Knee replacement gone bad: Patella & Recovery

Posted by hbaudouin @hbaudouin, Oct 15, 2023

In 2021, I had total knee replacement surgery. I remember feeling an air pocket that would pop while bending my knee during physical therapy. When I told the doctor, he told me it was normal. That whole year, my knee stayed swollen and tight. In 2022, I went for a 2 mile walk around my neighborhood. The following day, I woke up with my patella on the side of my leg. When I contacted the doctor's office, I was told I over did it. I waited another two weeks, and the doctor wanted to see me. They took an x-ray and saw that my patella component had come loose from the cement. That was in April 2022. I had to wait until June 2022, to have revision surgery. This past July, my husband and I went bike riding. Woke up the next day with a swollen and painful knee. I waited two days to contact my primary care doctor. They did not have an appointment and told me I needed to go to urgent care because they thought my knee might be infected. At urgent care, the doctor took an x-ray and told me that my patella has been fractured. I have been in a brace since July. I was able to find another orthopedic doctor. I felt like my first orthopedics surgeon did not listen to me and he never spent more than 5 minutes with me. During my first visit, he suggested that I should return to my surgeon since he knows my knee better. I told him I was not comfortable returning to him. According to doctor’s note: Possibility of displacement of the fracture in the future discussed. The complexity of the problem, which was explained to her in detail given the extensor mechanism injury, the possibility of her having some persistent pain, further loosening of the implant, repeat fracture, displacement of the fracture compromising her ability to stand, walk, etc. discussed in detail. The possibility of instability in the future is also discussed, given the extensor mechanism pathology that she has. She understands that possibility of refracture is there, using a prosthesis risk is also there, need of additional surgical intervention, possible patellectomy, allograft placement in the future etc. discussed. She is aware of all the scenarios. No guarantees expressed. " I have been back to this surgeon three times. Every time I go, all he tells me is to wear the brace for 4-5 more weeks. I feel that he is afraid to do anything because of my complicated case. I am wondering if anyone else out there has had this situation. What was done? How are you feeling? Is there a way to fix this problem? I am 59 years old and in pretty good shape. I am shocked that this has happened to me and that I don't know what my future holds.

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I have not had the horrible experience you have had but I think I would opt for a third orthopedic doctor’s opinion. It should like you need a doctor that does more
Than routine joint replacement.

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You may need to go to a different large city as surgeons won't do or say anything that reflects poorly on their friends. Nor will they take each other's patients.

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Hello @hbaudouin, I'm sorry to hear about your ongoing complications from your knee replacement. I'd like to invite a few members who have dealt with patellar fractures either during or after their knee replacements who may be able to share their experiences with you: @krikett and @patellaprob.

@hbaudouin - seeking second and third opinions is not always as simple as it sounds. Do you have any barriers in seeking another outside opinion (like insurance, travel, etc.)? The suggestions from @mesor and @brockagain are validated suggestions, but is this something you think you'd be able to seek?

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I'm sorry for what you're going through.

If your surgeon used cement during the TKR, it seems you may have osteoporosis. Have you ever been tested for this? My surgeon told me he uses cement when osteoporosis is present. It may be worth looking into. Sorry I can't be of more help. I would be extremely frustrated if told to wear a brace long after a TKR.

All the best to you.

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Your experience is horrible. It should not have happened. It seems absolutely crazy. I have had two total knee replacements; a hip replacement; and a reverse shoulder replacement. I had excellent surgeons that specialized in just those body parts. I never had any problem - and no pain with either the hip replacement or the shoulder replacement.
Even if I had to use my savings to pay for it, I would go out of town to a large city that has a high volume practice with knee replacement experts that specialize in revision knee surgeries. I would find out what you need to have done to get the problem fixed and then do it. It might involve changing insurance. My understanding is that insurers cannot discriminate against patients for pre-existing conditions. But be sure to verify. Always verify.
I agree. Orthopedic surgeons (and any doctor) are loathe to say anything negative about their brethren in the same city or region. They fear lawsuits if you filed a malpractice claim, etc. . Lawsuits can be very expensive for the physician that tells you what the other doctor did wrong. Lawsuits take up inordinate amounts of time for everyone and that is the major issue.

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@hsminc

Your experience is horrible. It should not have happened. It seems absolutely crazy. I have had two total knee replacements; a hip replacement; and a reverse shoulder replacement. I had excellent surgeons that specialized in just those body parts. I never had any problem - and no pain with either the hip replacement or the shoulder replacement.
Even if I had to use my savings to pay for it, I would go out of town to a large city that has a high volume practice with knee replacement experts that specialize in revision knee surgeries. I would find out what you need to have done to get the problem fixed and then do it. It might involve changing insurance. My understanding is that insurers cannot discriminate against patients for pre-existing conditions. But be sure to verify. Always verify.
I agree. Orthopedic surgeons (and any doctor) are loathe to say anything negative about their brethren in the same city or region. They fear lawsuits if you filed a malpractice claim, etc. . Lawsuits can be very expensive for the physician that tells you what the other doctor did wrong. Lawsuits take up inordinate amounts of time for everyone and that is the major issue.

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Thank you for validating how i feel. Sometimes i feel like i am over acting but then i realize my quality of life should be better than what i am experiencing. I am working with Mayo Clinic and my out of network insurance coverage to figure out the cost.

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@hsminc

Your experience is horrible. It should not have happened. It seems absolutely crazy. I have had two total knee replacements; a hip replacement; and a reverse shoulder replacement. I had excellent surgeons that specialized in just those body parts. I never had any problem - and no pain with either the hip replacement or the shoulder replacement.
Even if I had to use my savings to pay for it, I would go out of town to a large city that has a high volume practice with knee replacement experts that specialize in revision knee surgeries. I would find out what you need to have done to get the problem fixed and then do it. It might involve changing insurance. My understanding is that insurers cannot discriminate against patients for pre-existing conditions. But be sure to verify. Always verify.
I agree. Orthopedic surgeons (and any doctor) are loathe to say anything negative about their brethren in the same city or region. They fear lawsuits if you filed a malpractice claim, etc. . Lawsuits can be very expensive for the physician that tells you what the other doctor did wrong. Lawsuits take up inordinate amounts of time for everyone and that is the major issue.

Jump to this post

Thanks for sharing about your successful joint replacements. I do agree it's best to do some homework to find a good ortho surgeon. We moved after retirement and I had to find a knee doctor to replace both knees.

I searched for doctors in their late 30s to mid 40s with a solid pedigree. I found a guy who did his residency at the Cleveland Clinic. Good enough for me. Both surgeries were successful and I did a lot of work to make it so. But it starts with a good surgeon. My Dr also used the Stryker/Make robotic assistant.

Question - what was your recovery like for the RSR? I'm sure that's next for me whether it's traditional or reverse. I don't really want to sleep in a recliner but will if I have to. What was pt like and is there anything that can be done ahead of surgery to aid recovery, like pt? Thanks!

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@JustinMcClanahan

Hello @hbaudouin, I'm sorry to hear about your ongoing complications from your knee replacement. I'd like to invite a few members who have dealt with patellar fractures either during or after their knee replacements who may be able to share their experiences with you: @krikett and @patellaprob.

@hbaudouin - seeking second and third opinions is not always as simple as it sounds. Do you have any barriers in seeking another outside opinion (like insurance, travel, etc.)? The suggestions from @mesor and @brockagain are validated suggestions, but is this something you think you'd be able to seek?

Jump to this post

Yes, insurance is probably my biggest barrier. I want to go to the Mayo Clinic; however, it is out of network for me. My husband and I are thinking about changing insurance to see if they will cover the Mayo Clinic. How do I get to @mesor and @brockagain's suggestions?

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@heyjoe415

Thanks for sharing about your successful joint replacements. I do agree it's best to do some homework to find a good ortho surgeon. We moved after retirement and I had to find a knee doctor to replace both knees.

I searched for doctors in their late 30s to mid 40s with a solid pedigree. I found a guy who did his residency at the Cleveland Clinic. Good enough for me. Both surgeries were successful and I did a lot of work to make it so. But it starts with a good surgeon. My Dr also used the Stryker/Make robotic assistant.

Question - what was your recovery like for the RSR? I'm sure that's next for me whether it's traditional or reverse. I don't really want to sleep in a recliner but will if I have to. What was pt like and is there anything that can be done ahead of surgery to aid recovery, like pt? Thanks!

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I felt better after RSR since my patella was no longer on the side of my leg. Since they didn't have to cut the bone, it was not as bad as the TKR. Because of the RSR, the doctor had to resurface the knee making the patella thinner. That's why this summer I fractured my patella.

I thought I had a good surgeon also, He came highly recommended by several people. I should have noticed the red flags. He would never spend more than 2 minutes with me and he never explained the surgery in detail. He was very arrogant. Once I had the surgery and I had my issue with my popping in my knee, his answer was alway it is part of the healing process. Then my patella component came loose and it took over 4 weeks to be seen because they did not believe me. Every time I would contact the office, I left like I was bothering them. I wondered what success rate the Stryker/Make robotic assistant surgery has?

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@hsminc

Your experience is horrible. It should not have happened. It seems absolutely crazy. I have had two total knee replacements; a hip replacement; and a reverse shoulder replacement. I had excellent surgeons that specialized in just those body parts. I never had any problem - and no pain with either the hip replacement or the shoulder replacement.
Even if I had to use my savings to pay for it, I would go out of town to a large city that has a high volume practice with knee replacement experts that specialize in revision knee surgeries. I would find out what you need to have done to get the problem fixed and then do it. It might involve changing insurance. My understanding is that insurers cannot discriminate against patients for pre-existing conditions. But be sure to verify. Always verify.
I agree. Orthopedic surgeons (and any doctor) are loathe to say anything negative about their brethren in the same city or region. They fear lawsuits if you filed a malpractice claim, etc. . Lawsuits can be very expensive for the physician that tells you what the other doctor did wrong. Lawsuits take up inordinate amounts of time for everyone and that is the major issue.

Jump to this post

Haha, fun thing about lawsuits, trying finding a lawyer that will even take your case has been impossible. I am past the statute of limitation from my first surgery. Even though I am still having problems and I don't know how much it is going to cost my in future.

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