I don't know how to deal with this....

[PostmodernProphet]

I've told you my father is 95.....about 25 years ago he had a knee replacement....about five years ago it began to give him problems....the technology they used then wasn't as advanced as now and the part they used was beginning to wear out....he had some metal on metal action going and he squeaked when he walked.....he opted not to do anything.....yesterday they took him to the doctor because he was having lots of pain.....

apparently his leg has broken where the metal is inserted into the bone.....it is never going to heal, because there is no other bone for the broken part to anneal to.....and the doctor said that at 95 his heart wouldn't take the surgery to go in and fix it.....so basically, the doctor said there was nothing they could do......

I don't get it.....is he basically doomed to have a broken leg for the rest of his life?.....his knee is swollen up double in size and he has bone and metal fragments that dig into his muscle when he moves....I don't know what to do to help him.....

[chloe]

I've told you my father is 95.....about 25 years ago he had a knee replacement....about five years ago it began to give him problems....the technology they used then wasn't as advanced as now and the part they used was beginning to wear out....he had some metal on metal action going and he squeaked when he walked.....he opted not to do anything.....yesterday they took him to the doctor because he was having lots of pain.....

apparently his leg has broken where the metal is inserted into the bone.....it is never going to heal, because there is no other bone for the broken part to anneal to.....and the doctor said that at 95 his heart wouldn't take the surgery to go in and fix it.....so basically, the doctor said there was nothing they could do......

I don't get it.....is he basically doomed to have a broken leg for the rest of his life?.....his knee is swollen up double in size and he has bone and metal fragments that dig into his muscle when he moves....I don't know what to do to help him.....


I would get a few medical expert opinions before giving into that prognosis. I was friends with a lady who had hip surgery in the early 80's and had metal and something had slipped or broke but her doctor just kept giving her pain medicine and so finally she went to a few different doctors until she got one who did surgery again, this time no metal and within a few months she could walk normal again which she had not been able to do for years.

[chesswarsnow]

Sorry bout that,

1. At that age, there isn't much one can do I suppose.
2. Except pray.
3. God willing things will get better, and the swelling will go down, and he can go home.
4. Just pray, as I have prayed for him.

Regards,
SirJamesofTexas

[Mr. P]

I sure wouldn't stop with one doctor, PMP. I can't imagine that today he'd just have to suck it up an live with it. There has to be something they can do.

[glockmail]

That's a tough call for guy who's 95, and heart problems. If he was younger they could go further down the bone but that would open up a huge area. He must have really worked that knee out to wear it out in 25 years.

I would think that some orthroscopic surgery to remove any broken fragments would help to reduce the pain and swelling, perhaps a mechanical insert to prevent metal on metal contact and further damage, an exterior knee brace to support it, then use it as little as possible, trying to maintain quality of life as much as he can.

[actsnoblemartin]

I would seek a 2nd medical opinion, and see what can be done.

I wish you all the best and offer this prayer

dear lord

please take care of pmp's father,

amen

[PostmodernProphet]

He must have really worked that knee out to wear it out in 25 years.

the procedure was fairly new yet in those days...they used a metal coated with plastic for the mechanism....five years ago the problem was that the plastic coating was wearing off so he had metal on metal abrasion.....they use a lot better stuff nowadays.....

[glockmail]

the procedure was fairly new yet in those days...they used a metal coated with plastic for the mechanism....five years ago the problem was that the plastic coating was wearing off so he had metal on metal abrasion.....they use a lot better stuff nowadays..... It seems to me that they should be able to repair the mechanical parts rather then replacing the entire thing, sort of like replacing suspension bushings instead of replacing the suspension.

[avatar4321]

Fasting and prayer. See other doctors. See if a path opens up.

I believe he can be healed. And I believe God can lead you where you need to go

[Nukeman]

I'll put my 2 cents worth in here.

Unfortunately at 95 our bones DO NOT HEAL very well. They take an exceedingly long time to do so. IF it was a simple hairline break you would still be talking a minimum of 18 months.

Your telling us that the implant fractured or "shattered" the bone at the point of implantation. This leaves NO WHERE to reset another implant. At this time even if they could reimplant the time for the bone to heal would be years not months.... They would have to build a "cage" to help graft more bone in to make a base to repair the knee, this is unfortunately not an easy procedure and is very taxing on the body. These types of problems are hard even in young healthy people, they sometimes lead to amputation because there is NO WAY to fix the Tibia and make it able to support weight....

I hate to say but he will probably be in a wheelchair unless he is still able to put weight on it than he is going to use a walker for the rest of his life.. :(


Look at it this way if you are puting a joint in some PVC pipe and it shatters where your putting it together your only choice is to cut it out and make it shorter (even if you could find all the pieces how would you hold them together). You don't have this option when dealing with bones

http://nosleepingdogs.files.wordpress.com/2009/05/kneexraysbf.jpg

Imagine the bottom part of the knee having NOTHING to rest on (damaged or broken bone) the implant actually preses into the bone cavity so without any bone there is nothing to build on. I think this is what your getting at and the problem that your father faces.


I am truely sorry but it is a VERY difficult thing to fix if at all possible.....

[Nukeman]

It seems to me that they should be able to repair the mechanical parts rather then replacing the entire thing, sort of like replacing suspension bushings instead of replacing the suspension.

From what I am reading I am going to make an asumption and say his knee is going to look something like this



http://www.scielo.br/img/revistas/aob/v16n1/en_06f1.jpg




IF the implant has nothing to rest on it is impossible to rebuild bone at this time...... When you get into attempting to reconnect all the bone fagments you wind up with a lot of metal and very little stability/strenght..

[Little-Acorn]

Definitely get a second opinion.

If it's the same, then maybe time for a wheelchair or power chair/scooter?

Most people never make it to 95 in the first place. The Lord has blessed your Dad with the opportunity to do so. But hoping for 100% mobility and function, may be more than the Lord intended to give?

Perhaps it is time to deal with the pain, and try to make him more comfortable, rather than keep trying to make him perfect?

I'm sure the time will come in my life, when I have to make the same kind of choice. I don't look forward to it... but I'll be grateful for the opportunities I'm given.

As George Burns once said, it beats the alternative.

[PostmodernProphet]

thanks for the technical talk, Nuke.....fortunately I had a chance to talk to my parents this morning.....the information my sister had given me wasn't complete....the bone hasn't yet seperated from the metal joint, but there are some bone and metal fragments that have broken off on the side and are floating free....he's got a lot of pain and swelling, but I was imagining him having a lower leg that was flopping around unattached to his knee and that isn't the case.....

they've given him some industrial grade pain killers and something to bring the swelling down.....

heading to Iowa Thursday....

[Jeff]

thanks for the technical talk, Nuke.....fortunately I had a chance to talk to my parents this morning.....the information my sister had given me wasn't complete....the bone hasn't yet seperated from the metal joint, but there are some bone and metal fragments that have broken off on the side and are floating free....he's got a lot of pain and swelling, but I was imagining him having a lower leg that was flopping around unattached to his knee and that isn't the case.....

they've given him some industrial grade pain killers and something to bring the swelling down.....

heading to Iowa Thursday....

Good luck to Y'all PMP, my prayers will be with your family

[glockmail]

From what I am reading I am going to make an asumption and say his knee is going to look something like this


...



IF the implant has nothing to rest on it is impossible to rebuild bone at this time...... When you get into attempting to reconnect all the bone fagments you wind up with a lot of metal and very little stability/strenght.. I made the assumption that the implants are still attached to the bone and that the implant itself has worn down.

[Nukeman]

thanks for the technical talk, Nuke.....fortunately I had a chance to talk to my parents this morning.....the information my sister had given me wasn't complete....the bone hasn't yet seperated from the metal joint, but there are some bone and metal fragments that have broken off on the side and are floating free....he's got a lot of pain and swelling, but I was imagining him having a lower leg that was flopping around unattached to his knee and that isn't the case.....

they've given him some industrial grade pain killers and something to bring the swelling down.....

heading to Iowa Thursday....Glad to hear it!!! If everything is still intact shuld still have most function in the leg. the implant if it is deteriorating will cause problems but at his age it is a VERY difficult call as to whether or not to replace!?!?!?!

[emmett]

PMP


In 1968 my grandfather was ran over by the family wagin and it crushed his hip and damaged one od his legs severely. He also has a similar knee replacement operation. Of course the technology was lacking in thoise days and he also had trouble with his shortly thereafter.

Grandpa's injury was very severe and left little area to anchor the bolts necessary to repair the mobility of his new knee. Was partially stiff even after surgery and allowed very little bend but he could walk. after only three years however the area of his knee that had been repaired began to worsen and the holes drilled through the bones to anchor the knee began to waller out. This cause the single piece knee to begin splitting. I don;t know how similar this would be to the injury your dad is dealing with but here is what they did at St. Joseph's hospital in Atlanta. The doctor was Joseph Levine and the surgeon was Joseph Clinkscale. Coincidentally my grandpa's name was Joseph too.

The surgery left my grandpa with a completely immobile knee mind you. He had no ability to bend it but was able to stand and walk with a stiff leg. The way i understand it, and remember I was but 10 or 12 at the time is that the knee as basically bypassed. Anchors were implanted above and below the knee into solid areas of bone resulting as I said in him not being able to bend his knee at all. It also placed a substantial burden on his foot since the transfer of weight was shifted to his foot. No repair work was done to the damage to his knee at all to avoid a lenghtier operation. There was concern for his age (high 70's at the time).

The suggestions that he is too old to sustain any surgeries could be indeed true. At 95, any anethesia at all can be terribly taxing on his heart. Just having to recieve blood for example is difficult being that it does not "take" like when we are younger. A transfusion itself can kill an elderly person.

I wonder if there is possibly an external device or brace that could be used to help stablize his leg and give him the leverage to stand without too much pressure. Something that would restirct too much bending of the damaged part while enabling him to stand and move about the room when necessary. At least this would not restrict him to a scooter chair permanently which of course would be the best choice for mobility if unable to go another route.

If his doctor feels it is too risky to operate in any fashion he is probably right but a second wouldn't be a bad idea. I would suggest checking into a compromise solution such as above however. I mean..I don;t know but checking it out couldn't hurt. The "no surgery" option sure would ring a bell with me if I was him. At 95 I'm sure he probably has no desire to go through that if avoidable.

I sure hope that whatever you guys do your dad is spared as much pain as possible. Also I would hope that whatever takes place it is his wishes that are honored without too much influence from others. After putting in 95 years he certainly has the right to take whatever risks he sees fit even if they seem a bit much for other family members. Prayers for your dad and for you sir.

[PostmodernProphet]

At 95 I'm sure he probably has no desire to go through that if avoidable.

mostly he grumbles about God taking his own sweet time about things.....

[Mr. P]

mostly he grumbles about God taking his own sweet time about things.....

I had a grandmother that did that.