). The doctor will most likely say that I have few options left.  Surgery will be the only option that could possibly have any long term results.
I have been in and out of PT, had set backs, and when it seems that things are going well my knees find a problem.  Sometimes it is very trying and you need to find another outlet to keep strong.  Overtimes, like yesterday, I came home from work, ate something, and passed out from the pain.
At some point I will need TKR.  My knees are not even remotely close to needing this.

Take care,
Mr. F

Offline Yankee

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Re: Patellofemoral PKR next?
« Reply #4 on: September 05, 2013, 01:29:34 AM »
Hello Mr. F,

I have been doing some homework on these implants, and had a sudden thought that I might well be allergic to bone cement. I had an allergic reaction to the same kind of thing in acrylic nails, (similar compounds)  - bad inflammatory response, throbbing pain in my fingers and my nails separated from the nail bed.  I would want to be sure before I had this stuff installed in my bones, where it could only be removed by a second surgery.  It's NOT uncommon, no one ever thinks to test for it, but Pub Med has many articles on people with poor results from surgery and most of them turned out to be allergic to the metal, or the cement, or both.  My MRI is worse after my recent fall, and surgery is now an option, but only if I am not allergic to the components.  Arthrosurface makes test patches for the metal parts but the bone cement is not part of their testing.

Your post about the hair falling out of your leg made me think "allergy", and I wonder if you are.  See if your surgeon will test you for allergies to both, it might shed some light on your continuing problems.  I can't think why, if your implants look so good, that you are still in misery from it.

http://www.ncbi.nlm.nih.gov/pubmed/23907451
http://www.ncbi.nlm.nih.gov/pubmed/17089297
http://www.ncbi.nlm.nih.gov/pubmed/20614402
http://www.ncbi.nlm.nih.gov/pubmed/18227996
http://www.ncbi.nlm.nih.gov/pubmed/22085108