Knee replacement after hauser

[Red_Shirt_crewman]

Many years ago I had a Hauser (modified) done on my right knee. The usual problems happened and I have now had a full replacement. My problem is that after more than 18 months since surgery, I still have swelling and have lost an estimated 30 degrees in range of motion (can't flex beyond about 85-90 degrees).

Has anyone else had these issues? Or am I alone?

[fawn2388]

I didn't have a modified hauser, however, I however have ahd techincally 3 TTTs on one knee. I was told I would need a knee replacement by the age of 25. I dont know much about PKRs or TKRs.

[tanyap]

Hi there,
I had a modified Hauser 20 years ago. I have a lot of problems now but my docs think thats its not the Hauser that has resulted in the current issues. What problems did you get that resulted in a replacement and how many years after your Hauser did it happen?
What do your doctors say about your lack of ROM and persistant swelling? How old are you now?
Tanya

[Red_Shirt_crewman]

As a result of the Hauser the pateller tendon scared while the quads atrophyed causing the knee cap to be pulled down (baja) with each flex. Wore out all of the cartilidge and added a bone spur to the top of the knee cap. Had the Hauser in '67 and diagnosed with all of the above in '87 and told need a replacement. I was 17 when I had the Hauser and am now almost 58. Could not have the replacement in '87 because I would have outlived the life expectancy of two replacements so had to wait until '06 for the replacement.

He seems to thing it's to be "expected", but I'm not as convienced.

[tanyap]

Hi,
My current OS tells me that my kneecap is in a more or less normal position, he thinks its a little low but nothing that would cause my current problems. My cartilage is very worn down on that knee, 8mm on good side, 1 or 2 mm on bad side and I have some small bone spurs on the sides of it.
He tells me that the Hauser has largely been abandoned because the repositioning changes the forces through the kneecap and causes the cartilage to be worn away, but that that was all that was available when I had it. My quads atrophied over the years but it was as a result of untreated dislocations. I began to dislocate again 3 years after the Hauser, but initially it was only once or twice a year and I would go back to physio to rebuild quads, then the dislocations (if thats indeed what they were), became more frequent but caused little or no pain and I could just pop my knee back into place and continue whatever I was doing. I stopped bothering with doctors or physio because I had no pain and found my knee just to be a minor inconvenience on occasion. Unknown to me my quads were atrophying away slowly and I eventually had a dislocation that resulted in immediate instability from which I have never recovered (3 years ago).
My current OS thinks that it is not my kneecap dislocating at all and that my lower leg is subluxing in relation to my upper leg, I have a large meniscus tear medially and he suspects my ACL is not working as it should be (it looks ok on MRI but seems loose on clinical examination).
He is scoping me in 3 weeks time to ascertain what is causing the problems.
I was 14 when I had the Hauser, (im 34 now) it took a long time to recover from and I was never able to run after it as the knee was never stable enough.
Tanya

[Red_Shirt_crewman]

The scarring and quad problems came because they cast me for 12 weeks after surgery. Have been told by several OSs that the knee going Baja, the bone spur, and all of the other problems were common results of the Hauser. My problem began because of a deformity in the joint, the shin bows out causing the patellar tendon to drag the knee cap outwards. An x-ray used to show the knee cap almost 45 degrees from the center.

• Chronology
  
  '58 - dislocated right knee for first time. No diagnosis and Ace wrapped
  '58 - '67 - numerous dislocations of right or left knee at least once a year usually as a result of some physical activity. Because of this did not play sports.
  '67 - diagnosis and recommended surgery. Had Hauser on right knee later that year. Full leg cast for 8 weeks, cylinder cast for 4 weeks. PT consisted of trying to walk again
  '71 - had two bone chips removed from right knee
  '71 - '87 - no apparent problems so returned to active life including recreational softball and took up jogging.
  '87 - right knee locked and diagnosis was the "expected" outcome of the Hauser. Told will need a full knee replacement however I would have outlived the two "allowed" replacements so asked to delay replacement
  '99 - had lateral release on left knee to stop reoccurance of dislocations
  '06 - finally life expectancy of knee replacement long enough compared to my age (56) so had full replacement (except kneecap) with plastic wear surfaces between metal parts and on back of kneecap.

[tanyap]

Guess thats why they have abandoned Hausers in favour of Fulkersons now eh? My Current OS says that it can take 40 years or more of 'common' problems showing up before they decide to abandon a procedure. I see by your chronology that you had some years of no problems - same as me, had the odd dislocation but for the most part just had a normal life for about 15 years.

Whats the story now? What are the docs saying about your problems since replacement?

[Red_Shirt_crewman]

They say there was a lot of scaring of the patellar tendon (which was blocked inwards to realign kneecap movement). The asst. surgeon said "It was a mess". The OS seems to think this is "normal" and I have to think he knows something since he was the only one who had experience in TKP after a Hauser.

I have scheduled an appointment to ease both my and my wife's minds.

[tanyap]

Good idea about the new appointment - always best to have these things checked out. I know it can be a long recovery after TKR but 18 months on you should not have swelling and ROM should be better, there could be something they recognise when you go see them.

Let me know how you get on - Ill be interested to hear what a new appointment shows.

[bluesky10]

Hi!
New to this. Hauser at 15 and did not dislocate. I got good results but kept grinding away at the patella. Pain. OS says it is time for TKR. I used to work in rehab so I know how painful TKR really are, at least initially. Did the TKR relieve the pain?