New Medicine For Pain Pathways

elainebadknee

Hi

Been to my doctor today as my physio dischrged me 2 weeks ago and said she had done all she could for my new knee but I still get a lot of pain....Trouble is as I've had lots of surgeries since was a teenager and got the TKR aged 44 this has left lots of little pain pathways that still are ongoing even though my osteochondritis dissecans is gone...Now I thought when got new joint my kneecap was gone too but she said no, tthey try and preserve it if possible but she has had anohter patient who had pain like me and needed more surgery on the kneecap which they were reluctant to do as going into the old scar, risk of MRSA is high....Yikes!
So im on amitripyline and Zacin cream if that doesn't work its going to beslow release gabapentin....I thought would be pain free but it seems not, but at least i understand why....

Elainexx

stickywicket

I think it's normal to keep kneecaps after a TKR. I still have mine. I hope the cream and amitrip help with the pain.

elainebadknee

Sticky

I thought cos had had a knee replacement that the whole joint had been replaced including the kneecap. Don't suppose will find out till go back for another review next year for definite...

Elainexx

barbara12

Elaine I would have thought the same, you would have thought this would have been discussed with you...very confusing...I hope you get some relief very soon..x

elainebadknee

Barbara

Well I got my operation notes and from what i read on there the kneecap is taken out a button put in place, cemented and then a cover type/false kneecap is inserted. This is something I hadn't thought of and cannot go through more surgery in the near future...Not ready for that so soon..

Elainexx

stickywicket

I think normally the kneecap is just pushed to one side while they replace the knee joint which consist of the tops of the femur and tibia.

barbara12

oh I have just googled it sometimes the patella is left in and used ..the things you learn on here ..

elainebadknee

Sticky

I definitely read about mine and it said about a button being put in place with cement then a false top kneecap to go on too....I should've asked my surgeon (or his registrar as never get to see him now he's done the op)...Its puzzling me now, niggling..

Elainexx

elainebadknee

Barbara

Depends what you read, I looked up the number of mine....I'd have wanted my old kneecap taken out as surely that had my OCD in it too?

Elainexx

stickywicket

elainebadknee wrote:

.I'd have wanted my old kneecap taken out as surely that had my OCD in it too?

:? Why? By that argument your fibula should have gone too. I've always trusted my surgeons to know their job better than I do. They've never failed me yet.

elainebadknee

Sticky

Argument? - youv'e lost me there...? I made a comment that as my knee had OCD and any part of it that had that disease in it should be removed and the did tell me where the OCD was and that I no longer have it.

Elainexx

stickywicket

Ellaine, you misunderstand me. I used the word 'argument' in the sense of 'logic' not in the sense of 'squabble'.

What I meant was that, as the kneecap is no more a part of the knee joint than the fibula, it would make no more sense to remove it than to remove part of the fibula. If you no longer have OCD then all relevant bits must have been removed and I'm very pleased about that.

elainebadknee

Sticky

Well it wasn't clear how the meaning was intended, thanks.

I would say the kneecap is a big part of the structure of the knee and without it some do well but most do not. I had OCD in all parts of my knee, medial, lateral and kneecap areas.

Elaine

chookgate

From pictures I've seen of knee anatomy, it looks like muscles, ligaments and tendons are attached above and below the joint, and also to the kneecap. I think a fairly critical part of the knee is the tendons that are attached to the knee cap, and that if they had to replace it, then it would be a very major surgery, and probably an even longer recovery period. Whereas replacing all but the kneecap just involves pushing the "soft bits" out of the way, cutting off the damaged bone and sticking the metal and plastic in place. I'm just guessing though.

What they did for both my TKR's was scrape off what was left of the cartilage from the back of the kneecap and replace it with a plastic button, and they also trimmed the bony growths on the kneecap that shouldn't have been there (caused by friction with the other bones).

elainebadknee

Chook

I only know when the local surgeon wanted to remove my kneecaps that the recovery would have been about the same as TKR surgery which suggests to me that it is as major as TKR surgery, I could be wrong....
As I've only got vague operation notes and it didn't occur to me that a year after surgery I might be talking with my GP about possible surgery for my kneecap then I am not 100% positive about what has been done. I got told I had deformities from years of loose body removals and that it was a complex knee replacement but that may be more common than it sounds...

Elainexx