Total knee replacement– complications/ pain a few yrs later

Moomin

Hello,

I posted here the other day, but had got incorrect details, so am now coming back again, hopefully with the right facts!

My mum had a total knee replacement nearly two years ago. To cut a long story short, at first it looked like all had gone well. The consultant was really pleased – x-rays showed a perfect new knee, the physio had gone really well. However, although the original osteoarthritis pain disappeared, the post-surgery pain never really went and recently got much worse. My mum was sent to have a scan of her knee.

The scan revealed that a fragment of bone from the TKR surgery was spotted and this has caused irritation / infection. We understand there are two options:

1. operate again and fish out the fragments of bone
2. less invasive option which somehow involves ‘sucking’ out the fragments.

My mum has an appointment with her orthopaedic surgeon coming up and obviously will want to talk through the options.

Has anyone on here had this experience? What treatment options are out there (does the above sound like a sensible way forward) and what are the risks of each.

What might be the cause of the bone fragments from the original surgery? Might it be something to do with the kind of knee replacement / its quality? (I’ve read a lot about some TKR products being better than others).

Is this a case of medical negligence and should we be seeking legal advice as well?

If anyone has any thoughts on this or direct experience, it would be very helpful to hear from you. As you can imagine we’re incredibly worried especially about the prospect of further surgery and associated risks and the potential prospect of increased pain / permanent disability if we can’t find a good way forward.

Thanks very much.

elnafinn

Hi Moomin,

I love your username. :-D

I cannot really help you with your questions except to say that your mum is not alone with having problems after a TKR.

My TKR on my left leg has been no problem and was performed in 2008. The TKR I had done on my right leg in 2010 was fine for three years only. I was back and forth to the surgeon for a further three years.

He did do keyhole surgery last year on this knee to move the knee cap over or something. I was in hospital for 5 days instead of only overnight, with a drain. This operation proved to be a complete waste of time and I am left with skin discoloration.

He referred me to a couple of his colleagues and in the end one of them operated this June and put in another TKR for me. He told me the prosthesis he removed was very worn in an unusual pattern.

I saw him at 5 weeks post op and we were both very pleased with the new knee. Of course it was still painful but I could and still can do all the physio exercises extremely well with an excellent knee bend. I can also kneel on both knees.

Unfortunately, about three weeks or so ago, I had a fall (slippery narrow, sloping path at a national trust park) onto my coccyx, not forward onto my knee or knees and all seemed ok for a couple of weeks. Now I have pain in my right knee when going up and down stairs and sometimes when walking and it is as bad as it was before this last operation.

I see surgeon in December at the 6 month check. I am hoping that things will be ok by then but I have a feeling they may not be....

As your mum will be seeing the surgeon she can ask any questions she has then. Best to write them down beforehand.

Do let us know how the appointment goes.

Take care
Elna

stickywicket

I can't really add to my reply on your earlier thread. TKRs are a very safe op but, as with any other, things can go wrong. Sometimes this can be the fault of the surgeon, sometimes of the patient and sometimes no-one is at fault.

I can only suggest you put your questions to the consultant when you see him. If you then feel there was some negligence on his part you could contact your local P.A.L.S. for advice. I would personally also ask which of his two suggestions he thinks would give the best result. I'm sure we all instinctively would opt for the less invasive one but only if the outcome was likely to be as good. You say the scan revealed “a fragment of bone” but then go on to write of 'fragments'. Was there just one? Or, might there be more? The answer to that might determine your best course of action.