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Heather Mills - Amputee Forum
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stevejw

Failed knee replacements?

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Hello.

I am in my early 40's and, for a number of years, have been struggling with my mobility following a failed total knee replacement. After several years of pain/restricted mobility I resolved to discuss options with my orthopaedic surgeon who said that we should attempt another tkr which was implanted last August. Unfortunately due to infection this operation was not succesful and I am now left with a very stiff and more painful leg than existed prior to the operation. My surgeon has suggested that I should have my leg fused but this will restrict my mobility even further. Amputation is an option - has anyone had the same experience?

thanks

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Hi Ther,

Sorry to read about your situation, I have every empathy with you.

I had lots of operations including three failed total knee rplacements. I ended up having my knee fused using an ilazirov frame, it took 18 months for it to fuse and I was in the most horrendous pain imaginable. Turning 16 bolts every four hours is no fun! I lasted 7 years with my leg fused but like you said I was actually more 'disabled' than before and certainly in a lot of pain.

Of course everyone is different and some have better experiences than the next, I can only share my experiences with you. I made the difficult decision to have an above knee amputation in April 2005. To say that it hasn't been plain sailing is an understatement, I had three revision surgeries in the first year following amputation! I still don't have a prosthetic leg and live from a wheelchair. The reasons for it taking so long is very complex and if you wish to know more you can PM me or look at all my previous posts.

Iknow how difficult it is to face such a decision and I do hope you feel at peace about yours when you have done all the research. You may well be better off with it fused if you can deal with the whole process of getting it fused, check out the various options for different external fixators. You may well be better off opting for amputation straight away, it may well be sucessful for you but learning to use a prosthetic leg is Imore difficult than people realise. If you have suffered long term pain then you are probably more likely to have continued long term pain post amputation.

Enough already, I feel I have said enough, feel free to ask any questions and check out the site for other peoples experiences.

Good luck.......................Lynne

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I suffered several attempts at saving my leg, and was going to have a fused (arthrodesed) knee. 16 months in, the infection took hold and I had to have an amputation above the knee. I have never looked back. I am more mobile now that I ever could have been wth my own leg.

I had an AK amputee visit me when I was in hospital who's Dad had a fused knee, there was no doubt in his mind what I needed... an amputation... I didn't realise then, and didn't know anything about being an amputee then (no internet :( )... but I realise now, he was right.

Obviously there are other issues and we are all different, but a straight question as to whether a fused (and quite likely painful) knee as opposed to an AK amputation... there's no comparison... my opinion would be amputation. Mobility is much better with a decent fitting artificial leg than with a fixed, straight leg.

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Have you gotten a second opinion? My Dad is 80 with a knee replacement and he walks circles around this AKA.

Whatever you decide you have my best wishes for a good outcome!

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Many thanks to you all for taking the time to respond. It seems that different people have had quite different outcomes. In terms of preparation and trying to improve the odds of a good post-amputation result, are there any 'golden rules', or insights that I should be aware?

Many thanks again for taking the time to respond

Steve

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Hi Steve

I think you hit the nail on the head when you said everyone has different experiences. I had a very complex, but amazingly successful, TKR on my BK. Lots of pain and lots of complications with limb fittings, but in the end it was very successful! :)

Listen to everyone's advice on here, yes, but you have to make up your own mind about what you want to do with your body. I've had to make quite a few major decisions surgery-wise over the years and I found that using a chart of 'Pros' and 'Cons', for each procedure, helped me to make my decision.

As for pre and post amputation. You need to go and visit your local prosthetist and get an honest assessment from them. Once you've got used to walking post-amp, you should be as active as you were before all your trouble started, assuming your general health is OK. You never know, they may even be able to put you in touch with someone who had an AK amputation under similar circumstances.

In the meantime, a couple of things you may wish to research for yourself (which this board may be able to help you with) is phantom limb pain and your future surgeon (some are better than others at amputation).

Lizzie :)

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This knee replacement issue is a big scare for me.

When I smashed my LEFT leg 19 years ago - it was close to amputation, smashed in an off-piste skiing accident with a guide. tibia and fibia pulverised and crunched tibial plateau. RIGHT leg amputed AK in an RTA 17 months ago.

I get more pain from the real leg rather than stump discomfort etc.

Had always assumed that at some point would have to have new knee. A school friend is a senior orthopaedic consultant (knee specialist) and he said - before the amputation- that OK for the inactive but for me best avoided. The technology is improving but couldn't do what I want with the replaced knee.

Know am scared at the thought of failed surgery and being a double amputee. Stopped me going back to skiing this season too! Am I finally becoming risk averse?

What is the success rate of knee replacement?

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This knee replacement issue is a big scare for me.

When I smashed my LEFT leg 19 years ago - it was close to amputation, smashed in an off-piste skiing accident with a guide. tibia and fibia pulverised and crunched tibial plateau. RIGHT leg amputed AK in an RTA 17 months ago.

I get more pain from the real leg rather than stump discomfort etc.

Had always assumed that at some point would have to have new knee. A school friend is a senior orthopaedic consultant (knee specialist) and he said - before the amputation- that OK for the inactive but for me best avoided. The technology is improving but couldn't do what I want with the replaced knee.

Know am scared at the thought of failed surgery and being a double amputee. Stopped me going back to skiing this season too! Am I finally becoming risk averse?

What is the success rate of knee replacement?

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Knee replacements are considered to be very successful operations with few people experiencing problems. However the vast majority of TKR's are implanted in people who are 65 years plus and live a moderately sendentry life style. Knee replacements are, by definition, artificial implants and have a finite life - typically this extends for 10 to 15 years although for active individuals this time frame can be shortened considerably (in my case the first tkr lasted less than 4 years).

A TKR is a bit like an amputation in one sense: once you've had it, there's no going back. My advice from my own experience would be to wait until your existing knee is so grumpy that life is grim - then look at it. Hope this helps

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Knee replacements are considered to be very successful operations with few people experiencing problems. However the vast majority of TKR's are implanted in people who are 65 years plus and live a moderately sendentry life style. Knee replacements are, by definition, artificial implants and have a finite life - typically this extends for 10 to 15 years although for active individuals this time frame can be shortened considerably (in my case the first tkr lasted less than 4 years).

A TKR is a bit like an amputation in one sense: once you've had it, there's no going back. My advice from my own experience would be to wait until your existing knee is so grumpy that life is grim - then look at it. Hope this helps

thanks - ties in with my gut reaction as to what to do. scared of the unknown though.

If only hadn't spent all that time in the mountains or on motorbikes. butt then would have missed out too!

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Knee replacements are considered to be very successful operations with few people experiencing problems. However the vast majority of TKR's are implanted in people who are 65 years plus and live a moderately sendentry life style. Knee replacements are, by definition, artificial implants and have a finite life - typically this extends for 10 to 15 years although for active individuals this time frame can be shortened considerably (in my case the first tkr lasted less than 4 years).

A TKR is a bit like an amputation in one sense: once you've had it, there's no going back. My advice from my own experience would be to wait until your existing knee is so grumpy that life is grim - then look at it. Hope this helps

I totally agree with you! You need to have a TKR when the pain is unbearable.

TKR's are excellent ops when you need them and when they work. They're not an easy option by any stretch of the imagination.

Btw, as a bilateral amp, my implant was predicted to have an approx. 8 year life span.

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thanks guys.

Saw the consultant on Thurs and all above is confirmed.....wait until it really sucks.

for me:

1.remove old metal from tibia

2. corrective osteotomy,

3. then do the knee

4. then be sedentary.

in the meantime got on my mountain bike for the first time today and was pleased!

best to all!!!!

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