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Author Topic: TKR failed twice - need help please  (Read 224 times)

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Offline sck

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TKR failed twice - need help please
« on: July 05, 2018, 02:42:51 AM »
Hello everyone, it is good to find this forum. Let me introduce myself. I am 63 year old male from India. I have had my share of knee problems over the last few years and am now thinking of coming to UK for consultation/surgery. Here are some case facts:

Due to arthritis for a few years, I was operated for TKR in both knees in Oct 2016. The surgeon used Zimmer Persona joints. My right knee developed discomfort - little swelling, lack of energy, stiffness etc. After trying painkillers for a few months, we did aspiration in March 2017. Even though the culture showed no bacterial growth, surgeons recommended 2-stage revision surgery, as the knee was visibly not good. Stage 1 was done in March 2017 and they removed the joint from the right knee and put cement inside. Culture showed growth of Non TB Mycobacteria. Even though the body did not show any sensitivity (CRP was normal), but that is what the lab report said. 9 months antibiotics course was prescribed after that, CRP was mostly normal during that time.

Stage 2 of revision surgery was done in June 2018. This time Johnson & Johnson joint was used. However, even after 1 month of surgery, the knee has not stabilized. There is visible swelling, discomfort and some fluid inside the knee. It also feels warm compared to the rest of the body. Since, I am still on an antibiotics course (another 1 month), we cannot do aspiration to figure out what is going on inside.

I am worried that the surgeons will next recommend fusing the knee (arthrodesis). Also, if the knee condition worsens a lot suddenly, we will have no option but to go along with the local surgeons.

It seems that the body is rejecting the artificial joint in the right knee. In this case, are there any other tests which can be performed to help? Given that the knee has had 3 major surgeries within 2 years, I am dreading my surgeon telling me that we need to open it up again. Also, what are other alternatives here please? I assume arthrodesis should be the last option.

If I want to come to the UK for consultation with ortho-surgeons, what is the best way to go about it?

My left knee, which was also operated for TKR in Oct 2016 has been stable after the initial surgery.

Sorry for the length of the message, but I wanted to give as much detail as possible. Really appreciate any help and suggestions. Thank you

S.C.K.

Online Vickster

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Re: TKR failed twice - need help please
« Reply #1 on: July 05, 2018, 08:26:07 AM »
Sorry to hear about your troubles.

Ref consulting in the U.K., the first step would be to decide where you want treatment (London will be more costly if you need further surgery) and with whom. You need to research which surgeonshace expertise in revision TKR and complications following TKR.

E.g. Someone like this Professor in Southampton 
http://www.professordavidbarrett.co.uk
Or https://www.nuffieldhealth.com/consultants/mr-timothy-wilton

Find those who list revision as an expertise and who have published research if at all possible. Some surgeons only have a private practice, others work in the NHS and privately (although as an overseas patient you'll be seeing them privately).

I would expect your initial contact will be via the surgeon's private secretary. You'll need to arrange to have your history and notes communicated from your current surgeon

Good luck :)
« Last Edit: July 05, 2018, 08:35:17 AM by Vickster »
Came off bike onto concrete 9/9/09
LK arthroscopy 8/2/10
2nd scope on 16/12/10
RK arthroscopy on 5/2/15
Lateral meniscus trim, excision of hoffa's fat pad, chondral stabilisation
More tears and wear, scope planned in Jan 2019 to tidy up

Offline sck

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Re: TKR failed twice - need help please
« Reply #2 on: July 05, 2018, 02:38:22 PM »
Thanks for your response Vickster. Very helpful.

It would be great if you or someone else can help me with my other question and concern.

Are there any medical tests which can be performed once it is established visibly that the TKR has not been a success.

Is there any other alternative apart from doing another TKR or knee fusion?

Also, if there is someone who has had success with revision TKR, then please let me know. I have not met anyone so far, even though doctors claim 95 pct success rate.

Thanks again

s.c.k.

Online Vickster

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Re: TKR failed twice - need help please
« Reply #3 on: July 05, 2018, 02:58:29 PM »
Those sound like questions for consultations with TKR expert surgeons

There might be some feedback in the TKR part of the forum

http://www.kneeguru.co.uk/KNEEtalk/index.php?board=37.0
Came off bike onto concrete 9/9/09
LK arthroscopy 8/2/10
2nd scope on 16/12/10
RK arthroscopy on 5/2/15
Lateral meniscus trim, excision of hoffa's fat pad, chondral stabilisation
More tears and wear, scope planned in Jan 2019 to tidy up