BoneSmart® Hip / Knee Replacement Forum
Knee Replacement & Hip Replacement
Patient Advocacy & Online Community


  1. PLEASE NOTE THAT ONE RECOVERY THREAD ONLY IS PREFERRED. PLEASE DON'T START ADDITIONAL THREADS ABOUT YOUR RECOVERY.

6 months after TKR Swollen and Blood around knee

Discussion in 'Knee Replacement Recovery Area' started by JohnF, Apr 21, 2011.

Thread Status:
Not open for further replies.
  1. JohnF

    JohnF New Member

    Offline
    Member Since:
    Apr 21, 2011
    Age:
    Messages:
    3
    Location:
    United States
    :cry:My most important question is, has anyone else had this problem?

    My TKR was done Nov, 15 '2010. The initial recocery was described by my OS status, everything looks great. This recovery rate continued great for about 16 weeks, had great motion. Did my time with PT all looked and seemed good. I continued at home and in the gym strengthening. At that time had excellent ROM, manageable pain, decent strength and manageable tightness in hamstrings.
    Everything seemed to be going well until about 3 months and a few day. After one busy day working out doing daily stuff, my knee all of a sudden swell as big as a ballon, Iced it elevated it, swelling went down somewhat. When the swelling began to be excessive and happening almost daily. I saw my OS and he recommended a few thing to try. Did as I was told and resumed regular walks and no other excercises for few weeks. Saw my OS again and the swelling was so bad he drain the joint (2 very large syringes of blood) and did a full range of lab tests on the fluid. All the lab tests were good. OS tells me he has never seen this happen before. I have been doing next to nothing for weeks and the swelling will not go away unless I do nothing but sit.
    I have seen another OS for the problem he took X-ray says eveything looks he's not sure whats happening. No one seems to know what going on here.....

    I would be grateful if anyone has had this kind of issue and how it was resolved.

    Thank You

    John
  2. Jamie

    Jamie Administrator

    Online
    Member Since:
    Mar 24, 2008
    Age:
    65
    Messages:
    36,737
    Gender:
    Female
    Country:
    United States United States
    Location:
    Kansas
    Hi, JohnF....welcome to BoneSmart. I'm glad you found us and decided to join the forum. But I'm so sorry to hear you are having these problems.

    As you probably know, this is definitely not the norm for recovery. I'm going to tag our forum nurse, Josephine and let her provide comments for you. @Josephine:

    It was a good thing to get a second opinion. Was this second doctor in any way connected with your operating surgeon (same practice? work out of the same hospital?). And was the second doctor an experienced revision surgeon? I ask this because revision specialists are the ones who are used to dealing with the more complex cases of problems with knee replacements.
  3. Josephine

    Josephine Forum Admin and Mother Hen Administrator

    Offline
    Member Since:
    Jun 8, 2007
    Age:
    72
    Messages:
    53,065
    Gender:
    Female
    Country:
    United Kingdom United Kingdom
    Location:
    North East
    Hi, John. This must be very disappointing for you after such a good start. Let me run through a few things:

    You have gross swelling and a joint effusion which are usually attributable to (in no particular order of importance)
    1. soft tissue disease (?type)
    2. loose implants
    3. infection in the soft tissues such as cellulitis
    4. infection associated with the implants
    5. torn ligaments or muscles

    So, you haven't actually said if you are in pain, have pain walking, bending or standing. It would be helpful if you would answer the following questions:

    ~ does the swelling in your leg feel like it's going to 'explode' when you stand up?
    ~ is there any pain in the joint when you stand, put weight on it and/or walk?
    ~ can you still get your normal amount of bend in the knee or is it too stiff?
    ~ does it make any noises or grinding sensations in the joint when you walk?
    ~ did you have any accident or extra activity just before this began?
    ~ and what Jamie said: was the second chap you went to local to or in anyway connected with the first one?


    With this information, I can maybe getter a better lead to what might be going on.

    Can't recall anyone having had an anywhere similar situation but I'll do what I can to help.
  4. JohnF

    JohnF New Member

    Offline
    Member Since:
    Apr 21, 2011
    Age:
    Messages:
    3
    Location:
    United States
    There is constant pain on a scale of 1-10, it's a 5 when the swelling is somewhat subsided. The pain is on the outside of the leg by the knee joint and just above the knee on the inside. I can stand, bend and walk short distances, when swelling is down. Note: Swelling when down is still double the size of my good knee.

    I can be sitting at my desk doing some work and all of a sudden I can feel my knee starting swell, it swells so bad I can hardly walk, I cant bend my knee all because of the pain, this can also happen if I'm doing a light work
    out or driving in my car. I have to get home ASAP get my knee above my heart with ice on it for a couple hours, then the swelling starts to subside, it take's a day or 2 to get swelling down enough to bend knee to walk... This happens 1 to 2 times a week.

    No pain in joint when just standing, when swelling is low.

    When swelling is low I have full range of motion

    A small amount of clicking on the knee cap.No accident. I was watching my young grandson for the day doing a lot of standing, sitting and walking around alot, but had no pain at the time, my knee swelled up later that evening and has never been the same since.

    My doc give me a couple names of doc to see for a second opinion, I saw the head guy at UCLA med center.

    Just a note there is also a bumb on back of my knee, that show up on day 2 in hospital.

    An MRI was performed on Monday of this week, will see doc to Monday of next week to see if they were able to spot a problem.

    John
  5. Jamie

    Jamie Administrator

    Online
    Member Since:
    Mar 24, 2008
    Age:
    65
    Messages:
    36,737
    Gender:
    Female
    Country:
    United States United States
    Location:
    Kansas
    John....it's probably not a good idea to seek a second opinion based on a recommendation from your surgeon. That takes the independent viewpoint out of the process, as they obviously have some relationship. You probably should seek out someone on your own. And, as I mentioned....it needs to be a doctor who does a lot of revision surgeries. That's the person who is used to seeing unusual problems like yours.
  6. Josephine

    Josephine Forum Admin and Mother Hen Administrator

    Offline
    Member Since:
    Jun 8, 2007
    Age:
    72
    Messages:
    53,065
    Gender:
    Female
    Country:
    United Kingdom United Kingdom
    Location:
    North East
    Thank you - there will be a bump at the back of the knee if you are getting joint effusions. It's the joint capsule being inflated like a balloon.

    Given those details, I would imagine you either have cellulitis or some other infection but I would further conjecture that it's not affecting the prostheses yet. A most curious and unusual set of circumstances. I would also suggest no workouts, light or otherwise, lots of rest and as little activity as possible until this is nailed. Manage the pain and swelling, the rest will take care of itself.

    You are taking pain meds, btw? And ibuprofen for the swelling?
  7. Truivia

    Truivia Member

    Offline
    Member Since:
    Apr 3, 2011
    Age:
    52
    Messages:
    203
    Location:
    United States
    Hi John, I am so very sorry this is happening to you.

    You said something about work - are you still working?

    Please keep us updated how you are doing.
  8. JohnF

    JohnF New Member

    Offline
    Member Since:
    Apr 21, 2011
    Age:
    Messages:
    3
    Location:
    United States
    MRI was taken, review found no problem according to doctor. Going to be tested for metal allergy and run more blood tests.
    Doctor said it's possible I might need a thicker pad, the knee may not be loading properly. He also said he has seen this problem one other time. When they went back into the knee and replace the pad with a thicker one, it cured the problem. Will be consulting another doctor before this happens.
  9. Jamie

    Jamie Administrator

    Online
    Member Since:
    Mar 24, 2008
    Age:
    65
    Messages:
    36,737
    Gender:
    Female
    Country:
    United States United States
    Location:
    Kansas
    Getting other opinions sounds like an excellent idea, John.
  10. RestAssured

    RestAssured Forum Advisor

    Offline
    Member Since:
    Oct 3, 2009
    Age:
    49
    Messages:
    7,785
    Gender:
    Female
    Country:
    United States United States
    Location:
    Texas
    Yes, get another opinion! Did they do a white cell scan?
    That will tell them if there is infection! MRI's don't always pick it up according to my revisionist.

    When you get that opinion, see a revisionist that has no ties to your original doctor if possible.

    Goodluck and let us know what you find out!:biggrin:
  11. Bouncy

    Bouncy New Member

    Offline
    Member Since:
    May 20, 2011
    Age:
    Messages:
    5
    Location:
    United States
    I am exactly 3 years post TKR on the left knee and experienced the same problem 4 days ago. I had a similar experience about one year ago, although with less swelling and stiffness, and it cured itself after about one month. Since then the knee has been great and I am quite active participating in cycling, swimming, hiking, elliptical trainer, etc.

    Saw the OS this morning and he had the preliminary results of the blood test, which was done on the aspirated blood taken from the knee two days ago. The final results will be available a few days from today. The results indicate NO INFECTION and the OS does not anticipate a different result after the 5-day waiting period. His conclusion is that something was torn, possibly a piece of the synovial lining that got caught in the knee joint and was pinched. X-rays and lack of intense pain when standing indicate NO malfunction or loosening of the implants, according to the OS.

    I do have loose medial and lateral collateral ligaments and the OS suggested that they could be tightened by placing a thicker spacer between the upper and lower knee implants. Is it possible that a piece of the ligament tore or was pinched by the implant? After reading the previous comment, it seems like a real possibility. The OS did not think such a procedure was necessary at this stage. (Glad he is not eager to cut.) Whatever happened is likely to happen again and it could come at a time when medical help is not available, so I'd like to have the problem solved ASAP. Any suggestions?
  12. Jamie

    Jamie Administrator

    Online
    Member Since:
    Mar 24, 2008
    Age:
    65
    Messages:
    36,737
    Gender:
    Female
    Country:
    United States United States
    Location:
    Kansas
    Hi, Bouncy....welcome to BoneSmart. I'm going to tag Josephine, our forum nurse, to address your question.

    I do think before you have anyone go back into your knee that you seek out a good revision surgeon for a second opinion. This should be a doctor totally independent of your current surgeon.
  13. Bouncy

    Bouncy New Member

    Offline
    Member Since:
    May 20, 2011
    Age:
    Messages:
    5
    Location:
    United States
    Thanks, I'll get a second opinion before anything is done.
  14. Josephine

    Josephine Forum Admin and Mother Hen Administrator

    Offline
    Member Since:
    Jun 8, 2007
    Age:
    72
    Messages:
    53,065
    Gender:
    Female
    Country:
    United Kingdom United Kingdom
    Location:
    North East
    Well, who knows for sure! It's always a bit of an educated guess as to what happened.
    Changing the spacer is one solution but a less invasive solution is to get to work on the muscular structure and strengthen it. It might take you a while and you won't know until you've given it a good try. However, this comment ..
    puzzles me.

    At first you say you are glad he's not in a rush to cut but then you want it resolved ASAP. Can't have your cake and eat it, my friend. Fast means change the spacer - not fast means taking time to see if building up the muscle strength will do the biz. Even then you might still have to have the spacer changed. It's a gamble.

    And why would it be likely to happen when no medical help is available? Are you moving to a deserted place somewhere or something?
  15. Jamie

    Jamie Administrator

    Online
    Member Since:
    Mar 24, 2008
    Age:
    65
    Messages:
    36,737
    Gender:
    Female
    Country:
    United States United States
    Location:
    Kansas
    Oops, Jo....wrote the message; forgot the tag. Good thing you're on the ball!!!
  16. Josephine

    Josephine Forum Admin and Mother Hen Administrator

    Offline
    Member Since:
    Jun 8, 2007
    Age:
    72
    Messages:
    53,065
    Gender:
    Female
    Country:
    United Kingdom United Kingdom
    Location:
    North East
  17. Bouncy

    Bouncy New Member

    Offline
    Member Since:
    May 20, 2011
    Age:
    Messages:
    5
    Location:
    United States
    Thanks for your comments. About this one, my wife and I do a lot of travelling and just got back from a month in South Africa, which included safaris in primitive areas - some w/o electricity, and hiking in the mountains of Lasotho. Last year I hiked to the top of Machu Picchu. This episode of the knee stiffening, along with blood in the knee and swelling occurred while just walking, so I shutter to think of what I would have done if it happened on the top of Machu Picchu or while on a safari.
  18. Jamie

    Jamie Administrator

    Online
    Member Since:
    Mar 24, 2008
    Age:
    65
    Messages:
    36,737
    Gender:
    Female
    Country:
    United States United States
    Location:
    Kansas
    Ohhhhhhhh.....well, that certainly explains your comment!!!!
  19. Josephine

    Josephine Forum Admin and Mother Hen Administrator

    Offline
    Member Since:
    Jun 8, 2007
    Age:
    72
    Messages:
    53,065
    Gender:
    Female
    Country:
    United Kingdom United Kingdom
    Location:
    North East
    Indeed it does! I often think of that when these brave chaps are doing expeditions to far flung places - what if? :hate-shocked:
  20. Bouncy

    Bouncy New Member

    Offline
    Member Since:
    May 20, 2011
    Age:
    Messages:
    5
    Location:
    United States
    How traumatic is the surgery to replace the spacer with a slighter thicker one vs. the original TKR surgery? Also, what about post surgery PT?
Thread Status:
Not open for further replies.

Share This Page

Open
Close X