TKR Discomfort more than 2 years out

[JPL2016]

Hi All - so grateful to find this site. I had a TKR of my right knee in 2/23/22. Flexion and extension are great, but my knee has never debt normal post surgery. It just doesn’t feel right and I get kneecap pain. I can’t quickly run up or down stairs like before and kneeling is very uncomfortable too. I’ve seen another surgeon at a different practice for a second opinion. He basically told me that my flexion and extension are great, the knee tracks well, so it’s not a surgical issue. He suggested I do quad strengthening exercises and off I went. Well, I’ve been doing a recumbent elliptical and other quad exercises but it’s not helping. Has anyone explored doing additional PT combined with massage to address this sort of thing? I’m still having to take extra strength Tylenol twice a day and am starting to wonder if a revision is in my future. Sigh….

 

[mendogal]

So it's been a bit over two years since your replacement. Your range of motion is clearly functional.

Kneeling can remain uncomfortable forever for some people with successful knee replacements.
Some of us have lingering sensory nerve issues unrelated to knee function that make the feeling of even very partial weight bearing on the knee feel.... well, weird!
The normal spectrum seems to be from barely tolerating touch-down kneeling with the thigh and lower leg at right angles to being able to slowly come to close to full kneeling often with a pillow under the butt.

I can't address running up and down stairs. I'm thrilled to be able to walk blocks-long outdoor hillside stairs sequentially with no pain. May I ask what happens when you try to take stairs at a run?

Additional PT is unlikely to help unless the therapist can identify a soft tissue structural or postural deficit or imbalance the two of you can work on together.
A good bodyworker can provide massage that will release any trigger points or contracted areas, allowing for more free movement.

It's a long shot, but a podiatrist is a good resource for doing gait analysis; sometimes imbalances manifesting in the knee or hip have their origins in the feet and can be alleviated with specific stretches, exercises, or shoe inserts.
I hope you've bought new shoes since your surgery. Pre-joint replacement shoes often have a very imbalanced wear pattern that prevents us from adapting to our new structures!

 

[JPL2016]

Thanks for sharing your thoughts! When I try to run up the stairs, it hurts my kneecap. I think I’ll look into some massage therapy in the short time to see if things need loosening up and I guess I’ll continue to work on quad and core strengthening. I’m also starting to wonder if golf may be causing some issues. Patience is a virtue they say!

 

[mendogal]

You're welcome! Oh I should add this, as you're apparently an active person:

Starting in the 1990s when young female athletes started racking up more knee injuries (ACL ruptures) than the young men, college athletics and others put a lot of time and money into researching various potential causes.

One thing stood out like a sore thumb... er, knee .... there are jumping and cutting movements that can be initiated by either the quadriceps or the hamstrings (hamstrings are an anomoly in that they are both flexors and extensors!).

Men inititated these high risk moves with their hamstrings. Women initiated them with their quads, which placed greater stress on the knee structure. A lot of coaches started retraining the gals to use their hamstrings.

My point is: don't excusively focus on quad strength. Include your hamstrings (and glutes!) in your regimen. No guarantee, but it might have a positive effect on your pain.

 

[JPL2016]

You’re absolutely right about needing hamstring and glute work. And let me clarify my activity level so no one is misinformed. When I refer to running up the stairs, I mean that little run up to the second floor on the balls of your feet to grab the clothes out of the dryer before they wrinkle! And as for golf, I’m in a senior ladies “ Nine & Wine” group; and my husband and I play a round or two each week. I’m 61 and retired.., not an athlete by any stretch.

 

[Jockette]

Hi and Welcome!

I had quite a bit of improvement, in everything, in my second year post op. I hope you will, too.