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Had total knee replacement. What are the repercussions of not having the right size patella to begin with?

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Orthopaedic Surgeon
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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 flexion, limited mobility, constant pain, 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 Sat, 5 Oct 2013 in Arthritis
Answered by Dr. Praveen Tayal 23 hours later
Brief Answer:
Serratiopeptidase helps in reducing inflammation.

Detailed Answer:
Thanks for posting your query.
Persistent pain 4 years after total knee replacement can be due to neuropathic pain, XXXXXXX scarring (arthrofibrosis), loosening of the prosthesis, patellofemoral instability, postoperative stiffness, etc. The shaving of patella to make it of right size is a common procedure and is usually not the cause of the persistent pain that you are having.
A direct clinical examination and investigations like CT scan and arthroscopy are needed to identify the exact cause.
The serratiopeptidase supplements that you are taking do decrease the ongoing inflammation but these are not likely to help you much in increasing the range of movement.
Do a hot fomentation at least thrice daily and elevate your legs as much as you can. By “elevate,” I mean having your feet higher than your hips.
If you do get a sharp pain that you haven’t had before, especially after exercise or physical therapy, there may be an inflammation in one of your muscles or ligaments.
The treatment usually involves pain killers under guidance of a pain therapist, physiotherapy, occupational therapy, etc.
You need to consult your surgeon for proper diagnosis and further management.
I hope this answers your query.
In case you have additional questions or doubts, you can forward them to me, and I shall be glad to help you out.
Wishing you good health.
Dr. Praveen Tayal.
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