Bad Surgeons, Bad Communication, or Just Bad Disease?
I cannot tell you how many message board and blog posts I have read over the past years concerning treatment that sounds as though it would only be offered in medieval times. I am not sure whether this is because the patients posting do not understand what is offered to them or they simply are going to the wrong doctors. It may also be a case of such bad disease that there may not be a reasonable surgical solution.
Here is the challenge for now:
If you feel you have been a victim of some type of flawed orthopedic surgery or decision-making in your case, post it here. Lay it on. I will then take all these posts, review them with a group of colleagues, and see if we can make heads or tails of them.
Dr. K.
(If you think you will post something to get ammunition for a lawsuit - forget it. We will analyze the posts to give positive, general information for everyone to learn from.)
Related Topics:
Here is the challenge for now:
If you feel you have been a victim of some type of flawed orthopedic surgery or decision-making in your case, post it here. Lay it on. I will then take all these posts, review them with a group of colleagues, and see if we can make heads or tails of them.
Dr. K.
(If you think you will post something to get ammunition for a lawsuit - forget it. We will analyze the posts to give positive, general information for everyone to learn from.)
Related Topics:
- WebMD Video: Stopping Post Operative Orthopedic Pain
- WebMD Video: Knee Replacement With More Flexibility
25 Comments:
Hi Doctor K,i had a open reduction surgary of my tibia.And the doctor gave me a L shape plate with nine screws.And was in a wheelchair for 16 weeks.And then eventualy my doctor told me when i turn 64 i would need a tkr.Well then every since then i had major pain with no sign of relieve.I got tired of my doctor ignoring all my symptoms.So went to another doctor.And this new doctor said i needed a knee replacement.But he also told me he had never done one.And that his other partners would do it.Well they thought it was not the best thing.So i went to doctor number 3.And he gave me my knee replacement.And told me my knee was the age of a 64 year olds knee.I also found out i had lines going through my knee also.And my knee was just about gone nothing was there i was told.Then i was also told my knee was never right before i had my tkr.I hope you can try to help me understand why i suffered so much.And why the first two doctors were of no help at all?
Dr.K, I have left many comments on many of your posts, all to go unanswered, by you, many answers from patients. This topic shows real concern by you for patients. I have been diagnosed with chronic arthritis, suspected to have been the root of many bouts of pain over the last 20 years or so by my specialist, citing hereditary geneaology as the deciding factor, which I totally agree with. I am disabled with a host of serious health issues, the most bothersome being chronic relapsing pancreatitis, fibromyalgia, severe arthritis, osteoporosis, and severe neuropathy with a diabetes kicker, to name but a few. I am an open minded health-concious person who believes you may be sincere in many of your posts in the past, which at that time I may have had a different view about your intentions. I now am impressed with your dedication and although I am not considering any surgeries, you hit the nail on the head by reminding patients that many of their problems could be of such a serious nature that nothing short of a miracle is going to be conducive to their needs. If I need any surgery in the future that falls under your fields of expertise, I would be glad to know that you care about your patients enough to share knowledge with them during patient visits and earlier posts by yourself, which would put you high in the running for me to consider you as my surgeon for that particular problem. I would be honored to have you research my previous comments to your posts, to see that I am truly impressed by this particular post, enough to see you as a patient. I can be found as boss302kirk@WebMD. Please continue to write interesting posts and you have an encouraged patient out here that will continue to read them with an open mind, being less critical, looking forward to your next post. Sincerely, boss302kirk
Hi I will provide a short history. 30 yrs ago I had a car crash that crushed my right femur. Spent 5 mths in tracting and still lost 2 inches in height. A year later had my left leg shortened to make both legs same length. I lost flexion in right leg. Left leg has 140 degrees of flexion, right had about 120 before January.
Arthritis started 10 yrs ago. End result was surgery in Jan 08 for total knee replacement. In Feb had knee manipulation as it was not bending. Its now 4 mths later. I still only have about 90 degrees of flexion. The new knee seems to have healed fine but it won't bend, no matter what I try - physio, message therapy, Dynasplint brace, radial shockwave, and just brute force. My main concern now is the non-stop pain. In Jan I assumed it was due to the surgery, but its still there. It comes and goes 3 or 5 times a day. It starts in the back of the thigh, very deep, and severe, moves down the leg to the outside of the calf and then into my foot. This is its worst at night when its spasms or "charlie horse" like pain.
The pain is there always and goes from mild to severe. Endocet is the only thing that releives the pain when its severe. I still can't go downstairs without severe pain. I also have constant pain at the top of my lower leg just below the knee joint.
My surgeon has said he has no idea what the problems are.
Please can you help with this pain and any suggestions on how to get more flexion.
Hi Doctor K I would like your opinion on a condition I have. I have pinched nerves on either side of my neck and I am in alot of pain that shoots down both of my arms. I went to a chiropractor and he took xrays of my neck and in the process he discovered that I only have 4 vertebrate's in my neck as he said I should have 7. Also he said I have a number of vertebrate's in my back that are fused together. I have always had neck and back pain intermittently throughout my life. But as you can imagine this was disturbing news for me. Please advise what if anything I should do about this discovery. I am 41yrs old. Thank you for your input, Lisa
First of all I want to say your awesome for doing this sort of thing... it is very frustrating trying to sort through all this and understand it fully.
About me, I have a bad left shoulder. I stopped counting dislocations at 28 I think. I have had surgery on it once, they did a bancart repair. It was never really fixed and was still unstable after that (I kicked ass in physical therapy but still didnt get to even 85%). Now it literally falls out of socket, its not even livable. After my recent MRI and discussion with my doc (Dr. Harrison of ogden ut) I am told the only fix is what he called a "latter repair". And that it probably wouldn't fix it either. He said my shoulder will never live up to my current lifestyle.
So... I am looking for some good advice, I am looking for someone who can be a resource and maybe give me some direction. At this point I am willing to maybe even try some less conventional and experimental surgeries if that would work.
Thanks for your time...
Hello,
I am looking for information on Knee Cartilage Replacement Surgery. I have had the first part surgery where they took the sample to grow in a lab, but I very sacred about the second surgery and would like to know more about it and what to expect.
Thank you,
sharon
Dr.K, Hi, I am a 47 year old female who had arthroscopic shoulder surgery in November.2007. I injured my left shoulder in April 2007.I went through all of the physical therapy before surgery and after. My first MRI report before surgery read... Shows a definite high grade articular surface supraspinatus tear with suspected small full thickness communication explaining the subacromial bursal distention.I decided to have surgery.I still have limited motion and pain in my shoulder constantly.My shoulder aches all the time and I get pains that shoot down the outside of my arm to the elbow.I told my surgeon about the problems I was still having and he just kept telling me my shoulder was fine.His report on the operation read : shoulder arthroscopy,subcromial decompression.debridement of partial thickness rotator cuff tear.I went back for a follow up appointment surgeeon said there was no more he could do for me.He said the shoulder was fine.I then went to another doctor(in the same practice as my surgeon ) for a second opinion.After he examined my arm he stated that I have a positive impingement still and my rotator cuff strength is weak with external rotation. He sent me for a second MRI.The findings were The supraspinatus tendon is slightly thickened and has slightly increased signal present in a longitudinal fashion, characteristic of tendinopathy with equivocal longitudinal partial thickness tear. there are few degenerative A small amount of fluid within the subacromial bursa.changes noted at the insertion site on the greater tuberosity. a small amount of fluid within the subacromial bursa.When I went back this doctor he said that they have done everything they can for me and there was no more they could do.He suggested for me to go and get disability.I then went to another doctor for a 3rd opinion.I just felt there has to be something they can do.I can't live with this the rest of my life. I am not on any pain meds or anything.The 3rd doctor said it could be that he needs to complete and take down the high grade part and make it a full thickness tear and advance the healthy tendon and reattach it..Not sure what to do at this point.Any advice from anyone would be appreciated.I really don't understand all of the medical terms.All I know is my shoulder is not any better after surgery and it is painful and very frustrating.I can't even sleep at night.I'm still not sure what to do. I didn't call the 3rd doctor back yet for surgery.I'm not sure what to believe at this point.Thank you for your time.
Greetings Dr K; I recently went through arthroscopic surgery for the second time. My Dr cleaned out a lot of "MUCK" like he put it. While doing the surgery he found more than he bargained for. He found that I have an ulcer on my femur. I have never heard such a thing before. When I think of an ulcer; I think of ones' stomach. After surgery we had a short discussion and he said I would have to go through a partial knee replacement. One of the things he mentioned was it never showed up on my X-rays or MRI. I have been experincing swelling of my foot and he said it could be the heat..and I told him how could it be the heat (in the month of March). He replied maybe it has nothing to do with my knee. I go back in a day for my post-op to discuss his findings and when he feels or thinks I should go through my partial knee replacement. I do know; I need to heal from this surgery first. Could you explain to me how I may gotten a ulcer on my femur and also why my foot swells also?
GREENILADY
HI Doctor K, I had both my knees replaced not at the same time the first one three years before the other,The last one did not go as well as the first. With the second one there was a lot of brusing and discolaration and a lot more pain I'am still having pain in the calf of my leg and also have very bad charlyhorses at night that make me jump out of bed. I have had thearpy twice on this leg and nothing helped is there any thing that I may have done wrong in helping this leg heal properly. It still blows up like a balloon and I have to put pillows under it to help the swelling go down. Any help from you would be appreciated..I love reading all of your remarks..Thanking you in advance
i need help I don't have health insurance so maybe you can save me a trip to the doctors. my head hurts but only at the bottom under the ears that area has been swollen. my neck,back,arms,hips,and legs are wery stiff and ache. my wrists sre so sore and stiff I have a hard time moving them. my fingers are swollen and in pain constantly. my knees and ankles only hurt when I get up out of a sitting position and wake up. my toes hurt and will not pop. two rapid release tylenol did not help anything but my head. please help
Dr. K., I had TKR in 2005. I desperately need to have my other knee replaced but I most likely will not ever do it.
I went in to this surgery with great trust and respect for my OS. In fact, we had a long history together. He had done arthoscopic knee surgery on me years before. I would not have chosen anyone but him to do this surgery.
But, I no longer have any of that respect. in fact, I think he may be a little barbaric. I have told you about this before but here it is again.
When I first woke up in the recovery room I was being put into the CPM machine. I was prepared for this and not at all surprised by it happening, but I was not at all prepared for the excruciating pain that came with this. I knew something had to be wrong. I remember not just crying but sobbing as the pains were so great. Also, the PT girl was talking to the gasman, who was still in the room. I heard him ask her, "Why does he do this, not one other OS ever puts them in at that degree." Her answer, "I don't know why he does it but it demands it be done that way."
I found out that I was put in at 70 degrees and went to 85 degrees on day one immediately following surgery. I was on this damn machine for 12 hrs straight doing 70 to 85 degrees. I hope you know how very painful this was and at the end of 12 hrs. I had lost all trust for him. I have asked many times and I can find no one else who goes in at such degrees on day one.
I can only hope there is some reasons why he thinks this is a good option, and that he honestly believes in that reason. Otherwise I don't even want to think about what that makes him. Can you think of a reason why he would do this?
Also, if and when I ever do consider having my second knee done is it appropriate to ask about this ahead of time with my new OS?
Celine
Dr. K I have had knee surgery and was told that it would be a complete replacement like the one before. After surgery my doctor told me my knee was deformed and he was afraid to put an artifecal knee cap in. He did the replacement and left the artifical knee cap off and did not put a cartlage in to cussion the bone. Now I am in worse pain then ever. He is telling me that if he does surgery again it will destroy my knee and I will not be able to use that leg. I have had a second opoian and was told it could be done and fixed right but my knee cap may brake. I was told if that happened they could wire it togather and it would be fine. I am afraid to have surgery again, but at the same time I would like to have some releaf from this pain.
Hello Dr. K, My wife has MS. She had a lateral release and microfracture on left knee in April 2007 due to Level 4 degenerative osteoarthritis. Since that surgery she has suffered spasticity. She has been going through PT ever since. The spasticity is preventing her from walking. Surgeon and neurologist are at a loss to find symptom relief with baclofan, botox, etc. Because of the severe nature of osteoarthritis, she had a total knee arthroplasty in May 2008. Since then, spasticity has become more severe. ROM is 40 - 120. She is now confined to a wheelchair because she can't walk. Still going to PT. Just wondering if there are studies about treatment for spasticity in MS patients following TKA. Spouse is only 51 years old so successful treatment is absolutely critical. Any help you can provide will be helpful.
Hi Doctor
Can I ask about the use of stem cell in the cure of osteoarthritis of the knees.
My name is Paula, from Central Texas. I'v been diagnosis with JRA, SLE,fibro. and many more. My question is can Lupus make a person fall asleep without knowldge of any type?
People are tell me that at times they see me asleep,and yet I can't remember anything.
Please help me!!!!
Hi Doc. I just stumbled across this post and would be very grateful for your input!
3/1984 - Age 19 - I was a pedestrian hit by a car, shattered the middle ~1/3 of my LEFT Tib/Fib. Had a pretty nasty malunion, bones are fused together and a bit shorter than my other leg.
I am told since that my pelvis shifted to compensate for shorter leg.
6 years ago -- Age 36 -- I shattered my LEFT tibial plateau, a "Schatzker Type VI" Fx. I had compartment syndrome and a quad-compartment fasciotomy.
I allowed my muscles to atrophy terribly by non-use due to pain. Further, I was stuck ~15 degrees from straight.
~19 weeks ago I had a TKA. He made it a bit "loose" due to my range of motion issues -- gave me full extension and ~120 degrees of flexion -- which is about where I was pre-surgery.
From my first step to my last, this knee has a very painful "clunk" that happens ONLY when walking.
When I bend it, just before my toe leaves the ground, when knee is at ~25 degrees of bend -- CLUNK
When I step through, just before my heel-strike as the leg is straightening, at ~25 degrees, just before my heel strikes ground -- CLUNK.
EVERY D*** STEP, from the first one post surgery to now.
What's odd is that I can do squats, ride a bike, -- any sort of "closed chain" exercise and it is FINE, but when I walk -- "Clunk-Clunk" with every step.
This has gotten worse over time, and has become painful. A week or so ago it started clicking when I'm on the bike, where it never had before, and again at about 25 degrees.
My Surgeon basically doesn't want to hear about it. "It's plastic and metal. Sometimes they make noise. Don't worry about it."
Obviously I've been unsuccessful in making him understand (1) it's not "sometimes" and (2) it HURTS!!
The last time I brought it up he asked if I had a history of OCD -- said I seem to be obsessing about it. I guess I am, in a way, as I cannot walk without pain. In THIS regard I am worse than before surgery. If I walk ~1/4 mile in a day I am CRIPPLED -- every clunk feels like I'm being stabbed!!
A Third opinion may have the answer: He thinks it's a fat pad impingement. He gave me a cortisone shot and put me on Celebrex for a month. If this doesn't solve it, he wants an arthroscopy to excise the fat pad.
If THAT doesn't cure it, he wants to put a thicker plastic bearing/spacer in.
He used the term "patellar clunk syndrome" but everything I've read about this says it clunks when extending from deep flexion, under load. I get the clunk only when NOT under load.
He said he believes the joint is separating a bit from gravity, and due to my (mild) extension lag my patella is a bit slack. These combine to allow the fat pad to be pinched, and when it pops free is then I feel the "clunk."
IF my patella is tight, or my knee joint is pushed together, no problem.
This SORT OF makes sense to me, though the clunk I feel doesn't seem like anything caused by squishy fat... It feels sharp and hard -- like a little hammer banging on the bones.
I would deeply appreciate any input you may have!!
Please respond to my user name at yahoo dot com.
Thanks again!!
DD
Dr. K; I would appreciate any comments or suggestions you might have for someone with a history of pulmonary embolism and positive lupus clotting factor getting a knee replacement surgery. Do you think it is too risky?
Dr. K: is it too risky for someone with a history of pulmonary embolism to get a knee replacement?
Steve C: To ask specific questions of Dr. K, please visit his message board.
Dr. K,
I had a total right knee replacement on June 25, 2008 and now I've noticed that my left leg is 3/4 inch shorter than my right leg. Is this normal after surgery? If so, will this correct its self with continued physical therapy? I am really concerned that my decision to have this surgery has compromised my left leg, hips, and ankles and the pain from these areas will be on going.
I would really appreciate some guidance in this matter.
Hi, I am very new at all this so I hope that I am posting this right. I am 29 years old and have been recently diagnosed with arthritis in my neck. I was told over the phone so I have not talked directly with my doctor yet. I would like to know if their is any preventative measures that I can take while I am still young to keep the arthritis from getting worse? Is their a good pillow you could recommended or exercises that I can do? And what about taking glucosamine? Dose it really do any good, and can you take them together? I am currently taking mobic.
Thank you,
Amy
Dr. K,
I am a 42 year disabled vet. I fell in 2005 and ripped my knee cartilage to shreds. I was sent home and the cartilage in my right knee was removed leaving me bone-on-bone. I was diagnosed with Chrondromalacia. I lived that way for 2 years and the pain was excruciating.
In 2006, I went through the O.A.T.S. procedure to replace the cartilage, and although a manipulation under anesthesia was done 2 months later, it worked ok for a few years. Unfortunately it is showing deterioration again.
May of 2008, the same doctor performed the same procedure on the left knee due to the same diagnosis. This time I am having worse post-op pain, more swelling, quad atrophy in both thighs with tears that are not healing in the quads, and the doctors don't know why. They have recently decided to check for bone infections, and based on post op x-rays and MRI, it has been determined that the O.A.T.S. procedure did not work this time.
What is frustrating me the most is that because I am under 50 years old, no one wants to do a knee replacement, and they say until then there may not be much they can do. I don't want to run marathons I just want to do the daily things to live with out the pain. I am not guaranteed to see 50' I think my quality of life today is important.
Do you have any idea what could cause muscle atrophy and tears that won't heal? Could if have anything to do with the actual procedure or the synthetic cartilage that is used?
This post has been removed by a blog administrator.
Dr. K,
I injured both of my knees, tearing both menisci, some years ago. My left knee began to lock up and became painful. I am a nurse so my job entails a lot of walking and standing. I had arthroscopic meniscus "cleanout" and less than a year later, was informed that my knee was bone on bone. I began investigating my options for relief and found some articles on the use of "Unispacers." This was the beginning of the end, as far as I'm concerned! I found a doc in San Antonio, Texas, where I live and we discussed whether I was a candidate or not, for this procedure. I was, he said. After trying medication (Voltaren), Steroid injections, and Synvisc injections, I decided to go ahead with the Unispacer insertion. I had also spoken with one person who'd had the procedure about 1 year before. I should've listened to what he said because he said if he had to do it again, he wouldn't. Anyway, I had the Unispacer put in and began the excrutiating recovery. PT, medication, and my will couldn't make the thing work. I couldn't extend or flex my leg during walking. I had to either walk with a straight leg or keep it bent. After four months of this, I couldn't take it anymore, and insisted that we talk about knee replacement as this was my next option. I underwent a TKR 11/05. My doctor informed me that the Unispacer had failed, it had never "slid" along the tibial plateau the way it was designed to do. I believe, and he concurs, that this really traumatized my tibial plateau, made the bone "soft". The TKR was successful and I proceeded through PT for about 7 weeks. I was just about to return to work and became very ill and couldn't walk on my leg. In the hospital, it was discovered that I had contracted a staph infection in my knee. I was, to say the least, devastated! I went through the I&D and got a PICC line and received Oxicillin for about 6 weeks. I now take 1000 mg of Dicloxicillin a day. I had to have a manipulation about 6 weeks after the onset of the staph also. I, also, have lived on 10 mg Hydrocodone a day (approximately) since then. I've gone through having epidurals and PT and I have gotten no relief from any of it. I started on Lyrica and it relieved some of the nerve pain that I had begun to experience but the replaced knee is constantly in pain. My left knee (the "good" one), of course, is no longer any good. It is, in the past month, deteriorated to the point of being in pain at a level of about 7-8 every day! I can't figure out which leg to limp on! Anyway, my question is, now that you've gotten the relevant story details, what are my options for pain relief at this point? I'm familiar with PCA pumps but was wondering if there is such a thing as a "pain ball" for local pain relief. They are used in Postpartum for women with C-Section for localized pain. I would really love some information on this, if there is such a thing and if there isn't such a thing, can there be??
Thank you so much for your expertise in this.
Becky Taylor
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