Knee Cap operation

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bryden

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Hi there

I´m a new member on this forum, and i am from sweden.

I recently had a surgeon on my right knee with a new type of operation in sweden called knee cap operation, instead of a full plastik they put in a oval hat with a screw in the upper leg that will work as a kneecap on my innerside of the knee.

sry for the lack of info but i havn´t found a site yet that explain my op.

My question is!

Why does it hurt so much after two months when i walk, it seems to me that it´s the same pain like it use to be.

Is that normal?

The knee is getting very big after just 200m of walking and i start to limp couce of pain.

Very stiff in the leg in the morning with pain.


I have an appointment with my doctor 9 jan 2012 but im afraid that the op was a fail.

Is there anyone in here that recognise my problem? is it a problem or just normal?

Over and out from Sweden

Regards from bryden A.K.A Björn
 
Hi Bjorn,

You must be hungry for information, and frustrated. I have no knowledge of your surgery but googled some words and came up with "kneecap replacement surgery" which involves all or partial kneecap rather than knee replacement.

You will get some insight no doubt from Josephine, who is an orthopedic nurse of vast experience.

Any surgery of tissues around the knee causes an insult that takes a year or more to recover from. While the muscles have a good blood supply, the tendons and ligaments do not. Tissues that have less blood supply take longer to heal. Tendons are the white ends of muscles that attach to bone. Ligaments are fibrous cords that attach to a bone on one side of a joint to a different bone on the other side of a joint and hold the joint together. There are many tendons and ligaments in the knee. These need months to heal. Until they heal, they hurt!!

On this forum we emphasize good pain control, something maybe to talk to your doctor about.

I'm guessing that you will learn from your doctor that things are just fine. It takes a lot of patience to go through these kinds of surgery.
 
Hello, Bryden, and welcome to BoneSmart. Our first member from Sweden!

I'm sorry I've taken so long to get to your post. I can't say I've ever heard of anything such as you describe. Usually when the knee cap is arthritic, so is the femur (thigh bone) underneath it. Therefore they both need replacing. Do you have a copy of your xray? Could you post it for me?

In any case, the surgery you have described is still major knee surgery and you cannot expect it to be all better in two short months. Right now you are in the middle of what I call the "angry tissue" stage where everything is still painful and not yet healed. So right now, yes I would say what you are experiencing is normal but never the less, it shouldn't be like that.

You don't mention pain medications or icing and elevating, so could you please answer these questions for me ....

1. are you taking any pain killers? If so, how much and how often?
2. are you resting a fair bit, elevating your leg and icing your knee? If so, how much of each?
3. how much activity are you doing? How often do you walk 200m? Do you ever walk further than this? Are you still using a cane when you walk?
4. are you back at work yet? What kind f work do you do?

I am going to give you a fair bit of reading to do which will advise you on all these aspects of recovery.
The importance of managing pain after a TKR and the pain chart
How Long Does Healing Take ......

Elevating your leg to control swelling and pain
Using ice
Some suggestions for home physio (PT) and activity progress

Chart representation of TKR recovery
Energy drain for TKRs

After this, please post your answers to my questions and I can advise you how to proceed.
 
Hi, Bryden...welcome to the forum. I hope you are able to respond back to Josephine's questions so that we can learn more about what you are going through. This forum has a wonderful community of folks who are more than willing to provide support for you.
 
First! Thanks for replaying

To answer the questions!

No painkillers.

Answer to question 2-3

Yes im resting my leg as much as i can, but i have a dog to walk 3-4 times a day so i walk alot cause i have to.

No i`m not back at work, i work at a lumber store and have a very physical job.

It´s a rare op in sweden but not in the US according to my doctor.

Yes i have the X-ray and i will send it to you in priv.

Again! Thanks for the answers and care, It warmes my heart ;)

Regards Björn A.K.A bryden
 
My question is why does it hurt so much after two months when I walk
The knee is getting very big after just 200m of walking and I start to limp because of pain
Very stiff in the leg in the morning with pain.
- No painkillers.
- Yes I'm resting my leg as much as I can but I have a dog to walk 3-4 times a day so I walk a lot
Well, I noticed here some very important points:
1. three times you said you have pain and yet you are taking no pain killers. I don't understand that - why not? Even some simple over the counter things like a paracetamol/ibuprofen cocktail would be good

2. it's okay to walk your dog as long as you rest at least an equal amount in between times. I would suggest that you need to rest at least one hour after each walk and more other times. Can you not get a relative, friend or neighbour to walk your dog at least one time to give you some rest? I know dog walkers and they will usually be more than happy to help out when the owner needs some help, if only for the dog's sake! :wink1:

3. you say your leg gets swollen after walking and is stiff in the morning (which is actually the same thing). That's not surprising but are you elevating your leg and icing it when you rest? Elevating your leg to control swelling and pain

Finally, did you read all those articles I gave you links to? You haven't mentioned them or if they helped you understand your situation better.
 
I find this post very interesting as my OS just told me yesterday that he recommends kneecap replacement surgery. OS says most need TKR but my damage is limited so I don't need all replaced. Since then I've been searching online but there doesn't seem to be much information regarding the surgery, recovery, etc like there is for TKR. I'm concerned and worried. Should I book the surgery or not?
 
Welcome, recommend you read the pre surgery articles in the library for questions to ask your surgeon. You may have to ask your OS for more specific information, as there is not much available elsewhere. Have you considered getting a second opinion from another OS in a different office?
Some of the PKR people may have also had patella resurfacing, you can find them in the post op area.
Good luck with you search, and your decision making.
 
I would think it might be worth getting a second opinion from another surgeon who is in no way connected to your current one. That means he is not in the same practice, was not recommended by him, nor does he practice at the same hospital.

Either way you go, it's major surgery and you want to be sure that you won't be going back in a few months or a year to have more done. No one can guarantee that, but a second set of eyes on whatever is going on in your knee might help you make a more informed decision.
 
I should explain more.....had a lateral release in July 2011 for knee pain after trying cortisone and synvisc injections with no relief. Dr. came out of the lateral release procedure saying I would more than likely need my kneecap replaced but to see how much relief I got from the release. Went to PT for 3 weeks and seemed to have some less pain but in the past 4-6 weeks, it's gotten worse. I did run out of the RX for Mobic he gave me during that time so I don't know if not taking it was part of why my pain level increased. Anyway, went to OS for 6 month followup this week and told him that the pain was coming back and it was limiting my mobility and lifestyle. That's when he suggested I consider the kneecap replacement surgery but did say that I would have to sign a waiver to do a total knee should he go in and discover that the damage had progressed to the point of requiring a TKR. I don't see much on bonesmart about kneecap surgery recoveries. I don't know where to go for that information. Of course, I don't want a TKR if a partial will do the trick. I don't know what to do. I'm feeling lost....
 
Well, you got the gold standard coverage there - he is prepared and willing to do a total if, when he gets in there, he finds the condition of your knee warrants it. Can't say better than that.

But the usual kind of patello-femoral replacement is not minor. It's much the same kind of surgery as a total replacement - as will the recovery be - so you need to bear that in mind.

aflagsforworship.co.uk_jo_pic_images_patellvgv.jpg


There is also the risk that the disease might progress into other areas of the knee meaning it then has to be converted into a total anyway. That period might be a few months or could be a few years. It might be never - one cannot really tell, not even the surgeon.
 
Thx Josephine. I wish there was more information available regarding this type of surgery, how long it lasts, when or if TKR is needed later. I haven't called to schedule surgery yet because I'm scared to death. With a TKR I know what to expect by reading everything on this board. But the partial seems very iffy to me, especially since I can't find anyone that's had it and can tell me their story.
 
Have you read some of the PKR threads here on BoneSmart? We have had a number of members who have done just fine with them.

Here are a couple of threads, but there are more if you search:

Staggered PKRs

CrazyCatLady's PKR
 
Jamie - thank you for the links. I will read them. Knee is throbbing today. Can I take anything with my daily dose of MOBIC - Ibuprofen, Tylenol? I forgot to ask my dr that question at my last visit.
 
Since Mobic is an NSAID, it would not be advisable to take any other NSAID with it like ibuprofen, Advil, Aleve or Celebrex. However, you can take 1000 mg of Tylenol up to 4 times a day (for a daily total of 4000mg). You need to take the full 1000mg dose at a time and space them out by at least 4 hours.
 
Thank you! Hopefully this will help with the pain. Read the suggested threads and feel more optimistic. Going to call tomorrow to see about scheduling the surgery.
 
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