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Zimmer NexGen—Deciding on Revision Surgery?

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San Jose, CAPaul feels like he's stuck between a rock and a hard place—whether to continue suffering constant pain with his Zimmer NexGen Knee Replacement or undergo revision surgery—it's a tough decision. But if he does opt for revision surgery, he'll insist on a knee replacement product other than Zimmer.

The irony of his Zimmer knee replacements—Paul had both knees done at the same time—was that he chose the NexGen type because Zimmer led him to believe that it flexes more and gives a bigger angle. "Back in 2003 I looked at different knees available and the Zimmer NexGen flexed at 155 degrees compared to 135 degrees with other makes, so I would be able to bend my knees more with this device," says Paul, who adds that he had two replacements at the same time because he had the same problem in both knees.

Paul figured, why suffer surgical pain twice? "My meniscus membranes between the knee joints were worn out in both knees," he explains. "After surgery both knees gave me pain so I looked for support to wrap around my knees. I went back to my doctor and complained about the pain and that I needed this support. He was surprised and fearful: 'Don't use the supports—the concept with knee surgery is that you shouldn't need anything else,' he said.

"I got a Zimmer t-shirt from my doctor's office with the slogan, 'No cane and no pain,' but that wasn't the case. And I continued taking the drug Vioxx to kill the pain. As a matter of fact I almost died from taking Vioxx; I was in my fourth year of using the drug when it was discontinued. I actually felt my heart stop while shopping—I was rushed to a cardiologist and he said to stop taking Vioxx immediately because it was declared unsafe. One week later it was taken off the market. To think that indirectly these Zimmer knees almost killed me! So I got used to living without painkillers and just used ice to keep the swelling down.

"Rehab took about three months but my knees were always swollen when I walked, and they still swell today. I went back to my doctor again and had new x-rays to make sure everything was in place. His assistant surgeon said that the glue didn't get in all the way but 'not to be concerned.' But it was concerning for me. My left knee has the kind of pain you feel with a fracture—it is a very deep and sharp pain, especially if I walk a lot. I used to be very active; I even hiked five miles with this knee just a few years back, but I can't do that anymore. When I go for interviews (I'm an independent contractor), I can't show pain on my face—I force a smile. I can groan a bit at home, but not in public.

"I followed up with two annual visits to the surgeon, then in 2005 my insurance changed and I had to stop the annual visits. But in 2010 I mentioned to my Medicare doctor that I should have another x-ray to see if my joints are OK. This time the x-ray report said it 'seems' that the left knee joint has loosened. Then I had to be very careful and had repeat x-rays this past April. It showed no change but still loose. How can I be sure whether I can even go on vacation? My doctor said they could do a bone scan to confirm if it is loose, which I had in early May. It determined the left knee is indeed loose and he recommended partial or full revision surgery.

From what I read online, revision surgery has even higher failure rates than replacement surgery. My mother-in-law had revision surgery and it was a bad mistake—the new knee chipped inside her body. For now I am undecided and biding time: The pain associated with surgery is horrendous, even though they keep you medicated. I talk to friends who have different points of view—some say to get revision surgery done while I'm still young: I'm 69 but look 55, although with this knee problem I'm feeling my age.

"Every morning I get up and don't know what to do, I can't make up my mind. My doctor warned me to take frequent rest on vacation because I might fracture my bone, and implanting a new knee would be harder—I would have to wait until it heals. So now it isn't just a problem with loosening, it can really damage my body at this point. My wife and I just returned from Europe and getting around was very difficult…

"Of course if the problem is because the doctor didn't use enough glue, I might be looking at a Medical Malpractice lawsuit because it could be the doctor's fault. But I know that Zimmer oversold and over-promoted its NexGen knee. I was told that I could go dancing and play doubles tennis. I love tennis but I'm not going to take a chance after this—having all this metal in my body.

"I keep checking online to see if my knee has been recalled. One attorney I spoke with said his law firm is only collecting cases with patients who had total knee replacements and I had partial knee replacements, but he also said that some firms are handling my type of NexGen knee and to pursue my case with other lawyers because partial knee replacements are now being evaluated. I plan to take my recent x-rays to my surgeon so he can compare them to the x-rays he took after surgery. That will confirm whether the NexGen knee is defective."

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