I am seven months postop after a TKR. I need another opinion.

Johns Hopkins mothership is located in Baltimore, Md. downtown. My surgeon Dr. Min Lu is moving to that location. I think he listens to the patient and he believes in physical therapy. I was very satisfied with Dr. Lu.

Johns Hopkins would be the choice for me. I had a different kind of procedure but I admire their professionalism. Good luck.

@gravity3 thank you!

@aileenredding thanks!

@aileenredding
https://www.hopkinsmedicine.org/orthopaedic-surgery/specialty-areas/hip-knee/knee-replacement-surgery
IMO two of the most important aspects of a TKR recovery are to NOT use a tourniquet to control bleeding and use one of the minimally invasive techniques. The web site says they do the latter. I would just ask and make of the former. Johns Hopkins is one of the best medical schools in the country so I would be confident that they have some excellent surgeons there.

The other key aspect, IMO, is that the surgeon have extensive experience doing the exact same procedure. Ask the surgeon how often she has done the exact procedure (e.g., if she is now doing a functional alignment (which I think is good) has she been doing it for long?

I went to Dr. Nazarian at Rothman in Philly for relentless knee replacement pain for 2 years after surgery. He aspirated fluid from my knee, which was inflamed, and had metal allergy testing done. He also injected it with a steroid which helped for a bit. He also did an X-ray to check placement, which helped said was good.

Bottom line: it still hurts.

He thinks I have an inflammatory response bigger than just my knee…

I had a very similar situation. Had initial left TKR done November 2023 by a surgeon who was the Surgical Director For Joint Replacement at a major teaching hospital. Incidently, this surgeon had performed a left TKR and bilateral hip replacements on my wife without post op complications. I expected some discomfort and swelling post op, but after 4-5 months of physical therapy and repeated examinations by the surgeon, who indicated that this was normal and that there was nothing wrong. He did however, recommend a Genicular Nerve Block, but my insurance company said the procedure was experimental and not covered. The out of pocket cost was too expensive. I returned to the surgeon and his comment was "Just live with it". Having worked in healthcare for almost 50 years, that comment was a "red flag" and I immediately sought a second opinion from a surgeon that specialized in TKR revision.
After an initial exam by the revision surgeon, he determined that the implant had not been properly balanced and that was the reason for the persistent pain and swelling. Arrangents were made for the revision for February 2025. The surgeon was going to attempt to balance the implant, but was unable to. We had discussed this scenario and if the balancing was not able to be done, he would explant the initial implant and replace it with a new one from a different manufacturer. Needless to say, that did the trick. No pain or swelling and I am 14 months post op and fully functional.
Definitely seek a second opinion with a surgeon that specializes in TKR revisions. It may take a little research, but well worth it. When a physician tells you to "live with it", seek a second opinion. I live in coastal NJ and am not familiar with revision surgeons in central Pa. Be persistent and good luck.

Wow. You have collected some great suggestions. Good Luck

Hi Roxie,
Sorry to hear that you are still having pain issues. I believe we have corresponded before.
My life went from 60 - 0 over night due to the TKR as the pain precludes walking, stairs and affects everything I do.
I am 27 months post TKR. I have severe pain and effusion which the surgeon told me was nerve damage and he could not do anything. Two RF nerve ablations did not help. I fired him!

4 Ortho opinions later (including UCSF and Stanford) the diagnosis is mid flexion instability. Although no obvious issues are observed in the x rays there was too much laxity in the knee and I had a partial revision with a semiconstrained liner. I chose this option over a full revision knowing that it was a 50-50 success rate. It did not help.

My new surgeon and I agree that there is a mechanical problem with the implant causing impingment/irritation to soft tissue. The nerve ablations were never going to fix the problem as long at the soft tissue kept getting irritated by the implant.
I will have a full revision this month with a hinged implant.
Hopefully this will fix it.

I am in the Kaiser California HMO system. The east coast has many good Ortho facilities. Hopefully you can find someone who listens and provides a 'game plan' for a successful result.

I have been very proactive to get the attention and help I need. Keep advocating.

@aileenredding thank you!