Pain months after Total Knee Replacement

Not all surgeons are created equal. The way I find the best physicians is to first google hospital ranking for the specialty I'm interested in - like 'hospital ranking orthopedics', then I look at the website 'HEALTH.USNEWS'. That's a U.S. News & World Report website. Then I google the physician's name I'm interested in & again look at HEALTH.USNEWS'. What I'm interested in is where he did his training, especially where he did his 'clinical fellowships'. Hospital for Special Surgery in NYC is #1 in the nation for orthopedic surgeries, then there's Columbia NY Presbyterian, and there are other top hospitals for orthopedic surgery. The better ranking hospitals only offer better physicians an affiliation with their hospital. There are also top orthopedic hospitals in California & elsewhere. Once I asked a foot surgeon at HSS about whether the foot surgery I needed was something that any foot surgeon could do, and his reply was "the better surgeons have very few surprises either during or after the surgery and even bad surgeons can have a successful surgery". As far as revision surgeries, they require a higher skill level than the first surgery.

I wish I would have done what you did, I took the first referral that the ppc gave me and thought the surgeon was top, but then realized that I was going to be operated on by interns, trainees, etc., including the anesthesia specialist. I signed a paper allowing the procedure to be done at a teaching environment. I’m on Medicare and health care supplement, and the surgeons and hospital make only what Medicare pays, so in order for them to justify the surgery they put you with a teaching hospital environment. In other words, I was being a person that people can learn on. From my waist down, I am a wreck! Not going into specifics, but last year I was at least 70% of a healthy 71 year old male! Now I’m about 15 - 20%. I can’t walk any meaningful distance, sit for any length of time, have satisfied sex, am depressed, and really do not want to live! So, I agree, find the best surgeon, team, and hospital, and confirm that he/she will be doing the surgery…

I'm so sorry to hear that happened. Does the doc have any idea why - was it glueless, broken bone...?
I know it is disappointing as well as painful, to realize that not every surgery is perfect. I had to have 3 hip revision/replacement surgeries after my initial replacements, and never considered NOT doing it - the pain and disability from the bad hips made me determined to have the best hips I could. And I'm glad I did it - over 10 years now of being able to live with good mobility.

If your surgeon has a good explanation for what happened, and you are comfortable with them, you could consider not changing docs. On the other hand, if they have a doc to refer you to who deals with more complex cases...

So I will ask - are you willing to continue to live with the pain and loss of mobility if there is a way to fix it? That is a decision only you can make.
Good luck , and let me know how you decide to proceed.
Sue

It's better to go the extra mile to nail down the best surgeon you can find, even if it requires some travel. Medicare pays by the procedure code used. Any physician that takes Medicare 'assignment' will accept the 80% of the 'approved' Medicare amount for the physician's services (Part B) and Part A pays for the hospital's charges (100%). I'm on Medicare and have an AARP United Healthcare supplement plan (Plan F) that covers the remaining 20%. The supplement will only kick in if Medicare Part B approves the physician's charges first. Almost all surgeons take Medicare assignment. The AARP United Healthcare supplement (Plan F) does not require a referral and does not have a restrictive network of providers, but the monthly premium is probably a little higher than some other Medicare supplement policies. Some private insurance plans have a narrow network of physicians whose charges they cover and may require a referral. It may not be too late to have a better surgeon fix the problems you now have. Usually interns only assist the operating surgeon. Good luck.

Thanks for ur reply. I have the same supplement that u do, and I pay the higher premium so I have as little cost as possible if a I would have to have something done.

Pretty sure, the surgery was not done by the surgeon, and know the anesthesiologist was not the one on record cause she was probably young enough to be my granddaughter. There is too much to go through and provide info to support my thoughts, but know that I am not the same person, physically or mentally, I was 1 year ago. The original hospital has completely dismissed my concerns and issues. Not sure what anyone can do to correct what is going on.

Thanks again.

Don't give up. Current prosthesis design & materials, in the hands of a good surgeon, can fix a multitude of problems caused by a bad surgical outcome. Also surgeons now use robotics, whereas before robotics, the surgeon did a lot of the procedure without the accuracy of that technology. There are ways to ensure that the physician you want is the one doing the operation. You sign a SURGICAL CONSENT FORM and in that document, you can insist that your wishes are written into the document before you sign it. Also, there are (2) types of health care providers that administer anesthesia in a hospital setting. One is a board certified anesthesiologist PHYSICIAN and the other is a CRNA. The CRNA is a Certified Registered Nurse Anesthetist. They're an RN with some additional training in anesthesiology. You also sign a anesthesiologist's consent form that's presented to you by the anesthesiologist MD. Usually the anesthesiologist MD is working more than one OR and is not going to stay in your OR for the duration of the entire procedure, but you can insist in the consent document that the anesthesia physician administers all the anesthesia drugs and the CRNA then usually only does the monitoring. And if an anesthesia problem occurs, that the anesthesia physician is right next door and can be in your OR immediately. I definitely wouldn't give up. Even though you don't want to go through another surgery, you have ways to ensure that what you want is what you get. Many hospitals try to cut corners and only use CRNA's with only minimal oversight from the anesthesiologist MD. Also, in many cases, the anesthesiologist PHYSICIANS do not work for the hospital, but are in a private group practice.

Thanks again. Sounds like u are quite familiar with the process. Well, I would hope that someone putting a needle in your spine is very skilled and a MD. Unfortunately, I did sign a form consenting to allowing interns, students, or whoever do the procedures. I had a hernia operation with the same hospital but not teaching and it went entirely different.

My main issue is not with my knee, although it was very painful and still numb and aches at times. It is the rest of my body from the waist down. I did everything they said and was a very good patient. What’s wrong cannot be corrected by more knee surgery.

Thanks. Point is, I agree on getting the best. I would now know how to go about future surgery if I would ever elect to have one.

Good day I need some help, I have been on opioid pain medication for a long time for pain I was having in my knee. I recently had knee replacement surgery and they prescribe me more however it isn’t working, they have tried to up the dose and I’m still getting no relief which is causing me issues with getting started with rehab. At this point I have given up and stopped taking the medication they have been giving me,My doctor did say he was going to send me to a pain specialist if what I was being prescribed didn’t work but just wanted to ask if anyone else has been in the situation and what was recommended?

@angelacol you will notice that I have moved your post into a discussion on knee replacement to allow you to better connect with members who may relate to your situation.

Members like @sprinrosa64 and @jeff101 may be able to share their experience with you with regard to pain following surgery.

Have you ever seen a pain specialist before?

Hello,

I have not been replying to any posts cause I feel it’s useless. As far as I go I did see a pain md and all they wanted to do was put a spinal stimulator in my back. I won’t go into details but I was 85% healthy before my knee went bad and the TKR to being in constant feet and back pain and decreased sexual response after the operation. My issues are not coming from DN or PN. I wish I could have seen a more qualified MD before I went through with hell resulting operation. You tell me!