Revision TKR Jan’s new knees- 1 for the left-2 for the right<

[jboles]

I have a question for @Josephine. I have an online portal for my doctors, they post test results and email you reminders and such. Anyway, today I received an email about the last X-ray that was done. It stated there was small joint effusion. I've emailed my OS to see if I should be concerned with this. Is this usually just swelling?

 

[Josephine]

It's not swelling. An effusion just means a small amount of fluid in the joint. This is not unusual, a lot of joints have a small amount of fluid in them from time to time. It really doesn't mean anything. But radiologists are trained to comment on any little abnormality for the sake of the record, as it were!

BTW just as a matter of interest, exactly which joint was the report referring to?

 

[jboles]

The LTKR , done on July 17, I guess the reason it sort of upset me was I'm supposed to have my right knee done soon, but we are trying to make sure I don't have an allergic reaction to the implant. I had the LLT test and found out I'm allergic to a lot of different metals. My implant is the Smith and Nephew oxidized zirconium femoral component with an all poly tibial component. The least amount of metal possible. I understand one of the symptoms of an allergic reaction is joint effusion.

 

[jboles]

I had my last PT appointment today. I'm really glad that part of recovery is over, at least until the next knee. My extension is 0 and ROM is 120. My knee is still really swollen, so I'm sure I'll continue to get more ROM as the swelling goes away. The swelling goes down overnight but comes back during the day, it doesn't like sitting at my desk. Walking without a cane is really the only thing I still have a problem with. And I know that's not going to get much better till my other knee is fixed. I'm pretty satisfied with where I'm at for 2 months.

 

[Celle]

You're doing really well for only 2 months post-op.

I'm not surprised your knee still swells in the daytime - you're already back at work and your knee probably isn't being rested and elevated for as long as it would prefer. However, you're coping and things will continue to get better.

 

[Pheebs52]

@jboles, what a wonderful update! I'm thrilled for you!

 

[jboles]

Thank you @Pheebs52 . Now if I can just stay out of the ODIC club! I have a tendency to visit there.

 

[SusieShoes]

For two months out, you're doing fantastic! And working, too. Very few manage that so early. You're right about that being the reason your knee is unhappy, but you're doing the right things to help it along. Your ROM is already impressive!

 

[jboles]

@SusieShoes Thank you. Working really helps my mental state more than anything. I need to feel useful, sitting at home is very depressing to me, and I'm sure others feel the same way. I'm fortunate to have a position that allows me the opportunity to work at my own pace. If I had to be on my feet all day, there's no way I could be back at work so soon. I'm really dreading and looking forward to having my right knee done, if that makes sense? My right leg is soooo crooked, and I have so much pain in the calf from the angel it is in, that it really has made rehabbing the left knee very difficult. When I walk I have no pain in the knee/leg of the operated leg, while the unoperated leg really gives me a fit. Now it's just a waiting game to make sure I don't have any allergic reaction to this implant before we proceed with the next one.

 

[SusieShoes]

Has your OS said how long before you know if there's a reaction? That's my curiosity asking. I hope you can get your other leg done soon. Your legs were both crooked before, and now one isn't, so I can only imagine that messes with your gait. The pain isn't going to get better, for certain.

I also have a desk job, and work at home besides, so no commute. Returning to work for me was more a mental thing. I couldn't concentrate well enough until three months had passed. But having a situation where we can stay off our feet is really beneficial. Many jobs are much more physical. I think of all the teachers who come here and hope they can be back to work, and running after children, in six weeks. That's a lot to hope for!

 

[Pheebs52]

@jboles, "dreading and looking forward to more surgery" certainly makes sense to me. However, look at just how well you've done with Knee # 1 under very difficult circumstances considering the right leg is such a problem. That just has to provide you with some strong reassurance. I hope your recovery from Knee #2 is a relative breeze. I know each knee is different, but at least this time, you'll have a *good* one as a partner to your newest addition! Certainly the long term result will have you "Whistling Dixie," eh? I hope you can get it done ASAP so you won't have months of anxiety to stew over it.

 

[jboles]

@SusieShoes I have an appointment for the right knee on October 30. I'm not sure if I will keep this appointment or postpone it. There's the issue of still being anemic. I'm having trouble getting my blood count back up, and both my OS and PCP have said that my levels have to at least be in the low normal range, and they are nowhere near there yet. My PCP wants to recheck it the first week of October and we'll make the decision then. As for the allergies, until the last X-ray showed some effusion in the joint we were pretty sure it was going to be okay. But my understanding is that this could possibly be an indication of an allergic response. More than likely it's nothing, but we have to be sure.

 

[Thesoutherncook]

Fingers crossed for a good report from the OS on the look at x-Ray for possibility of allergic reaction....lets don't even go there. When you get the 2nd knee done, you will be surprised at how much stress will be alleviated by the simple fact that you will know what to expect. You're doing great with this recovery. I'm impressed that you are mentally able to get back to work already! My brain is finally shaking off the fog! But, perhaps that is because I had no deadlines and nothing to go back to except my art! Keep us posted!

 

[jboles]

The OS said the effusion was caused by bleeding from surgery that it would likely take several months to go away. I'm not so sure about his answer since prior X-ray didn't note it, but I don't guess I have any choice but to believe him. I have a place in the incision that has always hurt. It's about the top 1 to 2 inches of the incision. When the thigh swells or I bend my leg it's like it makes a indention into the thigh. I asked OS about it and he said he believes it's where the internal stitches haven't dissolved completely. Just wondering if anyone else has had this type of thing?

 

[Thesoutherncook]

 

[sistersinhim]

he believes it's where the internal stitches haven't dissolved completely

That sounds logical to me. Something is causing the puckering, and stitches make sense to me.

 

[jboles]

@sistersinhim I hope it isn't the dreaded scar tissue that we all worry about so much.

 

[sistersinhim]

I'm sure it's not adhesions. It we didn't have scar tissues, then our knees would never knit back together! It takes quite a while for adhesions to form, and your knee is too young for that. You are using it every day, keeping it moving. ROM just takes more time to achieve for some due to more swelling. I was blessed. My swelling never got above moderate!

 

[Pheebs52]

@jboles, I have something very similar to what you described on a small area of my incision. Guess what? My OS said the same thing! I guess we have to believe them, right? Yeah, we do.

 

[Polkadot]

@jboles, what a great 2-month report!

Now if I can just stay out of the ODIC club! I have a tendency to visit there.

At least you won't be in the Slow-Benders Club, although we do have a lot of fun at our meetings.

Regarding your possible allergy, the knee you were given sounds like the one I got because my doctor found out just before surgery that I react to base metals. (He delayed my surgery an hour and had someone get and prep the S&N knee from wherever they store them). I've been wondering about how allergic reaction shows. Hopefully the effusion is nothing important and you can continue with your stellar recovery.

Re pain at the top of the incision: I've had that, too. Some days, it feels like it's really pulling. I figured that was due to some extra swelling. I especially noticed it when Jose made his appearance!