I feel very bad about the situation you are in. I'm fairly certain you live with disabling pain that really effects a lot of your activities. I curious as to what your surgeon felt your problem was -- did the hip become loose? is it unstable? is their an infection present? etc. Different diagnoses carry different chances of success or failure. I'm wondering if you could provide a better description of your problem.View Thread
Complex tears are in a way a fancy term implying "shredding" or fraying of the meniscus. These types of tears do not heal. It's difficult to advise you whether surgery is an appropriate course for you, since you didn't include anything about your symptoms -- just a description of your knee based on a test. Its always important to determine if your symptoms are concordant with the MRI findings in order to see if surgery would be a reasonable alternative to relieve your symptoms.View Thread
You do a great job of describing your symptoms, however there could be plenty of things right or wrong with your knee. I assume your surgeon ruled out an underlying infection, so I'll assume your knee isn't infected. I'm curious by your description "feels like the knee is going in and out of the joint" and your response to a medial unloader brace. These two results seem to point to some type of instability you may in your knee. I'm going to guess this instability is localized to your medial compartment but it could be from other causes as well. I think you are the right track about seeking a second opinion -- or third in this case. Between a good set of xrays, an appropriate physical exam, and review of your lab work, a reasonable differential diagnosis should be formulated. I would advise against "exploratory" surgery -- such as looking around with an arthroscope, until some reasonable diagnoses have been ruled in or out. Good luckView Thread
After knee replacement, the activities you describe are certainly possible, however they wouldn't be considered normal by any means. I've personally treated patients who have skied moguls and rock climbed after surgery, although again these would be considered exceptions and not the rule. It's always surprising when I receive pictures from patients or letters from patient's about some of the crazy or more adventurous things they do after knee replacement. I do have one reservation however. Most knee replacements are cemented. With severe stress I worry about the bone/cement or cement/prosthesis interface failing leading to premature loosening of the prosthesis which leads to knee revision. There exists cementless implants for TKA, however these are usually used much less commonly in the United States because on average they even have more problems with loosening than the cemented varieties. There are newer versions of knee replacements that have entered the market recently that use the concept of metaphyseal fixation -- meaning they are fixed within the bone similar to hip replacements rather than traditional knee replacements which are glued onto the bone. These metaphyseal fixation variety replacements are being used most commonly in cases of revision -- or in the worst possible scenario. I often wonder however if using this type of knee replacement would be beneficial in the initial setting as well as the revision setting to diminish the risk of premature loosening. I know some surgeons have used these "revision" parts in the primary setting, but I have not seen any long term studies (>5 years), that would prove they are indeed better in terms of decreasing the loosening rate.
From your description, its really hard to tell whats wrong, although I suspect its possible your acetabulum (or socket) has shifted, or your femoral stem has subsided (or settled -- meaning its sunk further into the bone). Although these problems are not common, they both have been described. Hip replacements, just like any mechanical part, has the possibility of failing at any time.View Thread
Just a word of advice -- the best method for you is one where the surgeon is very meticulous and does the surgery properly for you. I know there is no way to judge the competence or skill or your doctor, however ultimately you want to know if he does good work. There are pros and cons to all approaches -- ant vs post.View Thread