TKR is a gamble

Posted by ouch89 @ouch89, Oct 16 8:37am

I've had TKR on both knees with one successful and the other a horror show. The unsuccessful knee surgery was 6 1/2 years ago followed up with PT and home exercises for 12 months. The knee was never right with my doctor never acknowledging a problem. Ten months ago I decided to have revision surgery with another surgeon and again the PT and home exercises routine. I've made the conclusion that this knee will never be right and I'll have to live with the effects it has on my quality of life. The successful knee surgery was 3 years ago and after the problems with the unsuccessful knee I decided to avoid the pain of PT and just do the minimum. Go figure!

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@heyjoe415

I don't agree ouch, with all respect. I believe that a significant % of TKRs result in bad outcomes because patient don't do their part and blame the surgeon, hospital, OR staff, etc. - and then come and post here.

I still think this is a small minority of all TKRs. However the vast majority of people with bad outcomes will post on forums like this. Human nature I guess. Reading through this forum over the last 3 years, I see very little evidence of what you claim to see. There are many, many negative reviews of TKRs. I don't doubt you. I just don't see what you're seeing. You wrote "negative reviews are never seen". Not on this forum.

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We have different views on the medical community. It's wonderful seeing all those happy TKR patients limping around with their canes. We, the doctor and I, went forward with my revision TKR when I pointed out the issue with the X-Ray. I pointed out the misalignment that he didn't see, or acknowledge. Please don't reply!

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@heyjoe415

I think modern TKRs for the most part result in a large majority of very happy patients. These are patients who keep their weight close to normal, exercise, prep for the surgery with a trainer or with specific exercises that a good surgeon will provide, and of course, follow post-op procedures and don't smoke.

TKRs started in the late 60s. The procedure itself and the technology have advanced quite far. The keys to a successful procedure are pretty basic - 1) do your research on the surgeon and find someone in their late 30s to mid 40s with a solid med school and residence pedigree, and a few years of experience and positive patient reviews. 2) Find a surgeon who uses robotic guidance for precision cuts during surgery. 3) Do exercises for 6 months prior to surgery to strengthen the muscles that support the knee, and 4) Do all of the suggested post op exercises, usually 3x/day and attend and participate fully in post-op PT.

Do all of this and the outcome will be overwhelmingly positive. The responsibility for a successful recovery from TKR is primarily on the patient.

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I wish I had gone with the robotic assist surgeon but I was turned off by his staff. Unfriendly, unhelpful, did not return phone calls or emails or just to say I had to come in if I have more questions (a 1+ hour drive), and just a I can't be bothered, eye rolling attitude. So I stuck with my local older surgeon who I'd been seeing for 5 years who did the traditional surgery. Now I'm having ongoing problems still almost 5 months out from surgery that he does not want to take seriously always telling me everything looks good, other patients just ignore their clicking (mind you I ne er described it as "clicking") , and no way he will even look in with the arthroscope until at least another 4 months of healing. Hindsight is 20/20. I went for a 2nd opinion and diagnosed with Patellar Clunk syndrome. 😭

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Just curious ouch89...if you had the same surgeon do your revision surgery? I've had a 2nd opinion who made a diagnosis of patellar Clunk surgery (I wrote to you about this) but the 2nd opinion doc is out of state. Not sure if I should have the fix it surgery with my original TKR doc who says I have to wait another 4 months for more healing or just leave his care altogether. 🤷🏼 Decisions, decisions.

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@irenesara

I wish I had gone with the robotic assist surgeon but I was turned off by his staff. Unfriendly, unhelpful, did not return phone calls or emails or just to say I had to come in if I have more questions (a 1+ hour drive), and just a I can't be bothered, eye rolling attitude. So I stuck with my local older surgeon who I'd been seeing for 5 years who did the traditional surgery. Now I'm having ongoing problems still almost 5 months out from surgery that he does not want to take seriously always telling me everything looks good, other patients just ignore their clicking (mind you I ne er described it as "clicking") , and no way he will even look in with the arthroscope until at least another 4 months of healing. Hindsight is 20/20. I went for a 2nd opinion and diagnosed with Patellar Clunk syndrome. 😭

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All my surgeries were done with robotics with top rated surgeons. One successful, two unsuccessful. There are many factors that can be listed to determine successful outcomes but only one that will throw a wrench. I hope that with time you'll be more comfortable.

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@irenesara

Just curious ouch89...if you had the same surgeon do your revision surgery? I've had a 2nd opinion who made a diagnosis of patellar Clunk surgery (I wrote to you about this) but the 2nd opinion doc is out of state. Not sure if I should have the fix it surgery with my original TKR doc who says I have to wait another 4 months for more healing or just leave his care altogether. 🤷🏼 Decisions, decisions.

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The revision surgery was done with another surgeon who also did my successful knee. I'm at the point of making another follow up appointment but hesitate when I'm having a better day. The healing process is so long that we can get easily frustrated. Good luck.

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@ouch89

We have different views on the medical community. It's wonderful seeing all those happy TKR patients limping around with their canes. We, the doctor and I, went forward with my revision TKR when I pointed out the issue with the X-Ray. I pointed out the misalignment that he didn't see, or acknowledge. Please don't reply!

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I'll always reply to a misleading post. People shouldn't be unnecessarily scared by a conspiracy theory about TKR Drs, and a ridiculous statement about "all those happy TKR patients limping around with their canes". That kind of statement is irresponsible. I used a walker for the first week after surgery, a cane for the second one, and then I threw them away. You did get the happy part right though.

You're taking your experience and applying it to all TKRs that ever have been and ever will be performed. Sorry you had a bad surgeon. You are an exception.

Finally, if you're surgeon made such a mistake, why would you use him or her for the revision?

There are way too many inconsistencies in your comments to take them seriously, if they happened at all. I guess trolls can be found everywhere.

And I'll repeat something, it's on the patient to find a surgeon and do the work necessary post-op.

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@irenesara

Just curious ouch89...if you had the same surgeon do your revision surgery? I've had a 2nd opinion who made a diagnosis of patellar Clunk surgery (I wrote to you about this) but the 2nd opinion doc is out of state. Not sure if I should have the fix it surgery with my original TKR doc who says I have to wait another 4 months for more healing or just leave his care altogether. 🤷🏼 Decisions, decisions.

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Hi Irene. I suggest finding another surgeon. And please look for. surgeon who specializes in revisions, as it sounds like that's what you need. Finally, I'm not sure why a scope is necessary to diagnose your problem. Time to find another Dr I suggest. All the best to you.

("Patellar Clunk Syndrome" is new to me. Where did you find an explanation of this situation?)

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I Googled it. Up to 20% of people can get it after TKR, and is more prevalent in those that get posterior stabilized prosthetics, which I have. 🙄

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@heyjoe415

I'll always reply to a misleading post. People shouldn't be unnecessarily scared by a conspiracy theory about TKR Drs, and a ridiculous statement about "all those happy TKR patients limping around with their canes". That kind of statement is irresponsible. I used a walker for the first week after surgery, a cane for the second one, and then I threw them away. You did get the happy part right though.

You're taking your experience and applying it to all TKRs that ever have been and ever will be performed. Sorry you had a bad surgeon. You are an exception.

Finally, if you're surgeon made such a mistake, why would you use him or her for the revision?

There are way too many inconsistencies in your comments to take them seriously, if they happened at all. I guess trolls can be found everywhere.

And I'll repeat something, it's on the patient to find a surgeon and do the work necessary post-op.

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The revision was with another doctor. Apparently you're so intent trying to get your point across that you didn't read. Like your point of view it's about what you think - I can back up my comments. Not being objective doesn't help readers. Please no more!

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@ouch89

The revision was with another doctor. Apparently you're so intent trying to get your point across that you didn't read. Like your point of view it's about what you think - I can back up my comments. Not being objective doesn't help readers. Please no more!

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You're correct ouch. I misread your original post and for that I apologize. I still wouldn't give up on PT, or better, find a trainer with a degree in kinesiology at a good gym. Preferably, do both. Please don't give up.

And for all of you who have had bad outcomes from TKR due to a bad surgeon, or a surgeon's mistake, or other considerations mostly out of your control, I am truly sorry.

For those considering a TKR, research and find a good surgeon who commits to follow-up visits. If you need to lose weight, hold off on the surgery until your weight is down to what your surgeon recommends. (I was about 20 lbs overweight at 5'11" when I had the TKRs and I managed fine. Now I am at normal weight, largely because the TKRs allowed me to get back to the gym. When I suggest losing weight, be reasonable with yourself.) If you smoke - quit (I did, a side benefit). And finally and most important, get your leg muscles in shape pre-surgery and do all of the post-op rehab.

Sorry again ouch. I wish you the best. Just please don't give up.

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