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R.A Flaring in Knee replacements Options
Rebecca D
#1 Posted : Wednesday, February 17, 2010 11:55:27 AM Quote
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Hi there

Has anyone had problems with the R.A flaring in knee replacements? I had my one knee replaced in October 2008 and the other 3 months later, had lots of problems getting them right. I was really making progress six months ago until the R.A started flaring badly in both knees and bringing me to a standstill again. ThumbDown Steroid injections helped temporarily.This is such a cruel disease, you go through all the suffering of surgery and then the disease starts attacking around the pockets of the replacement. I now need more DMARD drugs to stop the knees flaring.

I would be interested to hear if anyone else gets flaring in their knee replacements or any other replacements? My hip replacements never seem to be affected by R.A inflammation.

Many thanks
Love
Rebecca
lyn2
#2 Posted : Wednesday, February 17, 2010 3:20:41 PM Quote
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HI Rebecca

I'm sorry I can't help with your question but just wanted to say that I'm sorry you're having this problem, it doesn't seem right after you've gone through all the operations.

Lyn
BarbieGirl
#3 Posted : Wednesday, February 17, 2010 6:56:29 PM Quote
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Same here Rebecca, cant believe it. I am pretty new to all this and obviously naive, as I thought once you had TKR that was it!!! well, untiil it needed doing again after years anyway. Hope you get some answers and help x
BARBARA
hen
#4 Posted : Wednesday, February 17, 2010 7:51:22 PM Quote
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Hi Rebecca,

I found your post really interesting as I had a knee replacement in September 2007 and yes it does swell, stiffen and becomes painful during a flare, although NOTHING like it used to pre-op. I too find this strange because none of my other earlier replacements (shoulder, elbow, ankle) do this. To be honest that knee is permanently slightly swollen and warm and much bigger than my other 'normal' knee. I did ask about the swelling/heat at my last post-op review and was told that the RA can still affect the knee cap, which is not replaced apparently, and the surrounding tissue. I did wonder why they don't replace the knee cap itself in that case but since I had a million and one other questions I didn't get to raise that point! There must be a reason I suppose. Anyway I am still happy with the outcome as it's so much better than before. Yours do sound as if they're giving you more of a problem...I assume you have had it checked to rule out infection etc?

Hope things improve for you very soon.
Diane x
LynW
#5 Posted : Wednesday, February 17, 2010 7:58:03 PM Quote
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Hi Rebecca

I'm guessing that it's the actual synovium behind the knees that's causing the problems rather than the replacements themselves? I had a few similar issues following a wrist replacement and had to have further surgery to drain a build up of fluid and some odd little bits of bone (can't remember what they called them, osteophytes, I think!) that remained after the initial op. Did the trick though and no further problems!

I haven't had a knee replacement but it was on the cards. The surgeon suggested a synovectomy to scrape away the solid synovial layer from behind the kneecap and that seemed to work. He told me it would only be a temporary fix but that was years ago and knee is still holding up despite being swollen constantly!

Surgery on knees is highly successful these days so perhaps a bit of fine tuning needed? Maybe a release of fluid, perhaps? Could you perhaps go back to see the surgeon who did the ops?

Going through all the discomfort of surgery to end up with problems is bad news. Replacement should actually be the end of it ... that's the point of the operation, less pain, more mobility! Hope you get a satisfactory solution to this. Take care,

Lyn x

PS Just read Diane's post. Surgeon told me that they don't often replace kneecaps as generally they don't suffer damage in the way that the actual joint itself does. Apparently kneecap replacement is a huge job and only undertaken if absolutely necessary. The infection angle is a possibility but I would have thought they'd have checked that before injecting steroid, my GP usually draws off a little fluid first to check it's clear.
My son, Ian, completed the BUPA Great North Run on 15th September running for the National Rheumatoid Arthritis Society (NRAS). You can read his story at http://www.justgiving.com/ianlukewilson

Rebecca D
#6 Posted : Thursday, February 18, 2010 11:02:37 AM Quote
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Thank you to you all for your kind and helpful comments.

The surgeon did check my knees for infection as I had an infection in the left knee last year. It all came back clear. Also very little fluid came off my knees. The surgeon and my Rheumatologist both agreed it is the R.A getting into the pockets in the tissues around the replacements. This was confirmed by my high CRP blood result. My Rheumatologist said I am very unlucky having such an aggressive form of R.A.

Alot of the synovium was taken out during surgery but it looks like R.A has found a way in.....

I do feel very disappointed having to add another DMARD just to control my knees. I was really hoping to be out of pain by now. But looking on the bright side at least the knee operations have got me out of a wheelchair.

Thanks again for all your advice.
Love
Rebecca x
jeanb
#7 Posted : Thursday, February 18, 2010 11:11:28 AM Quote
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Hi All

Sorry you are having problems, Rebecca.

I am having probems with one of my replacements carried out in 2006/7. I don't get flares as such, but when I have been sitting with the left knee bent, it is exceptionally painful when I straighten it out. There is a lot of crunching and cracking and I have been wondering whether there is some scar tissue or loose debris in there. Once I'm up, it is OK and causes no problems when I walk.

There's always something isn't there? Hope you get sorted out soon.

Love Jeanxxxx
LynW
#8 Posted : Thursday, February 18, 2010 10:02:40 PM Quote
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Hi Jean

It sounds like osteophytes!! The 'bits' go elsewhere once you move. My wrist replacement used to crunch something awful until the surgeon hoovered it out! You need de-cluttering!!!

Lyn x
My son, Ian, completed the BUPA Great North Run on 15th September running for the National Rheumatoid Arthritis Society (NRAS). You can read his story at http://www.justgiving.com/ianlukewilson

jeanb
#9 Posted : Friday, February 19, 2010 4:22:15 PM Quote
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Wonderful!!!!
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