TKR Swelling In Knee, Lower Leg And Ankle 10 Months On.

[Solar Cycles]

Things appear to be going from bad to worse at the moment. Two days ago my knee gave way and if it wasn't for me steading myself on the dining table I would have gone down, then yesterday evening I was standing from a seated position and my supposedly better right knee locked and I stumbled back onto my chair. This knee was x-rayed over three years ago and showed the early onset of arthritis, it does look like things have progressed for the worse there then.

Today I find myself back on crutches and in quite a bit of discomfort, with one leg unstable and the other with what appears to be bone on bone pain, so much for my plans of being fully fit and able this time 12 months ago. Too say I'm downbeat is an understatement, still I suppose it's not life threatening so I do have something to be thankfully for.

 

[jeano]

Golly. I hope this gets turned around for you soon. Best wishes.

 

[Solar Cycles]

Thanks jeano. I must say I'm feeling pretty depressed about the all thing, I was hoping to finally try and get my business back on track as funds are now non existent.

 

[maryo52]

How discouraging. There seems to be no rhyme or reason to it. Some of us luck out and others have unhappy challenges that go on and on. My knee is semi-not OK and I am always debating a do-over. I hope you are in the hands of someone really competent. But the day to day life outlook can really take a beating. My only suggestion is to adopt a mantra to get you through. "This is temporary" helped me, although it's hard to have faith that it IS temporary.

 

[Solar Cycles]

Hi Mary, never a truer word there and your right one has just to adopt a new approach to the challenge ahead, again. It's been a very trying few years with one setback after another but at least I'm still around to moan about it, so that in itself is a positive I guess.

 

[Solar Cycles]

Saw my GP on Friday he thinks that problems with the right knee are down to a tear in the cartilage, he contacted my consultant's secretary requesting a referral for this also but as often is the case here in the UK, one has to go round the houses to get an appointment, which as to be done as separate referral. I then received my appointment for my left TKR knee for the 17th April on Saturday but I'll have to wait and see if the one for the right is on the same day.

Meanwhile my right knee has got easier and isn't locking up like it was before, however I seem to be getting a dull ache around the patella and the lateral side of that knee. The left knee continues much the same, with some days better than others but the constant theme of instability, pain and burning sensation are still there.

 

[maryo52]

"Giving out" and "locking up" happen to be among the symptoms of a condition I've been reading up on that I have, which is flexion instability. The installation of the knee needs to be done so that it has a little bit of give straight, flexed, and everywhere in between. TKAs can have too much give straight but not flexed, flexed but not straight, and at all angles. Mine is when flexed. I was awoken in the middle of the night recently by pain when I guess I tried to straighten my leg and the knee locked up. I have not had "giving out" episodes but understand that this can happen. I hope your knee will be evaluated by someone other than the ortho that put it in. Here's one article with info (I found full articles as well on the net) http://www.ncbi.nlm.nih.gov/pubmed/9917666

You'd think that orthos would examine our knees afterward to see if it was done properly. If I bear any resentment, it's that I had to hear the news from second opinion docs instead of my own doctor who is supposed to be in a trusting doctor-patient relationship with me. My worst complain is the constant synovitis making the knee feel tight. Fortunately, you have appointments to address the issues of each knee, and no doubt have a list of questions ready.

 

[Solar Cycles]

Sorry for the delay in replying Mary. It sounds like you're also in the wars. It appears there are plenty of others also with major issues that have developed over a short period of time. I really felt that my recovery was going well, putting any concerns I had down to the "still recovering" period and I pushed myself hard in order to build up wasted muscles but still not overdoing things. It's the unknown which is very disconcerting and one where any scenario could be played out.

If it does turn out that I need revision surgery then I'm not sure whether I would really want to go down that road again so early after the original replacement, maybe I could live with it and just readjust my expectations and adapt to life as it is.

 

[maryo52]

I'm with you 100% on the "not being ready for revision" so soon. I try to take it a day at a time. There are days when I curse my knee, but most days we get along OK. I'm in a warm climate right now (confession: vacationing in the Caribbean!). The first two days my knee wasn't so good, but once I got snorkeling, it transformed into a more cooperative joint. Strengthening is the conservative treatment for this condition, so you are on the right track.

My worry with the instability is it increases the risk of falling. You are still "young" and so falls are less of an issue for you. I am 62. I worked on an ambulance for years, and I could write a book about the lives changed or destroyed by falls, and in nearly every instance the person who fell was actually being careful. I know I don't want an ambulance coming for me!!

You might look into the rigid brace option. Mine is an Ossur carticare Oasys which I bought online. It's way better than the one I had pre-TKR that was "professionally fitted."

 

[Solar Cycles]

Thanks Mary, that's something I've been looking at rather than going through hell again and maybe still not being right at the end of it all. There's a lot to be said about persevering with the pain you've got as it may be better than what you end up with.

 

[1ELISEA]

maybe I could live with it and just readjust my expectations and adapt to life as it is.

Hope that you are doing better after a few days rest!

That is a difficult decision, whether to have a revision or live with it "as is".
@skigirl wrote about her revision recently HERE

 

[Solar Cycles]

Thanks for that link ELISEA.

The last couple of days have been a little easier probably down to the fact that I've done nothing but sit around with my leg elevated, I did move around a bit yesterday and hence today my knee is stiff and swollen more so when I try to stand from a seated position, though the stiffness is mostly in the back of the knee. I did attempt to try the exercise the bike on Wednesday and that proved rather challenging with pain and a burning sensation down my tibia and a clicking painful feeling in the opposite knee. So I've knocked all forms of exercise on the head now, which for someone who loves the outdoors is proving very hard to live with at this moment in time.

 

[Solar Cycles]

Quick update and I'm now getting pain at both rest and night time on the right knee in all compartments, this is strange as it I still get locking on the medial side but most of the pain is on the top and bottom of the knee and also the lateral side at times. This is really hampering me with pain and instability in one knee and all this going on with the other.

 

[rjrober23]

It does seem alike the need for the second knee TKR follows quickly on the heels of the first. It makes for a lot of pain and discomfort. I know you're counting the days for the referral. I sure hope you get some answers and more important, solutions!

 

[Solar Cycles]

It does appear that the number of revisions needed in a short space of time is on the increase, whether that's down to an increase in knee replacements over the years remains to be seen though.

 

[Solar Cycles]

Just got back from seeing the consultant and the prognosis isn't good as it appears my options are some heel inserts to correct the valgus knee ( the X-ray showed the replacement was perfectly aligned ) and a brace to hopefully correct the instability which I will have to wear most of the time except at nights. Then if this doesn't solve things by the Autumn I will have to undergo a knee Arthrodesis, I'm totally gutted!

 

[busylizzie]

I too have been offered a fusion but have declined. I don't want to go down that route ever. How about asking for a second opinion referral from your GP. It does take awhile to organize. Try and go somewhere that is a centre of excellence and does a lot of revision surgeries, they have a lot more expertise. Don't go to a consultant that is based in the same area as your original surgeon. I don't know where you are based but in the north west of England I have gone to Wrightington.

 

[Solar Cycles]

Thanks for you replies. I had the replacement done at the Spire Yale in Wrexham, this was funded through the Robert Jones and Agnes Hunt hospital in Shropshire. I'm from NW England myself and prior to this I was seen at Wrightington by three different consultants and all of them didn't want anything to do with me due to the patellectomy I had years previously.

I'm putting together a list of possible surgeons too see for a second opinion, I think a fresh pair of eyes are needed as having a Arthrodesis seems a barbaric option in this day and age. Apparently the implant is perfectly aligned but my consultant thinks that the surrounding soft tissue and ligaments are not up to it, so a revision wouldn't be that helpful.

 

[Solar Cycles]

I had that done at the same time as my TKR, it seems the problem is with the medial ligaments. You'd think in this day and age having no patella wouldn't present that much of a challenge and something could be done to replace that.


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[Solar Cycles]

No I had an allograft using my hamstrings, I think I've read about that procedure somewhere have you got a link for it or better still a consultant who has done this before?