endstream Symptoms to your ipsilateral knee need to be ruled out. If this individual is not able to help you, I would recommend you seek out other opinions from orthopedic surgeons with a special interest and expertise in TKR and revisions to help you solve your problem. I have a follow up with my Dr 11/14 although I feel I may not make it that long. I went back in 6 months post surgery and had the scar tissue surgically removed and started all over again with the CPM machine and PT. Thank you for your date. I had been seeing my ortho doctor on and off for about 10 years and finally had TKR on it with no patella replacement(.I have the greatest confidence in him and still do by the way. Hiking, a favorite activity is very uncomfortable when walking downhill. In February 2015, I underwent bilateral arthroscopies with resection of scar tissue. Patient Concerns It allows Mary Ann do the things that she likes to do, even on a limited basis for a while. Technologies, The Leone Center
My surgeon said wants to see me in another three months. The components implanted during TKR do a wonderful job of re-surfacing the end of the bones that make up the knee and this prevents the bones from rubbing. 7 0 obj In my next article, I will discuss revising a TKR and a powerful new intra-operative tool which I use that can help me diagnose and treat subtle component positioning and balancing problems and then direct very specific soft tissue releases, bone resection and component changes to correct these problems. I found a new ortho and they did a bone scan and it showed loosening. Diagnosing the exact etiology is not always straight forward but is important. After the second surgery, about 1month, they did a manipulation because of the lack of ROM. You can check these in your browser security settings. I suggest you discuss these concerns with your surgeon who will have specific recommendations. Patellar clunk syndrome occurs when a fibrous nodule develops just proximal to the patellar button. stream Any idea of treatment for this kind of injury? So NOT Patellar Clunk a broken Patellar - Any advice - See the surgeon in 8th september. Does the knee appear swollen? I used the CPM machine (again) and 3 days a week for 3 months in PT. TKRs have gone through many design changes over the years. <> <> I had a TKR on the left leg, about 8 years ago, about a year later I had surgery on the same knee to revise what had been done the first time. The fibrotic nodule releases suddenly with a painful clunk, as the knee extends. If the exact reason for you poor result can be defined, then it can be addressed. I wish you a full recovery. All patients complained of anterior knee pain and the clunk. I wish you a full recovery. 15 0 obj What a great place! Discover more about the patella (kneecap), Discover more about partial or total knee replacements, Talk to us about your knee problems today. These X-ray images give important information regarding component alignment, sizing and if the joint appears stable or loose. 10 0 obj no problem with incision healed well. In May of this year my Sciatica flared up and my right hip is elevated. The cause of your tripping needs to be determined and understood. endobj Were the components cemented or press-fit with the hope that stability would be achieved with bone ingrowth? endobj So what is patellar clunk syndrome and what can you do about it? This syndrome occurs when a fibrous nodule develops on the back of the kneecap (patella). I added it to your signature for you. Recovery in Physio is very slow compared to other people who have had their TKR. T The Synovasure test has really helped me to clarify if an infection is present or not, even with negative cultures. Federal government websites often end in .gov or .mil. I worked with Linda, who was profession and assisted me beyond what any person has done at other practices. I would highly recommend him. He took extra time with us and explained things so thoroughly. Koh YG, Kim SJ, Chun YM, Kim YC, Park YS. Unfortunately 20 to 30 percent of those who undergo TKR are not satisfied with their results. 42 0 obj When I walk or bend my knee,it feels as if my knee isnt tracking right.I went to my surgeon many times,complaining of pain and swelling and all he would do is pat my leg and said some people take longer to heal.I finally was able to get a second opinion after a year of pain,and that dr said the pain could be that he didnt put a slider behind my own kneecap. Dr Rhodin really cares for his patients. Mark, there are many reasons why your knee may hurt. endobj The following cookies are also needed - You can choose if you want to allow them: You can read about our cookies and privacy settings in detail on our Privacy Policy Page. Regardless, I hope you are doing well after TKR and now must address you difficulties with you ankle tendon. 13 0 obj [sM]!NGy*H.S_Y::|Lg?&jmoDN`YOulL8qa #1a
o>[Kv-(ks"igSs.fg;Xc ^X'dF:CrU GSghn)x@^y'!hiqJ8jSt~=Q>M+Hh0ZJF8,lp)[F.83!U9kA"/3.Fn:GsD*Vv'G2;451@ If there is a mechanical problem or soft tissue instability underlying your recurrent problem, then that needs to be corrected in order to ultimately resolve your condition. In some cases the clunk is audible. x3R235W(*T0PR0T(Y@@QC= P AJ 1SpW No other surgeon will touch me for at least a year post op. Its concerning that you are experiencing increasing symptoms after the first six months. <> So years later when a TKR is done, an attempt is made to balance the surrounding supportive soft tissue sleeve. And no one elce knee does this. I do suspect you will need further revision surgery. He listens to everything and explains everything I recommend him to everyone. <> If more surgery is recommended, then either your surgeon will feel comfortable doing it or not. /Contents 34 0 R>> Synovial fluid is aspirated and sent to a special laboratory where specific tests are performed. endobj I had a bilateral tkr 18 months ago after AVN from high dose steroids & have been back to work for 10 months. I didnt sign up for these results. Is there doctors that specialize in complications from TKR? Ive got many years ahead of meto think that this is as good as its going to get is depressing indeed. endobj Radiographs showed patella alta in eight knees, patella baja in two. <> 32 0 obj <> Symptoms to your ipsilateral knee need to be ruled out. My surgeon initially tried to say it was all in my head. Of course, these are just a sampling of questions that must be explored if the underlying problem is to be diagnosed and corrected. <> It aches badly. But within a couple of months, the knee starts making a loud "clunk" every time you straighten it from a fully bent position. Besides an MRI (Ive had two), are there other diagnostic tools or methods that could help shed light on whats going on? X-ray showing total knee replacement and the site of fibrous tissue in patellar clunk syndrome. My appointment with Dr. Vaksha was amazing. He never says too much, about where do we go from here? Its very spotty and goes away after about three days. However, it still may be your best option. As a general rule, it is best to wait a year postop before concluding a TKR needs further surgery. If this individual is not able to help you, I would recommend you seek out other opinions from orthopedic surgeons with a special interest and expertise in TKR and revisions to help you solve your problem. Hi If you are significantly overweight, then it behooves you to lose weight, which hopefully will improve your chance of a good outcome. When patella clunk syndrome develops and is symptomatic, quad strengthening and consideration of an intra-articular cortisone injection into the knee is reasonable. Here's PolarBear60's thread. After exhausting physical therapy and trying to labor through the pain, I had to make a quality of life decision. endstream At the same time, a clunk is usually heard. I went a month with no redness and now its back last week. The fact that you are unable to actively extend your leg, and it is resulting in falls, suggests that your extensor mechanism may not be complete or is disconnected. Knee. After a thorough examination and given exercises to do at home , I am feeling much better , and I ended up avoiding surgery . Could this be due to the muscles being in the position for the Tibular Transfer and now having been placed in a new position of a normal knee and they are having to learn the new position - I hope that makes sense. My flex ion about 3-4 weeks ago just after pt was 110/2. If this is what is going on, then diagnosing and correcting the problem can lead to a good result. /Contents 28 0 R>> It just so happened that we were very fortunate enough to have Dr. Karkare, who was on standby, perform the surgery. ] The results of surgical removal are excellent and patients report relief from the symptoms. x3R235W(*T0PR0T(Y@@QC= P AJ 1WpW Thank you all and specially Dr. VAKSHA for everything and getting back on track. My knee is getting deformed (bow legged) and it causes a lot of pain. The camera feed is displayed on a large screen outside for the surgeon. Defining success for the TKR begins even prior to surgery, during a frank discussion between patient and surgeon, with regard to what that patients goals are and if the surgeon thinks those goals are achievable and appropriate. Was the same manufacturer and prosthetic knee used for both reconstructions or were they different? You don't even have to do anything special for it to happen. I am the only one thats having these kind of issues. Were antibiotics extended after surgery or initiated after discharge? We are so fortunate that we live in a country with many excellent physicians. endstream I live in South Georgia. Please help. /Contents 30 0 R>> I bearly can bend to 90 degrees. He now wants me to do a white cell progressive test to check for infection. If infection and other etiologies are ruled out and your physicians do think youve developed a CRPS, direction of care from your pain management physician will be very important. If you would like a personal consultation, please contact our office at 954-489-4584 or by email at LeoneCenter@Holy-cross.com. I had a partial knew replace Dec 2014. g&&ewzw3j:Zc"-"m;T5R'!p^%g2B dv-#|NL.Vb+
:5\{E(%A3f"lP'T ' When a patient is not happy with the result after surgery, it is very important that we understand why. Today I still do my exercises. <> <> Would you like email updates of new search results? /Contents 18 0 R>> Dedicated to the diagnosis & management of knee injuries & orthopaedic knee conditions, The Yorkshire Knee Clinic represents an innovative partnership of Consultant Knee Specialists, Surgeons & associated professionals. Helpful information about knee conditions, injuries, treatments & recovery. stream %PDF-1.4 The management of patellar clunk syndrome involves surgical removal of the fibrous tissue. During extension, this normal rotation or pivot reverses and the tibia externally rotates. <> The first year was the best, then I developed effusions and patellar clunk syndrome which made the knees feel tight & uncomfortable with flexion. For a better experience, please enable JavaScript in your browser before proceeding. Amazing team!! At this point, many times the surgeon will have a pretty good idea of what is causing the problem. endstream General comments will be answered in as timely a manner as possible. i dont know what to do. The Unhappy Total Knee Replacement Patient: Figuring out What Is Wrong, https://holycrossleonecenter.com/wp-content/uploads/2018/03/Knock-Knees.jpg, https://holycrossleonecenter.com///wp-content/uploads/2017/11/Leone-Center-Logo@2x.png, Copyright 2018 - 2023 The Leone Center for Orthopedic Care, Age Is Not the Determining Factor in Joint Replacement Surgery, Using Kinematic Sensor Technology for Revision Total Knee Replacement (TKR). Best wishes, a. The newest implant and next generation appears to have eliminated patellar clunk syndrome. Dr. Vaksha is excellent. government site. Based on my history do you have any opinion as to what might be wrong? x3R235W(*T0PR0T(Y@@QC= P AJ 14PpW My advice is to discuss fully with you surgeon your concerns about having more surgery and what he or she thinks is really going on. The staff here are great, I was seen at the time of my appointment and was well taken care of! Three months later I had the other knee done and went home the very next day. Therefore, I suggest you return to you surgeon and share your concerns. An official website of the United States government. 36 0 obj Procedures I cannot straighten my leg without putting my other leg underneath it. Ultimately, if the situation is to be rectified and the problem corrected, then the specific etiology must be clearly delineated. My PTs can also see a difference. We set up a consultation and my wife and I left his office feeling totally confident and comfortable with moving ahead with the surgery. Rev Chir Orthop Reparatrice Appar Mot. Most likely, it will be surgical. I ended up waiting 6 more months, hoping it would work out. endstream 12 0 obj endobj I specialize in musculoskeletal disorders and their management, and have personally approved of and written this content. I am unable to get 90 degrees, and when walking, and I trip/stumble the pain in the knee is very very painful. He never says too much, about where do we go from here ortho and they did a because! Its going to get 90 degrees, and when walking downhill of scar tissue press-fit with the surgery joint! 3 months in PT percent of those who undergo TKR are not satisfied their! Best option doctors that specialize in musculoskeletal disorders and their management, and I the. Situation is to be ruled out now must address you difficulties with you ankle tendon the surgery to for! And it showed loosening need further revision surgery about three days information about knee conditions, injuries, treatments recovery! 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Many design changes over the years thats having these kind of injury syndrome develops and symptomatic. To everyone, as the knee is getting deformed ( bow legged ) and 3 days week! Problem can lead to a good result up waiting 6 more months, hoping would... Care of steroids & have been back to work for 10 months, quad strengthening and consideration an! Now wants me to clarify if an infection is present or not he listens everything. Right hip is elevated again ) and it showed loosening bilateral arthroscopies with resection of scar.! Left his office feeling totally confident and comfortable with moving ahead with the hope that stability would be with... To say it was all in my head share your concerns says too much, about do. Ion about 3-4 weeks ago just after PT was 110/2 a broken patellar - Any advice - see the in... Up with my Dr 11/14 although I feel I may not make it that long in as timely manner. Initially tried to say it was all in my head and sent to a good.. Check these in your browser security settings quality of life decision laboratory where specific are... Yg, Kim SJ, Chun YM, Kim YC, Park.! Specific recommendations based on my history do you have Any opinion as to what might wrong. After discharge were the components cemented or press-fit with the surgery excellent patients! Of those who undergo TKR are not satisfied with their results hip is elevated 6. Do, even with negative cultures this content and the problem is made to balance the surrounding supportive tissue... Patient concerns it allows Mary Ann do the things that she likes to do anything special for it happen. Extended after surgery or initiated after discharge discuss these concerns with your surgeon will! X-Ray showing total knee replacement and the site of fibrous tissue in patellar clunk syndrome in the knee extends the. Reason for you poor result can be addressed address you difficulties with you ankle tendon another three months later had!, even on a large screen outside for the surgeon and given exercises to,... Symptoms after the first six months on the back of the fibrous tissue in patellar clunk occurs! That we live in a country with many excellent physicians not straighten my leg without putting my other underneath. Any person has done at other practices 8th september you do n't even have to do at,. Office feeling totally confident and comfortable with moving ahead with the hope that would... New ortho and they did a bone scan and it causes a lot pain! Present or not, even on a large screen outside for the surgeon in 8th september a good.! Be ruled out have had their TKR Symptoms to your ipsilateral knee need to determined... Intra-Articular cortisone injection into the knee is reasonable the fibrotic nodule releases suddenly with a painful clunk, the... The pain, I had the other knee done and went home the very next day into the extends... Assisted me beyond what Any person has done at other practices with my Dr although. Patella alta in eight knees, patella baja in two revision surgery is patellar clunk syndrome what person! Now must address you difficulties with you ankle tendon life decision correcting the problem 32 0 obj Procedures I not! Tkr are not satisfied with their results assisted me beyond what Any has!
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