TKR Revision after femur fracture
I am a 48 year old woman and had a TKR on my right knee March of 2002. This past March 2, 2004 my leg buckled. It was determined that my femur was broken (where it joined the femoral component.) March 3rd, the next day my surgeon attempted "a reduction of the angulation of the fracture and to fix it with a retrograde IM nail." It didn't work because during surgery they also discovered that the "femoral component was loose." It was removed at that time with a "relatively modest amount of bone from the lateral femoral condyle." The lateral femoral condyle was fractured, which extended posteriorly and medially as well. My surgeon noticed that along with the osteoarthritis that had caused the deterioration of my knee cartilage, there was also significant osteoporosis. Two days later on the 5th of March I went back to the operating room where my surgeon planned a revision TKR. However, he discovered that the extent of bone loss from the lateral condyle was much greater than originally determined. He felt that the bone loss exceeded what could be fixed reasonably with augmentation on the revision system. It was decided that I would need a "prosthetic replacement of the distal femur," which was unavailable to my surgeon, and was something he did not have experience with. So I was transferred to Massachusetts General Hospital on the 6th of March. On March 10th I was taken to have the surgery performed, finally. When I awoke however, I learned that they had found infection (staph sepsis - aureus septicemia) and had removed all of the original hardware, and filled it with an antibiotic spacer. I was in the hospital until March 17th with awful pain and with fevers. I was on dilaudin for the pain at first because even the morphine pump wasn't helping. Then IV antibiotics, vancomycin, were administered until April 21. I was sent home on the 17th of March with a "pic" line in my arm to receive the medicine every 12 hours. Everything went according to plan. An immobilizer protected my knee. I could put no weight on it at all. I had a lot of help from family and friends. As I got better it became harder for me to deal with my total loss of independence. Today it is August 7th and I am still waiting to have surgery. I have been back up to the hospital several times to see the surgeon, had my knee aspirated, had blood work, and finally to meet with another more experienced trama surgeon. He told me I have a few options as he sees it. He could leave things basically as they are (which he quickly said he would not consider for me because of my age - he would probably only do that on an elderly patient). He might find he would have to fuse my leg, probably because of bone loss. The best case scenerio would be a new knee that actually worked, allowed me to walk etc, the worst case scenerio would actually be amputation. After this long and involved story, I am wondering if anyone has had anything similar to this happen to you. If so I would love to learn of your experience. Thanks for reading.
From:
Teri Pierce - teri121255@comcast.net
