My Chronic Knee Pain After Replacement caused by Wrong Size Implant

Posted by cyd @cyd, Aug 5, 2020

Hello, I have seen a lot of people with similar stories of chronic pain in their knee after surgery. My experience: I had a total knee replacement although I worked very diligently with Physical Therapists and followed their instructions of what exercises to do at home, I still had extreme pain every single day.Upon the advice of my Ortho, I had a manipulation procedure. Skipping on past months, nothing I could do would relieve the pain short of sitting doing absolutely nothing but elevation and ice therapy. My pain management Dr. performed a Genicular Nerve Block. Nope, that didn't help either. Skipping on past months more, injections and water retention aspirations didn't help either. Then my Ortho decided the only thing to do was to go back in for a little clean up (knee scope). That proved to be not of any use. It's now two years after my replacement. Things are going downhill at a faster pace. I finally convinced another Dr. to take a look at me because you know the other Orthos don't like to take on someone else's patient. Anyhow, he immediately started ruling out causes. Tested for metal allergies, blood tests for infections, Nuclear Bone Scans for hard to detect hiding infections. You name it, he did it. I had mentioned to the original Dr. and now to this new Dr. that I had had such a hard recovery from the surgery that something right from the start must not have been right. My original Dr. thought it was laughable when I asked him a few times if perhaps the wrong sized implant was used . My new Dr. took that question much more seriously. The findings from all the tests showed loosing of the parts of the initial implant. My new Dr. also confirmed with imaging that the femoral part of my implant WAS too large for me causing the slow painful loosening of the whole knee implant. I was very wary but hey what could I do ? I couldn't live like that any more. Yes, I agreed to the revision and oh my gosh ! from the very first day I could tell a big difference in the way I felt. My pain and swelling was hugely less, my progress with Physical Therapy was 100 % more successful. My recovery time was amazing much easier. If there seems to be no explanation from your Ortho about very chronic pain my suggestion would be to find an Ortho to take your question of if you have the correct sized parts for your body implanted into you. You know how it is, when you go to your follow up appointments, you're always told that there's no problem everything looks like it's lined up just fine. I found out the hard way that this is a more common problem than you think. I couldn't believe it myself ! And yes, as some of you have stated my original Ortho Doc was as mad as a hornet that I had gotten another opinion. THAT'S YOUR RIGHT AND THEIR EGO PROBLEM. Hope my story might help someone else out their with unexplained seriously painful chronic pain on a daily basis.

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@wildebjef

I get my first knee replacement August 23 at 10:00 am. Due to Covifd 19, I must self isolate right after I have my COVID 😁 test 4 days before surgery. Then 4 weeks no driving ? Plus I must stay in my apartment 4 weeks???? What kind of Pain medicine will they give me? I have been taking Norco for years since my fractured leg , Advice please on how to prepare for 4 weeks? Will I be able to go to sleep in my bedroom where my CPAP machine is or should I move all medicine downstairs.

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Hello@wildebjef, I'm sure you must be anxious about the upcoming knee replacement surgery. I had my right knee replaced a year ago in April and upon the recommendation of my Mayo Clinic care team did pre-surgery exercises that they recommended. I believe the pre-surgery exercises along with post surgery exercises made my recovery much easier.

The FAQs of Knee Replacement Surgery with Dr. Ortiguera – Mayo Clinic
https://www.youtube.com/watch?v=kKLNfnKgjNI&index=16&list=PL3A5R5osulIQxfgSwCDqVuTtOJXnKnDT-

Here are some of the pre-surgery knee exercises that I found and used most of them for about 3 to 4 weeks prior to my surgery:
https://www.allinahealth.org/health-conditions-and-treatments/health-library/patient-education/total-knee-replacement/preparing-for-surgery/before-surgery-knee-exercises

I wasn't able to drive for about 4 weeks. I think it's based on how well your recovery goes and your ability to bend your knee like you need to with normal driving. We have a two level home with our bedroom in the lower level and the kitchen and living area on the main floor level. I mostly stayed downstairs during the first week or so and would limit my trips up the stairs. My wife was a big help to me in that respect so I didn't have to make trips upstairs. If it's more convenient to move you CPAP and medicine downstairs that may be helpful for you.

Do you have someone with you that can help if needed when you are home?

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@wildebjef

I get my first knee replacement August 23 at 10:00 am. Due to Covifd 19, I must self isolate right after I have my COVID 😁 test 4 days before surgery. Then 4 weeks no driving ? Plus I must stay in my apartment 4 weeks???? What kind of Pain medicine will they give me? I have been taking Norco for years since my fractured leg , Advice please on how to prepare for 4 weeks? Will I be able to go to sleep in my bedroom where my CPAP machine is or should I move all medicine downstairs.

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@wildebjef I have had two TKRs and both times was able to go upstairs to the bedroom to sleep. That's probably very individual but it sounds as if you live alone so you may want to stay downstairs, just in case you have a problem.

I had tramadol after the second TKR and also either hydrocodone or oxycodone, I forget which, for a very short time with a very small dose. Many people get great relief from ibuprofen but I unfortunately cannot take that, the only OTC pain reliever I can take is acetaminophen.

If you live alone and don't have friends or neighbors who you are comfortable asking for help with grocery shopping, there is Instacart and Whole Foods delivers. We have used both since March due to the pandemic. We are not going to grocery stores.

Good luck with the surgery. I hope it goes great and that your recovery is swift and easy. My ortho highly recommends using the recumbent bike, walking, and water jogging for rehab. If you can do any of those then that will help a lot. If you don't have an exercise bike perhaps there are places where you can rent one. My doctor told me to do it for 30 minutes, for five consecutive days and then take two consecutive days off for recovery.
JK

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How did you find out it was the wrong size implant? I see Dr. #14 on Monday to try and confirm that my knee was installed incorrectly. Its been 2 1/2 years, 2 other surgeries, lots of pain and lots of guesses.

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I would really like to know the way you found this out .

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@melcpa86

How did you find out it was the wrong size implant? I see Dr. #14 on Monday to try and confirm that my knee was installed incorrectly. Its been 2 1/2 years, 2 other surgeries, lots of pain and lots of guesses.

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Yes, how did you find out?

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Thank you so much for your story! I had a TKR 14 months ago. My story is a lot like yours. I had a manipulation under anesthesia in January-no help...June 29 this year, arthroscopic surgery to clean everything up. Still problems!! Still pain and so stiff!!! I have always felt like it might be too big for me too. I had a second opinion a while back, same answer you got...everything looked fine and he didn't want to get involved, he knew the surgeon that did my original surgery. I keep being told it takes time, it's getting hard to wait much longer to feel better!!

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Thank you for posting this. I’m about ready to lose my mind. My first knee replacement was March of 2017. I am still in pain and swelling! They’ve done ultrasound to make sure there wasn’t a blood clot. They’ve done the aspirations. They’ve had me do repeated PT. Wanted me to do the nerve block you mentioned- but two other Ortho Drs told me not to do it! When they do an X-ray they say it looks great! Well I know something is wrong! My 2nd knee replacement was a partial and it is fine. That surgeon told me he would help me with my other knee- and then he backed out. I’m only 65 and don’t want to live the rest of my life in pain. I take Meloxicam now. I need to find a surgeon who can help. I have felt for a long time like the part he used was too big! I live in central IN. I wonder where to turn. The thought of revision scares me with going through all of that again- but if it works- will be well worth it!

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@apriljoy

Thank you for posting this. I’m about ready to lose my mind. My first knee replacement was March of 2017. I am still in pain and swelling! They’ve done ultrasound to make sure there wasn’t a blood clot. They’ve done the aspirations. They’ve had me do repeated PT. Wanted me to do the nerve block you mentioned- but two other Ortho Drs told me not to do it! When they do an X-ray they say it looks great! Well I know something is wrong! My 2nd knee replacement was a partial and it is fine. That surgeon told me he would help me with my other knee- and then he backed out. I’m only 65 and don’t want to live the rest of my life in pain. I take Meloxicam now. I need to find a surgeon who can help. I have felt for a long time like the part he used was too big! I live in central IN. I wonder where to turn. The thought of revision scares me with going through all of that again- but if it works- will be well worth it!

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Tell your Orthopedic Dr You want Tramadol. I have been taking it for 3 years!!!

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@apriljoy

Thank you for posting this. I’m about ready to lose my mind. My first knee replacement was March of 2017. I am still in pain and swelling! They’ve done ultrasound to make sure there wasn’t a blood clot. They’ve done the aspirations. They’ve had me do repeated PT. Wanted me to do the nerve block you mentioned- but two other Ortho Drs told me not to do it! When they do an X-ray they say it looks great! Well I know something is wrong! My 2nd knee replacement was a partial and it is fine. That surgeon told me he would help me with my other knee- and then he backed out. I’m only 65 and don’t want to live the rest of my life in pain. I take Meloxicam now. I need to find a surgeon who can help. I have felt for a long time like the part he used was too big! I live in central IN. I wonder where to turn. The thought of revision scares me with going through all of that again- but if it works- will be well worth it!

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You shouldn't have this type of pain. Perhaps an appointment at Mayo?

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@housing1st

You shouldn't have this type of pain. Perhaps an appointment at Mayo?

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That’s what I’ve been thinking of doing. 3 years is too long. I need to figure out how to get an appointment.

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