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The Frankenstein walk

Discussion in 'Knee Replacement Pre-Op Area' started by keith55, Apr 9, 2012.

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  1. keith55

    keith55 Member

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    Now I know that's a controversial title but it is still a genuine concern. I've got grade 4 arthritis (i.e. no or virtually no cartilage) between my femur and patella in my left knee with some spurs etc. in the other compartments. That means pain of course - more noticeable when walking on slopes or standing for a period of time. Less so when sitting or walking for short distances on the level. But I can still bend and extend the knee fully or virtually fully so simple tasks that I take for granted such as getting in and out of the shower over my bath (not a walk-in) or putting my shoes and socks on are trivial. And you get used to pain. I don't like it of course but you learn to ignore it. When I've tried stronger painkillers, like co-codamol, I found the constipation much more unpleasant so I stick with 8 X 500mg paracetamol per day. I'm sleeping OK at the moment as I've taken on a new set of activities which I can cope with.

    I know some people who have had TKRs and none of them walk naturally. One person has two false knees and a false hip. When he stands I can tell his knees aren't properly straight. We went on a walk together. Now I had to ask him to slow down and he wasn't using a walking stick but he confessed reluctantly that he had to take painkillers (co-codamol) beforehand. One knee is just 11 years old and it is beginning to play him up. Another person obviously has one leg longer than another. He can stand longer than I can but his walking doesn't look right. My brother-in-law has permanent pain (one of the unlucky few his OS told him) and has to use a scooter to go shopping though he also has gout. But, of course, there are success stories recorded on this website and they must be genuine. There is a human tendency to stand by your decision no matter what though.

    I do know that the surgeons check the knee in bend and extension before sewing you up so why is it so difficult to get bend and extension?
     
  2. Janet2012

    Janet2012 Don

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    The swelling hasn't set in yet in the OR is my guess. Swelling can take a long, long time to go away. Months and months after my arthroscopic knee surgery and also with a hand injury. Longer term than that, I can't tell you.
     
  3. MapMaker53

    MapMaker53 Member

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    I'm 58 and had both knees replaced 7 months ago. Total recovery will take me at least a year due to my previous surgeries history, but I'm happy to say that I can walk quite normally at this point. The knees are a little stiff after being in one position for a while, but it takes time for the body to heal and rebuild the natural knee lubrication fluids. The difficulty in getting bend and full extension after surgery is basically a 3 category battle. (1) Your joint will have swelling after surgery, which inhibits movement, so you use ice and elevate to keep the swelling down as much as possible. (2) With swelling and limited movement, the joint begins forming fibrous tissue, (which I tend to think of as very strong spider webs - but that may be a medically inaccurate description) that bind up the joint. So there is a balance between moving the joint (for example physical therapy) and trying to keep the resulting swelling down. The third battle is pain management, but in my case that seemed to be the easiest battle of the three.

    The technology in materials used in today's TKRs has made advances in the last 11 years, so the knee you get today will probably be better than knees of the past regarding longevity. But it was still a very difficult decision for me to make. For me... the jury is still out, but I seem to be doing okay and improving a little bit more each day.

    Those with a better medical description please chime in.
     
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    • referee54

      referee54 Moderator

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      I had a BTKR over four years ago; it took longer than i would have liked it to for recovery---about five months to lose a slight limp---but I can tell you that I walk normally and I can umpire HS and college baseball games, too. That means that I have to, at times, sprint up to third base to cover a play there. That is not a walk, and people that learn that I have had a BTKR are amazed (I actually do not know why.)

      I did have to work on my gait during rehab and recovery, but if you were to see me walk and didn't see my two scars, you would think that I still had my original knees.
       
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      • TheHistorian

        TheHistorian Post-Grad

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        I am a month out, and I have a normal gait aside from a slight limp from some nerve damage in the right leg. (I had a valgus deformity that required a lot of correction.)

        That said, what is "normal?" Science might claim there is a "perfect" model for a human body, but no one breathing seems to have it.
         
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        • tashia

          tashia Sr Bonesmartie

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          I had a knee and hip replaced of my right side and now I am ready to do my left starting with my knee. I to my knowledge walk with out any limp unless I am hurting or they got stiff by sitting to long. I am very pleased with them. I know it takes time to recover but it is well worth to be out of pain. Normal gait I believe comes with time. However some have a problem. Please don't worry about it. I know you will be ok. Do take care and be careful. :doggieshmooze:Tashia:friends:
           
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          • bottomshollow

            bottomshollow Moderator

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            Keith,

            I have had a right hip replacement and then both knees replaced. I do have a 1/2 inch leg length discrepancy as a result of the hip surgery, but I have a 1/2 inch lift placed on the sole of all my right shoes. So I walk just the way I did before all the surgeries.

            I think most of us bionic types who weren't limping or who didn't have major problems with overall range of motion before surgery have none after and walk prefectly "normally". If a person is severly bowlegged or knockkneed or can't bend and/or straighten properly before surgery, they may need gait training after to walk "normally",

            Most people with joint replacement do not have the "Frankenstein" walk and neither will you.

            Just my two cents. Judy
             
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            • Dewy

              Dewy Member

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              It is certainly true that not all outcomes are good, and there seems to be a spectrum from very good outcomes (which give you a virtually natural knee) and the ability to do what you like with no pain or stiffness to people who are in very severe pain (worse than before the operation). The percentage of patients with bad outcomes is higher with knee replacements cf hips.

              However one the conclusions from a recent paper was that around 80 percent of total knee replacement patients are relatively pain free and without serious problems. This means at least that the odds are on your side for one of the better outcomes.

              It is also true that people who had a greater range of movement beforehand tend to have greater ROM afterwards.

              Partial knee replacements (for candidates who are suitable for this operation) tend to give a more natural knee function, and greater ROM.

              I appreciate that this is a difficult choice to make because although there is a good chance you will much better off after the operation, there is a (not insignificant) risk that you might be worse off.

              The worse state your knee is in beforehand, the easier the decision is to make, simply because you then have so much to gain and not too much to lose.

              You can improve your odds of success by choice of surgeon and hospital.
               
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              • MapMaker53

                MapMaker53 Member

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                Sobering advice, Dewy, and I absolutely agree. I personally never tell a person flat out that they will be fine afterward because there are too many factors in play that can make the difference between a good outcome and a bad one. I'm happy to help sort out those factors with an individual and explain the process to them, but I personally cannot actively encourage someone to take such a huge step. Because I'd hate to be wrong.
                 
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                • Roy Gardiner

                  Roy Gardiner Forum Advisor

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                  Fair enough. I am four months out from BTKR and walk VASTLY better than before. It is not yet a smooth, natural gait but it's improving all the time.

                  My life was severely compromised by bad knees, BTKR is a great thing for me.
                   
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                  • Josephine

                    Josephine NURSE DIRECTOR, BONESMART Administrator

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                    I walk normally - totally.
                     
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                    • FrogFeathers

                      FrogFeathers Post-Grad

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                      I walk normally too. And my recovery was hampered by an undiagnosed chronic pain issue. For every two steps forward I took in my PT and rehab, I'd fall back a step. At five and a half months, I walked all day long, without a cane, and wearing period clothing at a renaissance faire.

                      My human leg and my cyborg leg also have no discernible difference in length. And I, too, have run on this knee. Not jogging and not in the sense of exercise, but I've gathered the skirts of my period clothing in one hand and dashed down the length of a jousting arena.

                      I don't know if this means anything to anyone, but I hyper-extend all my joints. *All of them. My PT asked if I had a background in dance because of of my ability to hyper-extend my ankles. But even my cyborg knee hyper-extends like the human one before it did.

                      *my son shares this trait with me and when he fought in the MMA, nobody could get him to tap-out with an "arm bar" because his elbow would hyper-extend without pain. Just what I thought to be a funny tidbit of info. :wink1:
                       
                    • sheryl7

                      sheryl7 Graduate

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                      i have not had tkrs yet, and right now I feel like im walking like Frankenstein, I am believing that a tkrs will eventually end that for me, in what i have read.:snork:
                       
                    • kneesrus

                      kneesrus Sr Bonesmartie

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                      Great posts everyone. There are so many varibles on gaining range of motion. Body type is one, thick muscles or long, lean muscles. The ligaments that hold the bones together may have shorten or lost elasticity over time. Dark skin vs light skin is a variable. Does your DNA cause thick or thin scar formation.
                      You can only compare your outcome to yourself. Has the pain been reduced and you have improved your quality of life. These should be the main goals, not "what's your range of motion?"
                      Over the last 30 years of working with numberous TKR, range of motion has improved greatly. In the '80s, we were happy to get 100deg of flexion. Today, a majority of patients are able to achieve 115deg or better.
                      Remember, this is not a perfect science. If the OS believes they can improve your quality of life, then have it done. It is still your choice.
                      David
                       
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                      • Jazyb

                        Jazyb Post-Grad

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                        Hi Keith

                        My surgery was just over 3 months and I am having to work really hard on my gait to stop the pesky limp. I had a bad limp before the op due to OA and was told that I would have to work hard to loose it. I am positive that I will get to a point where my gait is normal - I am determined as part of the problem is the brain not cooperating. I have to re-train my brain!
                         
                      • KathyH

                        KathyH Sr Bonesmartie

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                        I'm sure that the day will come, Jo, when you won't be walking with a limp and it will probably happen that you will walk normally without even thinking about it. Really, three months since your op is not that long and you've made excellent progress so far.

                        I know for a long while after badly fracturing my knee that I was afraid to walk properly on that leg as I, naievely (spelling?) thought that if I put too much pressure on it it would break again! But then I did eventually walk normal - for 29 years in fact, until last year when my knee gave up. Now I walk worse than after my accident.

                        Kathy
                        xx

                        Kathy
                        xx
                         
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                        • referee54

                          referee54 Moderator

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                          "Mechanics is muscle memory." You are so used to limping that the abnormal has become normal to you---once you retrain your muscles and work on it, your limp will disappear.

                          I had gait issues to, and had to work diligently on losing the limp. It was frustrating, as I had a slight limp for about five months, but then, one day, it disappeared!

                          I have no doubt that yours will, too!
                           
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                          • Jazyb

                            Jazyb Post-Grad

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                            Thanks Tim and Kathy, I am determined to get it sorted. Tim that is good to know that it could take me the same amount of time - appreciate the information :thumb:
                             
                          • Mimi

                            Mimi Sr Bonesmartie

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                            Jo, I had a very bad limp before surgery. I probably had it for 5 years. At 3 months post surgery, I was just getting off the walker and using a cane. I had a slight limp till 5 months, Then one day it was gone forever :yay:

                            The best advice I can give is to plant that heel first and take a good stride. That helped me more than anything in walking. Just yesterday, at a meeting, someone came up to me and said, "you know, for having TKR surgery, you have a great walk!!" I was so surprised to hear that. It came from someone who is thinking about a TKR and had not seen good walks from others who had the surgery.:skeptical:

                            It just takes time, and you have done so well, I know it will be fine with a little more time and work.:dancy:
                             
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                            • Jazyb

                              Jazyb Post-Grad

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                              Thanks Mimi, that is good to know - I guess in time it will be more natural :thumb:
                               
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