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Undergone total knee replacement. Patella has been shaved and having constant pain. Knee is stiff. Taking medicines. Advise?

DOCTOR OF THE MONTH - Feb 2014
Feb 2014
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Answered by

Orthopaedic Surgeon, Joint Replacement
Practicing since : 2004
Answered : 5930 Questions
Question
I had a total knee replacement (Biomet Knee) in 2009. I just discovered that the Orthopedic surgeon who planned to use my patella had to get a 34mm patella while I was on the operating table. The patella had to be shaved 9mm because my patella was a 24mm patella. Is this normal and what are the repercussions from not having the right size patella to begin with? I have almost constant pain, take Loratabs and Ibuprofen daily for some pain relief. I had a manipulation surgery 6-8 weeks after the knee replacement. My knee is still stiff, I have 105 degrees mobility, limp and have problems bending the knee enough to get in and out of our small Honda Fit. I'm being told I need another replacement but do not want to go through it again but don't know what else I can do for mobility and pain. I am a 65 year old male. I want to get off the pain meds and obtain mobility. I am trying Serrapeptase to see if it will reduce my pain and inflammation for now. Do you know of any success using this supplement?
Posted Sun, 8 Sep 2013 in Bones, Muscles and Joints
 
 
Answered by Dr. Saurabh Gupta 1 hour later
Brief Answer:
Serrapeptase will definitely useful to reduce pain.

Detailed Answer:
Hi,

I am so sorry to hear about this very embarrassing happening. Hope it soon is controlled.

To deal with your first query about patella size during replacement- Amount of Patellar Resection (shaving) should equal thickness of patellar implant. In your case, patellar implant size seems to little bit more as after 9 mm shaving overall thickness is 34 mm.
Chances of postoperative patellar tilt increased when the postoperative patella was thicker than the preoperative patella. Passive knee flexion decreased 3 degrees for every 2-mm increment of patellar thickness.

To deal with your second query- Serrapeptase will definitely useful to reduce pain and inflammation. You can use it an alternative to NSAID’s (non-steroidal anti-inflammatory drugs) for your knee arthritis.

I do hope that you have found something helpful and informative and I will be glad to answer any further query.
Above answer was peer-reviewed by
 
Follow-up: Undergone total knee replacement. Patella has been shaved and having constant pain. Knee is stiff. Taking medicines. Advise? 8 hours later
I don't understand - is it normal to shave a patella 9mm from 34mm to 25mm or would it have been better to have a 24mm patella implanted to begin with during the operation? Are you saying that patella tilt is more likely to occur after the shaving and that may be why I'm experiencing the lack of mobility and pain? The patella is 34mm shaved to 25mm.
 
 
Answered by Dr. Saurabh Gupta 44 minutes later
Brief Answer:
It is normal to shave a patella 9mm from 34mm.

Detailed Answer:
Hi, sorry for confusion. It is normal to shave a patella 9mm from 34mm to 25mm.
Patella tilt is not more likely to occur after the shaving, its chances increases when shaving is less and overall thickness is more.

Hope this clears your doubt. Let me know if you have any more concern.


Above answer was peer-reviewed by
 
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