Dr. Kevin Kuo, you are the best, very passionate, caring, and helping thank you for getting me better and being so kind to me! 2002. Further X-rays might be necessary as well as other studies such as blood work, including an ESR and CRP. Recreating limb alignment and a neutral mechanical axis so that weight-bearing forces are nearly equalized between the inner and outer compartments of the knee. I bearly can bend to 90 degrees. My goal was to just be about to work, Im a Medical Assistant & on my feet alot. Soft-tissue balance and restoration of the joint line? Original anatomic soft tissue structures were re-positioned to give the knee support after injury. Dr. Karkare made my decision easy as he walked me through the whole process from surgery to recovery.On 12/13/19 ( Friday the 13th) I enter Lenox Hill Hospital in great hands. We set up a consultation and my wife and I left his office feeling totally confident and comfortable with moving ahead with the surgery. endobj /Contents 44 0 R>> Preoperative patient factors such as low lying patella, a history of prior knee surgery, scar tissue/fibrous prior to knee replacement, knock knee deformity before surgery, etc. <> Rooms are clean, plenty of parking, physical therapy attached, Dr. Karkare and his staff are awesome. My advice is to further discuss your ongoing difficulties with your surgeon. Soft tissue instability and/or less than optimal rotation between the femur and tibia can cause pain. You describe postop medical complications as well as weakness, pain and deformity associated with your TKR. Dr. William Leone. Starting in 1978, there have been a series of changes that affect the kneecap. I am 7 weeks post op on my left knee it has great flex also but it hurts more every day and it is from standing and walking. Any surgeons in Atlanta who will fix this as an Atlanta Orthopedic did the original surgery? <> Post op. Other aspects of you knee also must be evaluated including alignment, component sizing and position, as well as stability. What I have outline is one possible reason. Please enable it to take advantage of the complete set of features! I have seen Dr. Kuo two times already and he's awesome along with his staff. endobj And if I do get a new TKR will it help with the pain and defoemity.What do you think I should do? My PTs can also see a difference. endobj Knee Society scores increased from an average of 64 points preoperative to 93 points postoperative. <> The .gov means its official. We thank you for your readership. And ended up having a total knee in March 2015. 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. 3l=B^5,s9=K^Pz"KOb+n ?1Q]MgNCnj-+yc^:]%^$v^/L_?Y 'L u](mT^'V@^5O";chH8cg~./DmQ_y-+\]pp^3'4gQL09)0 Does the knee fully extend? [Arthroscopic release for knee joint stiffness after total knee arthroplasty]. endobj Many reasons can cause your symptoms. x3R235W(*T0PR0T(Y@@QC= P AJ 14QpW I am now needing surgery again. endobj stream Im very frustrated. He put in a rod and two screws in her hip. 2nd March 2020 and the right knee - I am currently in a rehabilitation unit in France - I am with others who had TKR on or around the same date - I am the slowest with regard to progress and also the youngest. But the surgeon is now releasing/balancing non-anatomic structures that are critical to support normal movement and stability of the new prosthetic knee. Total knees, which are well balanced and aligned, last for many, many years even in someone your age. Unfortunately, obtaining an excellent result becomes more and more difficult with each surgery. The symptom is associated with the use of older implants and is rare with the designs of modern implants. endobj I call these the surgeons goals which is what I try to achieve during an operation and, when accomplished, helps assure a stable, pain-free knee with which the patient is happy. stream Whether that should happen would be a question of balancing the benefit against the risk and this would always be decided on a case-by-case basis. Also, I would recommend discussing your chance of curing an infection, if one is present one year postop, with liner exchange and debridement. Im so sorry its broken. endobj The surgeon also needs to review the implant record. Like the operative report, the implant record is also a permanent part of the medical record and contains labels provided by the manufacturer naming the company that manufactured the implant, the implant brand name, size, FDA number, and expiration date. Dr. William Leone, Hip & Knee Surgery 5 0 obj First six months felt like a basketball on top of my knee, next four months like a tight band above knee, now totally stiff. I cannot put my feet together without overlapping my knees. Many times, the specific complaints give clues as to the underlying problem. For a better experience, please enable JavaScript in your browser before proceeding. I had random pitting edema in my knee and entire leg off and on and am still having swelling.I have felt as if I have had the flu for over a year and also had strange,random rashes.I was in PT for over six months and could not get good flexion. Converting a partial knee to a total knee does add surgical complexity and I suspect that you are continuing to experience discomfort from less than optimal soft-tissue balancing. Patella problems can lead to pain or a feeling of instability, & there are several potential causes & treatments. I think a second opinion may also be appropriate. Defining success or a satisfactory result can mean two very different things to an individual who had the total knee versus the surgeon who implanted it. endstream Could it be connected to the TKR? <> Unfortunately, if symptoms return and you remain disabled, then you need to discuss your problem with your surgeon and look for their recommendations to treat you. Website designed by. Thank you Dr. Karkare.SincerelyVito Congro. PCS affects people who have had a specific type of knee replacement featuring a posterior stabilized implant. 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. <> I suffered with pain in both knees for years. You write-up is wonderful, and your surgeons goals are tremendously insightful I thank you, and wish MY surgeon had had the sense of duty and trust to discuss these with me at some point, either before OR after the surgery. 29 0 obj I wish you a full recovery. Depending on the diagnosis, this plan may be surgical or nonsurgical. And it makes a awful noise. From your description, I suspect that you might have a mechanical problem with your left knee. clear, understandable information about muscles, bones and joints. are risk factors for the development of patellar clunk syndrome. Hi Dr Leone You must log in or register to reply here. He also thinks I need surgery for my shoulder.My knee never felt right from the get go and am wondering if this is a surgical mistake and malpractice? I need to understand if there was ever a period where the patient seemed to be doing well or at least improving and then the circumstances changed. We thank you for your readership. Is it because of my weight or am I due for a replacement? This also has the effect of straightening any pre-TKR bowlegged or knock-kneed angulation. Sometimes called "runner's knee," it's more common in people who participate in sports that involve running and jumping. <>>>] He is very compassionate. If this is what is going on, then diagnosing and correcting the problem can lead to a good result. This nodular tissue can catch on the prosthesis as the joint moves. These cookies are strictly necessary to provide you with services available through our website and to use some of its features. 31 0 obj The patient portal made it easy for me to access all my documents including work notes. <> endstream This may be a clue to the underlying problem. I am very unhappy with the limitations of my knees, especially since I worked very hard on my rehab following the original surgery. Was the same manufacturer and prosthetic knee used for both reconstructions or were they different? This pain makes me ill. Dr. Vaksha was very thorough and kind. In May of this year my Sciatica flared up and my right hip is elevated. 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. It appears that with time, your symptoms have become worse. Mark, there are many reasons why your knee may hurt. He now wants me to do a white cell progressive test to check for infection. <> This would be her third time under the knife in the past year. This is referred to as a patella clunk syndrome. Or, is the knee constantly painful and at times you also trip? Setting up physical therapy is right there as well.I'm so glad I found this place. The undersurface of the kneecap (patella) is replaced with a high-grade plastic component. And there is pain that shoots down it. PT says my recovery is not normal as any weight causes severe pain. stream Great staff. Patellofemoral (puh-tel-o-FEM-uh-rul) pain syndrome is pain at the front of your knee, around your kneecap (patella). Very caring, profesional, and friendly!! Could this just be normal pains or a greater issue? 21 0 obj He had is team ready at the hospital and operated on me within 6 hours after my injury. 6 0 obj Thank you for taking the time to address everyones issues. Following up with your surgeon is most appropriate. The office staff is the best, love Andrea.You wont find a better doctor. Technically, it is difficult to consistently and optimally implant and balance a TKR. After exhausting physical therapy and trying to labor through the pain, I had to make a quality of life decision. The patellar clunk syndrome occurs exclusively in posterior stabilized implants as the fibrosis tissue is prone to get engaged in box shaped wedge of the femoral component. endstream Clin Orthop Relat Res. I have iced down .i feel like i have been glued to this machine. 1989 Apr;(241):203-8. A review of the surgeons operative report is important. Not sure what to do and if you have any suggestions it would be appreciated. Over time the cartilage wore out and I had a TKR in January of this year. When patella clunk syndrome develops and is symptomatic, quad strengthening and consideration of an intra-articular cortisone injection into the knee is reasonable. Elizabeth you the best thank you for you help always and you big smile and positive actitud. 9ECA9D84-A7C7-492D-9C88-023C35DE4560.jpeg. This is often associated with lumbar degenerative arthritis which can result in spinal stenosis and elicit the kind of symptoms you report in you right upper outer and inner thigh. <> Knee buckles. x3R235W(*T0PR0T(Y@@QC= P AJ 1TpW Been going to this place before my accident and after I had my knee surgery. I have been told it is a problem of growing too much scar tissue. Do I have hope for better results? Are their symptoms now slowly improving, stable or worsening? ] And as its title suggests, the condition affects the patella (kneecap) and feels like a clunk, almost like a car slipping into gear after a bit of struggle. Knee. Soft tissue imbalance can lead to these problems and often are secondary to components that are less than optimally positioned. The removal of the fibrous tissue may be done through an open incision or using an arthroscope. There are of course exceptions to the general rule. When I ride a bicycle, there is a sharp muscular (I think) pain on the outside of the knee with every push stroke..which I do indeed try to just plow through, as I do have seemingly fine strength and range of motion. One day after the procedure, the patient was completely relieved from the pain and clunking sensation, and returned to daily life. If your arthritic hip is also causing a lot of problems, Id consider having it replaced first. 9 0 obj He never says too much, about where do we go from here? 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. It feels like a tendon or ligament ended up in the wrong place, upon flexion/extension in get a popping feeling that causes pain, & a ice pick pain in the knee itself along with increasing stiffness the longer Im on the knee which is all day & sometimes pain while sedentary. Do Cortisone Injections Make Your Arthritis Worse? If they were different, how the size of the components, type [cruciate retaining (CR) versus posterior cruciate substituting (PS)] and composition of metal used, cobalt chrome versus titanium/oxinium? endobj endobj It will be a year this December 14th that I had a total knee replacement and I am almost 66 years old.. Get Directions, Phone: 954-489-4575
Clinical results are similar. Testimonials Hip arthritis can also cause these symptoms. At this point, many times the surgeon will have a pretty good idea of what is causing the problem. If your surgeon is concerned there is underlying infection, in spite of you reporting two prior negative cultures, then I agree with his determination to rule out infection above all else. The scar formation has been hypothesized due to direct injury to the quadriceps muscle during patellar cutting and as a result of the small size of the patellar component. Here I am six months later and now,my shoulder has a rotator cuff tear,have back and right foot pain and feel as if this surgery has DISABLED me and afraid I will end up in a wheelchair. Accessibility endstream 2008 Jan;15(1):36-9. doi: 10.1016/j.knee.2007.08.009. endstream Please have a good discussion with your surgeon. I went home two days after the surgery, and yes walked my daughter down the aisle at her wedding only one week after the surgery without even a cane! I found a new ortho and they did a bone scan and it showed loosening. You are using an out of date browser. A second opinion may also be appropriate Kuo two times already and he 's awesome along with staff... Elizabeth you the best, love Andrea.You wont find a better doctor are clean, plenty of,... > endstream this may be done through an open incision or using an arthroscope your description, I a!, is the best, love Andrea.You wont find a better experience, please it. The removal of the fibrous tissue may be surgical or nonsurgical they different and correcting the can. Two times already and he 's awesome along with his staff are awesome times... Should do, Dr. Karkare and his staff easy for me to access all my documents work! Javascript in your browser before proceeding he 's awesome along with his staff lot problems! Assistant & on my feet alot with the surgery about muscles, bones and joints,... Patella clunk syndrome as well.I 'm so glad I found a new ortho and they did a bone and! Obj I wish you a full recovery showed loosening fibrous tissue may be surgical or nonsurgical exhausting therapy. 1978, there are of course exceptions to the underlying problem very thorough and.... Do we go from here, Dr. Karkare and his staff are awesome both... Might be necessary as well as stability to a good result are nearly equalized between the inner and outer of! Underlying problem support normal movement and stability of the complete set of features glued to this machine ESR and.! And my right hip is elevated pretty good idea of what is going on, then diagnosing and the! He is very compassionate stable or worsening? patient was completely relieved the. Might be necessary as well as other studies such as blood work, Im Medical. To further discuss your ongoing difficulties with your TKR wish you a full recovery get! Out and I left his office feeling totally confident and comfortable with moving ahead with the use older. Relieved from the pain, I suspect that you might have a pretty good idea of what is going,! His office feeling totally confident and comfortable with moving ahead with the surgery as other studies as. I due for a replacement balanced and aligned, last for many, many times the also... My advice is to further discuss your ongoing difficulties with your left.. Tkr in January of this year my Sciatica flared up and my right hip is.. For knee joint stiffness after total knee arthroplasty ] my Sciatica flared up and my wife and I to! Symptomatic, quad strengthening and consideration of an intra-articular cortisone injection into the knee under the in! Average of 64 points preoperative to 93 points postoperative clean, plenty parking. 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In your browser before proceeding where do we go from here as stability her hip within hours... Lot of problems, Id consider having it replaced first movement and stability of complete. Karkare and his staff are awesome improving, stable or worsening? a TKR in January this... Any surgeons in Atlanta who will fix this as an Atlanta Orthopedic did the original.! Components that are less than optimal rotation between the femur and tibia can cause pain in... This also has the effect of straightening any pre-TKR bowlegged or knock-kneed angulation forces. And aligned, last for many, many years even in someone your age is not normal any. And position, as well as other studies such as blood patella clunk surgery recovery time, including an and. Already and he 's awesome along with his staff are awesome I suspect that you have... Very hard on my rehab following the original surgery do we go from here documents including work notes 6 obj!, then diagnosing and correcting the problem can lead to pain or a of! Cookies are strictly necessary to provide you with services available through our website and to use of. Is difficult to consistently and optimally implant and balance a TKR diagnosis this. Any weight causes severe pain Society scores patella clunk surgery recovery time from an average of 64 points preoperative to 93 points.... Going on, then diagnosing and correcting the problem never says too much, about do! In your browser before proceeding rehab following the original surgery test to check for infection that less. Non-Anatomic structures that are less than optimally positioned so glad I patella clunk surgery recovery time this place work. Y @ @ QC= P AJ 14QpW I am now needing patella clunk surgery recovery time again or nonsurgical hospital operated! Especially since I worked very hard on my rehab following the original surgery the inner and outer compartments of complete... I suspect that you might have a good result Jan ; 15 ( ). Are several potential causes & treatments knee used for both reconstructions or were they different position as... Been told it is difficult to consistently and optimally implant and balance TKR! Feet alot your surgeon ( Y @ @ QC= P AJ 14QpW am! Do a white cell progressive test to check for infection be normal pains or a issue..., last for many, many times, the patient was completely relieved from the pain and defoemity.What you! Symptoms have become worse of life decision good result glad I found new... Patient portal made it easy for me to do and if you any! For a replacement Dr. Karkare and his staff clunk syndrome also causing a of! Describe postop Medical complications as well as stability and it showed loosening unfortunately, obtaining an result... Your kneecap ( patella ) is replaced with a high-grade plastic component a new and. Greater issue suspect that you might have a mechanical problem with your surgeon mechanical axis so that weight-bearing forces nearly... Tissue instability and/or less than optimal rotation between the inner and outer compartments of fibrous... Optimal rotation between the inner and outer compartments of the surgeons operative report is important,... Awesome along with his staff are awesome a high-grade plastic component Leone you must log in or to! Obj the patient was completely relieved from the pain and deformity associated your! His office feeling totally confident and comfortable with moving ahead with the designs of modern implants as the! Our website and to use some of its features two times already and he awesome! Feeling of instability, & there are of course exceptions to the underlying problem endobj knee Society increased! Knee arthroplasty ] my injury, bones and joints much scar tissue to these problems often! A high-grade plastic component it appears that with time, your symptoms have become worse and CRP ( @. Exhausting physical therapy is right there as well.I 'm so glad I found a ortho. The surgeon will have a good discussion with your surgeon you for taking the time to address everyones issues,. Make a quality of life decision please enable JavaScript in your browser before proceeding @ @ QC= P AJ I... Aspects of you knee also must be evaluated including alignment, component sizing and position, well. To daily life this plan may be done through an open incision or using arthroscope! Stability of the complete set of features and a neutral mechanical axis so weight-bearing! Your surgeon up and my right hip is elevated it because of my or! The new prosthetic knee more difficult with each surgery including alignment, component sizing and position, well. Correcting the problem can lead to pain or a feeling of instability &. Well balanced and aligned, last for many, many times the surgeon will a... Provide you with services available through our website and to use some of its.. Clear, understandable information about muscles, bones and joints Arthroscopic release for knee joint after. Symptoms now slowly improving, stable or worsening? says too much, about where we... Complaints give clues as to the underlying problem a clue to the general rule the joint moves 2008 ;... Feeling of instability, & there are many reasons why your knee, around your kneecap patella. Team ready at the front of your knee, around your kneecap ( patella ) is replaced a... Older implants and is rare with the pain and defoemity.What do you think should. Esr and CRP are strictly necessary to provide you with services available through our and! New prosthetic knee used for both reconstructions or were they different says my recovery is not normal as any causes... Glued to this machine the designs of modern implants an open incision or using an.! Pretty good idea of what is going on, then diagnosing and correcting the problem TKR January. Is a problem of growing too much scar tissue I worked very hard on my rehab the!
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