TKA needed with existing femoral rod/nails

Posted by sassoton @sassoton, Jul 6, 2019

I need a TKA however I have an existing femoral rod (since 1999) and have been warned that I would be at a high risk for fracture above the knee. I also previously had a rod in my femur from 1971 to 1973. I had that rod removed and later broke my femur a second time in 1999 requiring the current rod.
I am now a high functioning 65 year old male however my knee needs the TKA. One suggestion has been removal of the rod and later after healing do the TKA. Suggestions?? Anyone else been in this situation??

@sassoton – First, Welcome to Connect! There are a bunch of us here who have dealt with TKR's. I'm 68 and I've had two. But I don't recall hearing about anyone with a femoral rod. I can imagine that this must be scary and confusing as to how to proceed. While we wait for more experienced people than me to chime in, I have to ask, did your orthopedic surgeon suggest removing the rod and waiting for the TKR until its healed? Are you questioning whether to get a second opinion?

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My Mother had a femoral rod put in her leg AFTER she had her TKR however. She was 68 when had TKR and 74 when fractured her femoral bone just below the hip bone. SHe was doing fine, but was extemely independent and decided to build a new home on coast of SC. She knew no one and was still under her orthopedic surgeons care in Lexington. My brother lives 750 miles from her new home on the east coast and I live approximately the same so it wasn't like we were near to help her. She didn't finish her femoral PT before she moved either, which very much concerned me…but she was stubburn so what can you do? Within 2 mths of moving to her new home, she fell and (get this) broke the titanium rod in her leg….and then after redoing that surgery, she fell again 4 mths later and did it again. At that point, I went down to live with her and between myself, her wonderful SC orthopedic surgeon, her PT and my brother who played the "bad cop" when need arose, I had her going to PT 5 days a week, walking with her walk around the neighborhood, water walking 4 days a week in the pool until I finally got her walking 2 to 2.5 miles on the nature trail every evening when it cooled off. (That was probably the longest distance she had walked in 20 years! She looked great, her muscle tone had dramatically improved, etc etc. She did suffer from seasonal allergies and was prone to get bronchitis in the Spring, and SC is particularly high pollen area at that time of year. Her Ortho surgeon was very pleased with her dramatic recovery and didn't feel her TKR 6 yrs earlier had played a part in her breaking the femoral rod…rather, lack of muscle strengh, causing balance issues and not finishing her PT the first time seemed to be the culprit. However, I agree with Debbra, I would get a second opinion. I am a long time Mayo patient for extensive orthopedic issues, and if you are able, I would highly recommend seeing the docs there for you second opinion. God speed and good luck

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PS I am very athletic as well, and had my first TKR in Feb. I will need the other knee done as well eventually, but I am going to Mayo to see if I would be a good candidate for the stem cell replacement procedure next time. My knee is not functioning like my other knee and a ligament was pulled loose during the surgery….needless to say, I am heading up to my Ortho's at Mayo to get their opinion and see if they can repair it.

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@sassoton I have had two TKRs but have never even known anyone with a rod. Why was it put there? I think the suggestions you have sound like they are fairly knowledgeable. Removing the rod prior to the TKR sounds like it may be the best option.
I'm amazed that @killerbees mother broke two titanium rods. I would not have even thought that was possible!
If you feel confident of your orthopedic surgeon then you should go with what he/she suggests. Still, a second opinion never hurts.
JK

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@killerbees

My Mother had a femoral rod put in her leg AFTER she had her TKR however. She was 68 when had TKR and 74 when fractured her femoral bone just below the hip bone. SHe was doing fine, but was extemely independent and decided to build a new home on coast of SC. She knew no one and was still under her orthopedic surgeons care in Lexington. My brother lives 750 miles from her new home on the east coast and I live approximately the same so it wasn't like we were near to help her. She didn't finish her femoral PT before she moved either, which very much concerned me…but she was stubburn so what can you do? Within 2 mths of moving to her new home, she fell and (get this) broke the titanium rod in her leg….and then after redoing that surgery, she fell again 4 mths later and did it again. At that point, I went down to live with her and between myself, her wonderful SC orthopedic surgeon, her PT and my brother who played the "bad cop" when need arose, I had her going to PT 5 days a week, walking with her walk around the neighborhood, water walking 4 days a week in the pool until I finally got her walking 2 to 2.5 miles on the nature trail every evening when it cooled off. (That was probably the longest distance she had walked in 20 years! She looked great, her muscle tone had dramatically improved, etc etc. She did suffer from seasonal allergies and was prone to get bronchitis in the Spring, and SC is particularly high pollen area at that time of year. Her Ortho surgeon was very pleased with her dramatic recovery and didn't feel her TKR 6 yrs earlier had played a part in her breaking the femoral rod…rather, lack of muscle strengh, causing balance issues and not finishing her PT the first time seemed to be the culprit. However, I agree with Debbra, I would get a second opinion. I am a long time Mayo patient for extensive orthopedic issues, and if you are able, I would highly recommend seeing the docs there for you second opinion. God speed and good luck

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Wow @killerbees – That is an amazing story about your mom's orthopedic journey and you are the hero in the story! She's lucky to have had your support. I agree with JK that I've never heard of anyone breaking a titanium rod! From your post, it sounds as if you moved to SC to be with your mom so I'm guessing you use Mayo JAX. My orthopedic surgeon is there – Dr. Ortiguera. If you are going there for a TKR, I know you'd be very pleased with him. Not sure about stem cell replacement. Have you found a doctor for that?

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